question: Why can you have a meat stuck in your teeth for a day and when you swallow it you're fine, but if you leave the same meat on the counter for a day and try and eat it, you get sick?
comment: A good question. Why can you infect milk with bacteria and get yogurt instead of spoiled milk? Why does Italian dry salami keep without refrigeration even though it's inoculated with lactic bacteria for tartness? The answer is "competition". Food on the countertop is up for grabs by any bacteria, insects, fungus, or animals that can get to it. It can become a battleground as single celled organisms battle it out for who gets the food. Because the war starts with everybody on equal footing. Nobody has an initial advantage. When you have food stuck between your teeth though, the bacteria in your mouth have a home field advantage, and can quickly coat the piece of food, similar to inoculating a petri dish with bacteria. Thus by the time other bacteria or fungus can finally make it into your mouth to find the food, there is already an entrenched army of mouth microbes dug in and ready to battle it out. You also have fungus growing in your mouth as well, but it's kept in check by the bacteria, which is kept in check by the fungus. Sometimes when someone takes antibiotics, it kills the bacteria, giving the fungus an advantage, and it reproduces so well you end up with a layer of thrush on your tongue. It's all about balance and playing one side off the other. The same happens when you ferment beer or leaven bread. You introduce a preferred organism like yeast, and give it a good place to reproduce rapidly, and it in turn will defend the food from other microbes. Don't forget that penicillin is a drug derived from a strain of fungus that had developed it in order to fight off bacteria that competed for the same food and habitat. Microorganisms fight each other all of the time for food and shelter.
passages: Infection occurs when undercooked meat is ingested. The incubation period is 9–39 days. Human outbreaks have occurred in Europe. Rats are a known carrier. Contaminated water may be able to cause infection, but this remains a theoretical possibility.
  
  Section::::Clinical: Human.:Pathology.
   Once pathogens attach to host cells, they can cause direct damage as the pathogens use the host cell for nutrients and produce waste products. For example, "Streptococcus mutans", a component of dental plaque, metabolizes dietary sugar and produces acid as a waste product. The acid decalcifies the tooth surface to cause dental caries. However, toxins produced by bacteria cause most of the direct damage to host cells.
  
  Section::::Mechanisms of damage.:Direct.:Toxin production.
   In equilibrium, the bacterial biofilm produced by the fermentation of sugar in the mouth is quickly swept away by the saliva, except for dental plaque. In cases of imbalance in the equilibrium, oral microorganisms grow out of control and cause oral diseases such as tooth decay and periodontal disease. Several studies have also linked poor oral hygiene to infection by pathogenic bacteria.
  
  Section::::Role in Health.
   Often, a combination of events contributes to an outbreak, for example, food might be left at room temperature for many hours, allowing bacteria to multiply which is compounded by inadequate cooking which results in a failure to kill the dangerously elevated bacterial levels.
   BULLET::::- Ingestion of cat feces containing oocysts: This can occur through hand-to-mouth contact following gardening, cleaning a cat's litter box, contact with children's sandpits; the parasite can survive in the environment for months.
  
  BULLET::::- Ingestion of untreated, unfiltered water through direct consumption or utilization of water for food preparation.
  
  BULLET::::- Ingestion of unpasteurized milk and milk products, particularly goat’s milk.
  
  BULLET::::- Ingestion of raw seafood.
   BULLET::::- Sporidesmin A
  
  BULLET::::- Sterigmatocystin
  
  BULLET::::- Tremorgenic mycotoxins – Five of them have been reported to be associated with molds found in fermented meats. These are fumitremorgen B, paxilline, penitrem A, verrucosidin, and verruculogen.
   BULLET::::- Toxins. Many virulence factors are proteins made by bacteria that poison host cells and cause tissue damage. For example, there are many food poisoning toxins produced by bacteria that can contaminate human foods. Some of these can remain in "spoiled" food even after cooking and cause illness when the contaminated food is consumed. Some bacterial toxins are chemically altered and inactivated by the heat of cooking.
  
  Section::::Virulent viruses.
  
  Virus virulence factors allow it replicate, modify host defenses, allow it to spread within the host, and are toxic to the host.
   Most common bacterial foodborne pathogens are:
  
  BULLET::::- "Campylobacter jejuni" which can lead to secondary Guillain–Barré syndrome and periodontitis
  
  BULLET::::- "Clostridium perfringens", the "cafeteria germ"
  
  BULLET::::- "Salmonella" spp. – its "S. typhimurium" infection is caused by consumption of eggs or poultry that are not adequately cooked or by other interactive human-animal pathogens
  
  BULLET::::- "" enterohemorrhagic (EHEC) which can cause hemolytic-uremic syndrome
  
  Other common bacterial foodborne pathogens are:
  
  BULLET::::- "Bacillus cereus"
  
  BULLET::::- "Escherichia coli", other virulence properties, such as enteroinvasive (EIEC), enteropathogenic (EPEC), enterotoxigenic (ETEC), enteroaggregative (EAEC or EAgEC)
  
  BULLET::::- "Listeria monocytogenes"
  
  BULLET::::- "Shigella" spp.
  
  BULLET::::- "Staphylococcus aureus"
  
  BULLET::::- "Staphylococcal enteritis"
   The delay between the consumption of contaminated food and the appearance of the first symptoms of illness is called the incubation period. This ranges from hours to days (and rarely months or even years, such as in the case of listeriosis or bovine spongiform encephalopathy), depending on the agent, and on how much was consumed. If symptoms occur within one to six hours after eating the food, it suggests that it is caused by a bacterial toxin or a chemical rather than live bacteria.
   Humans can be infected with foot-and-mouth disease through contact with infected animals, but this is extremely rare. Some cases were caused by laboratory accidents. Because the virus that causes FMD is sensitive to stomach acid, it cannot spread to humans via consumption of infected meat, except in the mouth before the meat is swallowed. In the UK, the last confirmed human case occurred in 1966, and only a few other cases have been recorded in countries of continental Europe, Africa, and South America. Symptoms of FMD in humans include malaise, fever, vomiting, red ulcerative lesions (surface-eroding damaged spots) of the oral tissues, and sometimes vesicular lesions (small blisters) of the skin. According to a newspaper report, FMD killed two children in England in 1884, supposedly due to infected milk.
   Food may be contaminated during all stages of food production and retailing. In order to prevent viral contamination, regulatory authorities in Europe have enacted several measures:
  
  BULLET::::- European Commission Regulation (EC) No 2073/2005 of November 15, 2005
  
  BULLET::::- European Committee for Standardization (CEN): Standard method for the detection of norovirus and hepatitis A virus in food products (shellfish, fruits and vegetables, surfaces and bottled water)
  
  BULLET::::- CODEX Committee on Food Hygiene (CCFH): Guideline for the application of general principles of food hygiene for the control of viruses in food
  
  Section::::See also.
  
  BULLET::::- 1984 Rajneeshee bioterror attack
   The most commonly recognised bacteria that are responsible for initiating the biofilm formation that can eventually lead to caries are streptococcus mutans and lactobacillus. The key factors for virulence include their ability to metabolise glucose and similar sugars, their tolerance for a low pH environment and their acidogenicity. The presence of streptococci encourage adherence of more cariogenic bacteria, which in turn increases the likelihood for caries. Although factors such as the quality of saliva, using fluoridated toothpaste and chewing gum after meals can inhibit the growth of these bacteria and change the biofilm environment. Saliva containing more buffering agents such as calcium and phosphate ions alter the internal environment of dental plaque to become less acidic, favouring the growth of less cariogenic organisms. The fluoride components of fluoridated toothpaste can be bacteriostatic to cariogenic bacteria, decreasing their acidogenicity and proliferation. Chewing gum can disturb the mature and fairly stable acid producing plaque to alter the bacterial composition of the biofilm. In turn the disease causing organisms may still be present, but are so in reduced numbers. Chewing gum containing sufficient levels of xylitol also has the ability to reduce the number of streptococcus mutans present in the saliva as well as the mechanisms for the bacteria to adhere to tooth tissue, which reduces the chance for reinfection.
   Several foods can naturally contain toxins, many of which are not produced by bacteria. Plants in particular may be toxic; animals which are naturally poisonous to eat are rare. In evolutionary terms, animals can escape being eaten by fleeing; plants can use only passive defenses such as poisons and distasteful substances, for example capsaicin in chili peppers and pungent sulfur compounds in garlic and onions. Most animal poisons are not synthesised by the animal, but acquired by eating poisonous plants to which the animal is immune, or by bacterial action.
  
  BULLET::::- Alkaloids
  
  BULLET::::- Ciguatera poisoning
  
  BULLET::::- Grayanotoxin (honey intoxication)
   BULLET::::- 2013, March – A vegetable seller in western Germany, Rhine Main, realized that the lettuce he had been selling throughout the day contained rat poison. The poison appears as small blue kernels.
  
  BULLET::::- 2013, February–March – Contamination with aflatoxins results in a milk recall in Europe and a dog food recall in the United States. See 2013 aflatoxin contamination for further details.
  
  BULLET::::- 2013, May – A Chinese crime ring was found to have passed off rat, mink, and small mammal meat as mutton for more than in Shanghai and Jiangsu province markets.
   BULLET::::- "Ascaris lumbricoides"
  
  BULLET::::- "Eustrongylides" sp.
  
  BULLET::::- "Trichinella spiralis"
  
  BULLET::::- "Trichuris trichiura"
  
  BULLET::::- Protozoa:
  
  BULLET::::- "Acanthamoeba" and other free-living amoebae
  
  BULLET::::- "Cryptosporidium parvum"
  
  BULLET::::- "Cyclospora cayetanensis"
  
  BULLET::::- "Entamoeba histolytica"
  
  BULLET::::- "Giardia lamblia"
  
  BULLET::::- "Sarcocystis hominis"
  
  BULLET::::- "Sarcocystis suihominis"
  
  BULLET::::- "Toxoplasma gondii"
  
  Section::::Causes.:Natural toxins.
   In April 2015, the Arkansas Department of Health issued a warning to the public that customers who had eaten at the Subway outlet in Morrilton, Arkansas, may have been exposed to infection after an employee tested positive for the virus.
  
  Section::::Controversies.:Sandwich size.
   Furthermore, foodborne illness can be caused by pesticides or medicines in food and natural toxic substances such as poisonous mushrooms or reef fish.
  
  Section::::Causes.:Bacteria.
   These bacterial strains, most notably "S. mutans", can be inherited by a child from a caretaker's kiss or through feeding premasticated.
  
  Section::::Cause.:Dietary sugars.
   A healthy equilibrium presents a symbiotic relationship where oral microbes limit growth and adherence of pathogens while the host provides an environment for them to flourish. Ecological changes such as change of immune status, shift of resident microbes and nutrient availability shift from a mutual to parasitic relationship resulting in the host being prone to oral and systemic disease. Systemic diseases such as diabetes and cardiovascular diseases has been correlated to poor oral health. Of particular interest is the role of oral microorganisms in the two major dental diseases: dental caries and periodontal disease. Pathogen colonization at the periodontium cause an excessive immune response resulting in a periodontal pocket- a deepened space between the tooth and gingiva. This acts as a protected blood-rich reservoir with nutrients for anaerobic pathogens. Systemic disease at various sites of the body can result from oral microbes entering the blood bypassing periodontal pockets and oral membranes.
   BULLET::::- Interdental food packing – (food getting pushed down between teeth) - this can be caused by missing teeth, tilted, spaced or crowded teeth, or poorly contoured approximal dental fillings. Food debris becomes trapped, undergoes slow bacterial putrefaction and release of malodorous volatiles. Food packing can also cause a localized periodontal reaction, characterized by dental pain that is relieved by cleaning the area of food packing with interdental brush or floss.
   It may seem that if the contamination of food with a pathogenic bacterium is low and infrequent, the risk of becoming ill is such that there will be no public health problem. Such a view is incomplete: admittedly, consuming a low dose of this bacterium is associated with a low probability of disease. But this probability is not zero. This explains the sporadic cases observed in the population. And that is also why there is no concentration in food below which there will be no epidemic.
  
  Section::::Dose-effect relationship and dose-response relationship.:Toxigenic bacteria.
   How does the consumption of sucrose lead to these deleterious effects? For dental caries the answer is clear: it is converted to dextran, which is extremely adhesive and promotes the growth of acid-producing bacteria. For the general metabolic effects that lead to CHD and/or to type 2 diabetes, the author suggests that alterations either in the rate of production of insulin or in the body’s sensitivity to it may be one of the early effects of excessive sucrose consumption. This suggestion foreshadows the subsequent widespread recognition of insulin resistance and the metabolic syndrome, and the condition known as non-alcoholic fatty liver disease (NAFLD). NAFLD is believed to result from the accumulation of fat in the liver—often as a consequence of excess dietary sucrose. 
   Mammals susceptible to secondary poisoning include humans, with infants and small children being the most susceptible. Pets such as cats and dogs, as well as wild birds, also face significant risk of secondary poisoning.
  
  Section::::Pesticides.
  
  Various pesticides such as rodenticides may cause secondary poisoning. Some pesticides require multiple feedings spanning several days; this increases the time a target organism continues to move after ingestion, raising the risk of secondary poisoning of a predator.
   BULLET::::- Zearalenone
  
  BULLET::::- Zearalenols
  
  Section::::Causes.:Viruses.
  
  Viral infections make up perhaps one third of cases of food poisoning in developed countries. In the US, more than 50% of cases are viral and noroviruses are the most common foodborne illness, causing 57% of outbreaks in 2004. Foodborne viral infection are usually of intermediate (1–3 days) incubation period, causing illnesses which are self-limited in otherwise healthy individuals; they are similar to the bacterial forms described above.
  
  BULLET::::- Enterovirus
   BULLET::::- Ingestion of raw or partly cooked meat, especially pork, lamb, or venison containing "Toxoplasma" cysts: Infection prevalence in countries where undercooked meat is traditionally eaten has been related to this transmission method. Tissue cysts may also be ingested during hand-to-mouth contact after handling undercooked meat, or from using knives, utensils, or cutting boards contaminated by raw meat.
  
  BULLET::::- Ingestion of unwashed fruit or vegetables that have been in contact with contaminated soil containing infected cat feces.
  
raw_presuppositions: Meat in your mouth should grow bacteria.
raw_corrections: The bacteria in your mouth already fights off the new bad bacteria.