Introduction
Foodborne disease may be caused by pathogenic microorganisms or by toxic chemicals. For microbial
hazards, susceptibility may be increased by many factors, particularly those that reduce immune system
function. For example, neonates, infants, young children are more vulnerable to certain foodborne
diseases because of immaturity of their immune and physiologic systems. For the elderly, progressive
weaknesses of the immune system play a major role. Another group is pregnant women because of
immune tolerance to the fetus. Also vulnerable are those having poor nutritional status, existing health
problems, such as HIV infection and liver disease, and drug therapies which suppress the immune
system, such as those for cancer and organ transplantation. Such persons are not only more likely to
acquire foodborne infections, but also are prone to more severe disease outcomes, including higher
mortality rates. The main pathogens involved include bacteria (Salmonella, Escherichia coli, Campylobacter, Listeria monocytogenes) and viruses (norovirus, rotavirus), as well as parasites
(Cryptosporidium, Giardia, Toxoplasma gondii).
For chemical intoxications, windows of vulnerabilities may occur at different stages of life and can result
in both acute and chronic health effects. Chemical exposures of the fetus can lead to spontaneous ,abortion, low birth weight, structural congenital abnormalities and carcinogenesis. The fetus and the
young are also vulnerable to chemically induced mental and physical developmental deficits, such as
reduced intelligence caused by exposure to lead. Because children consume twice to three times the
amount of food on a body weight basis compared to an average adult, children are generally more
vulnerable because of their increased exposure to toxic chemicals. In the case of food allergies,
vulnerability is due to an overly active immune system in contrast to biological hazards where the
immune system is impaired. Allergies due to food proteins are not uncommon with the most
predominant being allergies to milk, eggs, peanuts, tree nuts, fish, shellfish, soy, and wheat and where
reactions can be mild to life threatening. While the number of people allergic to a specific food may be
low, the total number of people with food allergies is sizable. Another vulnerable group is those who
are deficient in a key enzyme that inhibits their metabolism of certain food components, such as lactose.
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