All Infectious Disease Tests

Lab Tests for Infections and health information

Do you think you could have an infectious disease?

Our lab tests can detect infections early on, allowing you to receive treatment before it's too late.

Infections can be caused by bacteria, viruses, fungi, or parasites. They can affect different parts of the body, such as your skin or lungs. Some infections are spread from person to person through sneezing or coughing, while others can be passed on through sex. Symptoms of an infection depend on which part of the body is affected but may include fever, chills, fatigue, and aches. They range from the common cold to life-threatening diseases like Ebola and Zika. Some infections can be cured with antibiotics; others cannot. If left untreated, they could lead to serious health problems like pneumonia or meningitis. 

The good news is that many of these illnesses are preventable through vaccination or other precautions. If you have an infection, it's important to get tested so you can find out what type of infection it is and how best to treat it before your condition gets worse.

Suppose you have symptoms that suggest an infection. In that case, it's important to get medical attention early, so you have a better chance of getting rid of your symptoms quickly and preventing complications caused by the infection. We provide accurate lab testing services so that people like yourself can find out if they have an infection without having to wait days for results from their doctor's office!

Our lab tests can detect infections in their early stages so you can get treatment before it's too late. We make it easy and convenient for you to get the lab work you need to know your health — quickly, easily, and most importantly, economically – with over 2,000 discounted tests available at 2,100 locations across the country. Additionally, your results are private and secure, so you can rest assured that your information is safe with us. For the most part, Quest Diagnostics' results are available within 24 to 48 hours.

To get lab testing for specific infectious conditions that could be affected by changes in your health, click on the links below.


Name Matches

Absolute Lymphocyte Count includes: WBC, Absolute Lymphocytes, % Lymphocytes, % Reactive Lymphocytes

Clinical Significance

Increased understanding of immunodeficiency syndrome and AIDS have identified the importance of absolute lymphocyte count in addition to the specific cell type such as CD4 lymphocytes. In pediatric ages up to 14 years old, acute infectious lymphocytosis is a clinical disorder, suspected to be of enterovirus-Coxsackie A subgroup that may have upper respiratory symptoms, fever, diarrhea and abdominal pain or a totally asymptomatic clinical course. Other conditions with absolute lymphocytosis are B. pertussis infection and lymphocytic leukemoid reaction. The most commonly known lymphocytosis with atypical morphology is due to cytomegalovirus and infectious mononucleosis. The malignant forms of absolute lymphocytosis are mostly due to lymphoproliferative disorders.


Adenovirus causes respiratory tract infections, conjunctivitis, and diarrhea. Infections are most common in individuals who are immunocompromised and in young children. Adenovirus Antigen Detection is useful to confirm the diagnosis of adenovirus infection in patients with gastroenteritis.

This test is used to determine the presence of adenovirus in a patient's specimen. Organisms may be detected by PCR prior to diagnosis by immunological methods. PCR provides more rapid results than other methods, including culture.



Description: The Antistreptolysin O Antibody test is a sensitive blood test used to detect recent streptococcal infection.

Also Known As: ASLO Test, ASO Test, ASO Antibody Test, Strep A Test, Streptococcus Group A Test

Collection Method: Blood Draw

Specimen Type: Serum

Test Preparation: No preparation required

When is an Anti-Streptolysin O Antibody test ordered?

When a patient exhibits symptoms that a medical professional believes could be related to a condition brought on by a prior strep infection, the ASO test is requested. When symptoms start to show, which typically happens a few weeks after a sore throat or skin infection when the bacteria are no longer in the throat or on the skin, the treatment is recommended.

For acute and convalescent ASO titers, the test may be carried out twice, with samples being taken roughly two weeks apart. This is carried out to ascertain whether the antibody level is increasing, decreasing, or staying the same.

What does an Anti-Streptolysin O Antibody blood test check for?

The hazardous enzyme streptolysin O, which is generated by group A Streptococcus bacteria, is the target of the antibody known as antistreptolysin O. The most prevalent antibodies generated by the body's immune system in connection to a strep infection with group A Streptococcus are ASO and anti-DNase B. The level of ASO in the blood is determined by this test.

A Group The bacterium that causes strep throat and a number of other illnesses, including skin infections, is streptococcus. Antibiotics are usually used to diagnose and treat strep infections, and the illnesses usually go away.

However, complications, such as rheumatic fever and a specific form of kidney disease, can occasionally arise from strep infections, particularly in young children, when they do not produce any distinguishable symptoms, are ignored, or are ignored but ineffectively treated. Due to frequent strep testing, these secondary diseases are now far less common in the United States, but they still do happen. Serious complications from these disorders include heart damage, acute renal dysfunction, tissue edema, and high blood pressure. If they are brought on by a recent group A strep infection, the ASO test can be used to assist identify the cause.

Lab tests often ordered with an Anti-Streptolysin O Antibody test:

  • Anti-DNase B
  • Strep Throat Test

Conditions where an Anti-Streptolysin O Antibody test is recommended

  • Streptococcus
  • Kidney Disease

How does my health care provider use an Anti-Streptolysin O Antibody test?

The main purpose of the ASO test is to identify recent group A streptococcal strep infections.

Antibiotics are typically used to diagnose and treat strep infections, and the illnesses usually go away. However, in certain persons, particularly in young children, complications, such as rheumatic fever and glomerulonephritis, might arise when they do not result in observable symptoms and/or go untreated. Therefore, if a patient has a recent history of sore throat or a confirmed streptococcal infection and symptoms suggestive of rheumatic fever or glomerulonephritis.

What do my Anti-Streptolysin O Antibody test results mean?

About a week to a month after the initial strep infection, ASO antibodies start to develop. After reaching a high 3 to 5 weeks after the sickness, the level of ASO antibody gradually decreases, but it may still be detected months after the strep infection has cleared up.

It is highly likely that the person tested did not recently contract strep throat if the ASO is negative or present at extremely low titers. This is particularly true if a sample collected 10 to 14 days later is negative as well as if a negative anti-DNase B test results. There is a slight chance that someone with a strep infection complication won't have an increased ASO. This is particularly valid in the case of glomerulonephritis, which can arise following a cutaneous strep infection.

It is likely that the person who was tested has recently had strep infection if they have a high antibody titer or an increasing ASO titer. ASO titers that are initially high and then start to drop indicate that an infection has started and might be on the verge of going away.

The ASO test does not foretell the type or severity of the disease, nor does it foretell if there would be problems after a strep infection. An increased ASO level may be utilized to support the diagnosis of glomerulonephritis or rheumatic fever in cases where symptoms are already present.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Rapidly growing mycobacteria and Nocardia/aerobic Actinomycetes can cause a variety of serious infections, particularly in immunocompromised patients. Resistance, toxicity, intolerance, and therapeutic failures may occur with traditional empiric treatment with drugs of choice. Antimicrobial susceptibility testing, especially with newer agents, may help to guide appropriate therapeutic choices.

This test is used to determine the presence of Avian Influenza RNA in a patient's specimen. PCR provides more rapid results than culture. Furthermore, this test will specifically detect the H5 virus strain.

Clinical Significance

Babesia duncani, also known as WA1, causes symptoms similar to those seen in cases of babesiosis caused by Babesia microti. Most of the documented cases have occurred in the Pacific Northwest.

Babesiosis is a blood infection caused by the parasite, Babesia. In the U.S., it is primarily spread to people by bites from infected blacklegged ticks, also called deer ticks (Ixodes scapularis). 


Babesia serological testing is used to diagnose infection by the Babesia tick-borne protozoan. Infection may cause hemolytic anemia.


Bartonella Species Antibodies (IgG, IgM) with Reflex to Titer. Includes Bartonella henselae IgG, IgM; Bartonella quintana IgG, IgM.

Additional charges my apply if one or more of the following reflex tests are run by the lab. If B. henselae (IgG) screen is positive, the B. henselae (IgG) titer will be performed at an additional charge (CPT code(s): 86611).
If B. quintana (IgG) screen is positive, the B. quintana (IgG) titer will be performed at an additional charge (CPT code(s): 86611).
If B. henselae (IgM) screen is positive, the B. henselae (IgM) titer will be performed at an additional charge (CPT code(s): 86611).
If B. quintana (IgM) screen is positive, the B. quintana (IgM) titer will be performed at an additional charge (CPT code(s): 86611).


 

Bordetella pertussis toxin (PT) Antibody (IgG), Immunoassay

Clinical Significance

Antibody levels above the reference range are highly suggestive of recent infection or vaccination.

Reference Range(s)

Bordetella pertussis toxin(PT) Ab (IgG), IA

  • ≤10 Years<66 IU/mL
  • 11-59 Years<43 IU/mL
  • ≥60 Years<32 IU/mL

Alternative Name(s)

Whooping Cough




Detection of antibodies to Brucella sp. Usually indicates recent or past exposure to the organism.

C3a desArg is a cleavage product of C3 complement component activation. Elevated levels of C3a have been reported in patients with acute lyme disease, acute pancreatitis, systemic lupus erythematosus, and adult respiratory distress syndrome.



Most Popular

Description: The chlamydia test is used to determine if a person has been infected with the sexually transmitted infection. It can be used to diagnose a person with chlamydia for treatment.

Also Known As: Chlamydia Trachomatis Test, Chlamydia STD Test

Collection Method: Urine Collection

Specimen Type: Urine

Test Preparation: The patient should not have urinated for at least one hour prior to specimen collection. Female patients should not cleanse the labial area prior to providing the specimen.

When is a Chlamydia test ordered?

According to the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists, all sexually active women younger than 25 and sexually active women 25 and older who are at elevated risk should have a yearly chlamydia screening. The American Academy of Pediatrics and the US Preventive Services Task Force both urge routine screening for these women.

The CDC recommends that males who have intercourse with other men get tested for chlamydia at least once a year. For sexually active, heterosexual men with no symptoms, health organizations do not advocate routine screening. When there is a large number of cases of STDs in the community, for example, healthcare providers may prescribe screening to their patients.

When a person’s sexual partner has been diagnosed with chlamydia or when a person has signs and symptoms of the infection, chlamydia testing may be performed.

Women and men who have been treated for chlamydia should be tested again three months afterwards.

What does a Chlamydia Urine test check for?

Chlamydia is one of the most common bacterial sexually transmitted infections in the United States, and if left untreated, it can lead to serious consequences. Chlamydia testing determines whether the bacteria Chlamydia trachomatis is to blame for an infection. In order to avoid long-term consequences and the spread of the infection to others, it’s critical to screen for, diagnose, and treat chlamydia.

Chlamydia infections are most common among people aged 15 to 24. According to the Centers for Disease Control and Prevention, 2.86 million Americans contract chlamydia each year, and women are commonly re-infected if their partners do not seek treatment. Because many people don’t have any symptoms and don’t get tested and identified, the true number of cases may be larger. Despite this, each year over one million new cases are reported.

Sexual contact with an infected partner is the most common way for chlamydia to spread. Multiple sex partners, coinfection or previous infection with another STD, and not wearing a condom appropriately and consistently are also risk factors.

Many people with chlamydia infections have no symptoms, while others may only have minor ones. Because the signs and symptoms of chlamydia are similar to those of another STD, gonorrhea, and can be misinterpreted, testing for both diseases are frequently performed at the same time.

Antibiotics are commonly used to treat chlamydia. It can cause serious reproductive and other health problems if not recognized and addressed.

In women, untreated chlamydia infections that originate on the cervix but progress to the fallopian tubes and ovaries can cause pelvic inflammatory disease.

Men who are not treated may become infertile in rare cases.

Lab tests often ordered with a Chlamydia test:

  • Gonorrhea
  • HIV Antibody
  • HIV Antigen
  • Syphilis
  • Herpes 1 and 2

Conditions where a Chlamydia test is recommended:

  • Chlamydia
  • Gonorrhea
  • HIV
  • Herpes 1 and 2
  • Syphilis
  • Sexually Transmitted Diseases
  • Pelvic Inflammatory Disease
  • Infertility
  • Vaginitis
  • Vaginosis

How does my health care provider use a Chlamydia test?

Chlamydia testing is used to detect, diagnose, and confirm that infections caused by the bacteria Chlamydia trachomatis have been successfully treated. Chlamydia is one of the most common bacterial sexually transmitted diseases in the United States, and if left untreated, it can lead to serious consequences. To avoid long-term consequences and the spread of the infection to others, it's critical to screen for, diagnose, and treat chlamydia.

Because the illnesses produced by these two bacteria might have similar signs and symptoms, testing for Chlamydia trachomatis and Neisseria gonorrhoeae is frequently done at the same time. Both of these bacteria can be acquired at the same time, and a person can get infected with both. Because the two infections require distinct antibiotic treatments, a clear diagnosis is critical. Testing should be done again to determine that the treatment was effective. After a person has completed therapy, this is done roughly three months later.

What do my Chlamydia test results mean?

A positive result indicates that you have an active chlamydia infection that requires antibiotic therapy.

A negative result simply means that no infection was present at the time of the test. It is critical for those who are at a higher risk of infection to have annual screening tests to check for infection, especially since re-infection is common, especially among teenagers.

If you're infected, your sexual partner(s) should get tested and treated as well.


Most Popular

Description: The chlamydia and gonorrhea test is used to determine if a person has been infected with either of the sexually transmitted infections. It can be used to diagnose a person with chlamydia or gonorrhea for treatment.

Also Known As: Chlamydia Trachomatis Test, Chlamydia STD Test, GC Test, Neisseria Gonorrhoeae test, Gonorrhoeae test, gonorrhea and chlamydia test

Collection Method: Urine Collection

Specimen Type: Urine

Test Preparation: Urine specimens: The patient should not have urinated for at least one hour prior to specimen collection. Female patients should not cleanse the labial area prior to providing the specimen.

When is a Chlamydia and Gonorrhea test ordered?

According to the Centers for Disease Control and Prevention and the American College of Obstetricians and Gynecologists, all sexually active women younger than 25 and sexually active women 25 and older who are at elevated risk should have a yearly chlamydia and gonorrhea screening. The American Academy of Pediatrics and the US Preventive Services Task Force both urge routine screening for these women.

The CDC recommends that males who have intercourse with other men get tested for gonorrhea and chlamydia at least once a year. For sexually active, heterosexual men with no symptoms, health organizations do not advocate routine screening. When there is a large number of cases of STDs in the community, for example, healthcare providers may prescribe screening to their patients.

When a person’s sexual partner has been diagnosed with gonorrhea or chlamydia or when a person has signs and symptoms of the infection, chlamydia testing may be performed.

Women and men who have been treated for chlamydia should be tested again three months afterwards.

What does a Chlamydia and Gonorrhea urine test check for?

Chlamydia is one of the most common bacterial sexually transmitted infections in the United States, and if left untreated, it can lead to serious consequences. Chlamydia testing determines whether the bacteria Chlamydia trachomatis is to blame for an infection. In order to avoid long-term consequences and the spread of the infection to others, it’s critical to screen for, diagnose, and treat chlamydia.

Chlamydia infections are most common among people aged 15 to 24. According to the Centers for Disease Control and Prevention, 2.86 million Americans contract chlamydia each year, and women are commonly re-infected if their partners do not seek treatment. Because many people don’t have any symptoms and don’t get tested and identified, the true number of cases may be larger. Despite this, each year over one million new cases are reported.

Sexual contact with an infected partner is the most common way for chlamydia to spread. Multiple sex partners, coinfection or previous infection with another STD, and not wearing a condom appropriately and consistently are also risk factors.

Many people with chlamydia infections have no symptoms, while others may only have minor ones. Because the signs and symptoms of chlamydia are similar to those of another STD, gonorrhea, and can be misinterpreted, testing for both diseases are frequently performed at the same time.

Antibiotics are commonly used to treat chlamydia. It can cause serious reproductive and other health problems if not recognized and addressed.

In women, untreated chlamydia infections that originate on the cervix but progress to the fallopian tubes and ovaries can cause pelvic inflammatory disease.

Men who are not treated may become infertile in rare cases.

If not diagnosed and treated, gonorrhea is a common bacterial sexually transmitted illness that can lead to serious consequences. Gonorrhea testing determines whether a person's infection is caused by the bacteria Neisseria gonorrhoeae. The importance of gonorrhea screening, diagnosis, and treatment in reducing long-term consequences and the spread of the infection to others cannot be overstated.

More than 820,000 people in the United States contract new gonorrheal infections each year, according to the Centers for Disease Control and Prevention, but only about half of these infections are reported to the CDC. In the United States, sexually active teenagers, young adults, and African Americans have the highest reported rates of infection.

Sexual contact with an infected partner is the most common way for gonorrhea to spread. Multiple sex partners, coinfection or previous infection with another STD, and not wearing a condom appropriately and consistently are also risk factors.

While some males with gonorrhea will experience symptoms, the majority of women will not or will confuse gonorrhea symptoms with those of a bladder or other vaginal illness. Symptoms in men usually emerge 2 to 5 days after infection, but they can take up to 30 days. Symptoms usually appear within 10 days of infection for women. Because the signs and symptoms of gonorrhea are similar to those of another STD, chlamydia, and can be misinterpreted, testing for both diseases are sometimes performed at the same time.

Antibiotics are generally prescribed to treat gonorrhea. Gonorrhea can have catastrophic consequences if it is not recognized and treated.

Untreated gonorrhea infections in women can cause pelvic inflammatory disease, which can develop days to months after infection and cause consequences.

Untreated gonorrhea can spread to the blood or joints, leading to disseminated gonococcal infection, a dangerous illness. Fever, numerous skin lesions, severe joint swelling, inflammation of the membrane surrounding the brain and spinal cord, and infection of the inner lining of the heart are all signs of DGI. In infants born to infected moms, DGI symptoms include arthritis, meningitis, and sepsis, a serious, life-threatening illness.

Antibiotics identical to those used to treat simple gonorrhea might be used to successfully treat DGI. Treatment-resistant gonorrhea, on the other hand, is becoming more common. To treat all uncomplicated gonococcal infections in adults and adolescents in the United States, CDC guidelines presently recommend dual therapy with ceftriaxone and azithromycin. If a patient's symptoms do not improve following therapy, a healthcare provider may need to do additional tests, including susceptibility testing.

Lab tests often ordered with a Chlamydia and Gonorrhea test:

  • HIV Antibody
  • HIV Antigen
  • Syphilis
  • Herpes 1 and 2

Conditions where a Chlamydia and Gonorrhea test is recommended:

  • Gonorrhea
  • HIV
  • Herpes 1 and 2
  • Syphilis
  • Sexually Transmitted Diseases
  • Pelvic Inflammatory Disease
  • Infertility
  • Vaginitis
  • Vaginosis

How does my health care provider use a Chlamydia and Gonorrhea test?

Chlamydia and gonorrhea testing is used to detect, diagnose, and confirm that infections caused by the bacteria Chlamydia trachomatis have been successfully treated. Chlamydia and gonorrhea are two of the most common bacterial sexually transmitted diseases in the United States, and if left untreated, it can lead to serious consequences. To avoid long-term consequences and the spread of the infections to others, it's critical to screen for, diagnose, and treat chlamydia.

Because the illnesses produced by these two bacteria might have similar signs and symptoms, testing for Chlamydia trachomatis and Neisseria gonorrhoeae is frequently done at the same time. Both of these bacteria can be acquired at the same time, and a person can get infected with both. Because the two infections require distinct antibiotic treatments, a clear diagnosis is critical. Testing should be done again to determine that the treatment was effective. After a person has completed therapy, this is done roughly three months later.

What do my chlamydia and gonorrhea test results mean?

A positive result indicates that you have an active infection that requires antibiotic therapy.

A negative result simply means that no infection was present at the time of the test. It is critical for those who are at a higher risk of infection to have annual screening tests to check for infection, especially since re-infection is common, especially among teenagers.

If you're infected, your sexual partner(s) should get tested and treated as well.

We advise having your results reviewed by a licensed medical healthcare professional for proper interpretation of your results.


Chlamydia trachomatis is associated with infections of the mucous membranes of the urogenital system, the upper respiratory tract, and the eye. In industrialized countries, C. trachomatis usually causes sexually transmitted disease. In developing countries, it is the major cause of preventable blindness (trachomatis). Sexually transmitted diseases caused by C. trachomatis include nongonococcal urethritis, cervicitis, salpingitis, epididymitis, proctitis and Lymphogranuloma venereum. Infections are often asymptomatic. Thus, infected individuals may unknowingly transmit chlamydial disease to others. Coinfection with C. trachomatis and Neisseria gonorrhoeae is common, with multiple chlamydial infections of the upper respiratory tract occurring primarily in newborns exposed at parturition through an infected birth canal. Approximately 10-20% of such infants develop pneumonia and 50% develop inclusion conjunctivitis. In adults, eye disease is often transmitted by the hands from genital secretions or from eye secretion of infected babies. Isolation in tissue culture remains the reference method for diagnosis of chlamydial infection, especially when testing individuals under the age of 13 years. The usefulness of serological tests depends on the site of infection, duration of disease, infecting serovars and pre-vious exposure to chlamydial antigens. Because C. trachomatis is ubiquitous, there is a high prevalence of antibodies in sexually active populations. Antibodies may persist even after treatment, making assessment of a single IgG titer difficult. Consequently, serological diag-nosis is seldom used to diagnose active, superficial genital tract infections.


C. difficile is the major cause of antibiotic-associated diarrhea (AAD) and pseudomembranous colitis.

Additional Charge Possible: If the GDH Antigen is detected and the Toxin A and B are not detected or the GDH Antigen is not detected and the Toxin A and B are detected, Clostridium difficile Toxin B, Qualitative, Real-Time PCR will be performed at an additional charge.

After treatment with antibiotics, many patients develop gastrointestinal problems ranging from mild diarrhea to severe pseudomembranous colitis. This organism is an opportunistic anaerobic bacterium that grows in the intestine once the normal flora has been altered by the antibiotic. For diagnosis of toxigenic C. difficile, current practice guidelines from the CDC recommend confirmation by Nucleic Acid Amplification Testing (NAAT) if the glutamate dehydrogenase of C. difficile (GDH) Antigen is positive, and toxin is not detected by Enzyme immunoassay. Additionally, if toxin is detected without the presence of GDH antigen, confirmation by NAAT is also recommended.


TP antibodies represent IgM antibodies to Coccidioides. Their detection indicates recent, active infection




 Food and waterborne illnesses known as food poisoning are conditions brought about by drinking or eating water or food that’s contaminated by the toxins of microbes they produce. In most cases, the cause of gastrointestinal issues like diarrhea, abdominal pain, vomiting, and nausea. There are lots of non-infectious causes of illnesses instigated by contaminated water and food. At the same time, some microbes are likely to cause infections in other parts of the body apart from the digestive tract. But since most of these are beyond this article’s scope, we will not be covering them here. 

In the U.S., the CDC or Centers for Disease Control and Prevention estimates that about 1 in every six people get sick annually from consuming contaminated beverages or food. Of those, about 128,000 are hospitalized, and about 3,000 die from arising complications. 

Waterborne and foodborne illnesses can affect anybody at any time. However, they tend to be more severe in: 

  • The elderly and very young children, as they may experience severe dehydration 
  • People with compromised or weakened immune systems such as those who’ve had an organ transplant or who have HIV/AIDS. In these subsets, these conditions can be severe and very hard to resolve.  
  • People who suffer from chronic diseases like liver disease, lung disease, heart disease, or diabetes. 
  • Pregnant women – some of these conditions could prove harmful to the developing baby. 

Foodborne illnesses may involve one person or maybe part of a widespread outbreak. Most of these cases come directly from what an individual or individuals have consumed. In some instances, they are passed from one person to another, especially in confined populations like in nursing homes, daycares, or cruise ships. 

Outbreaks tend to occur when more than one person develops symptoms after they have consumed the same drink or food that’s contaminated with the same toxins or microbes. At the same time, they may occur across multiple states or within a locality. Government and public health agencies continuously monitor water and food quality and take swift action to identify, contain, and address the source of an outbreak. However, this task has, in recent days, become harder since a lot more food is being imported to the United States from many foreign countries and as people travel the world. 

When it is suspected that cases of food poisoning are related, public health experts do their best to get the medical histories of the people who’ve been affected and take samples, often stool samples, which they send to public health labs for testing. During outbreaks, people affected are generally advised to share their information about recent travels, the food they have eaten recently (what they have eaten in the last couple of days), symptoms, as well as the type of diarrhea (bloody, watery) they are experiencing. This helps make the process of identifying the root cause much easier.  

Often, samples of suspected sources of contamination also get tested. Public health labs use molecular tests called PFGEs or pulsed-field gel electrophoresis that “fingerprint” DNA to study microbes isolated from individuals who are ill and then search for the pathogens in water or food samples. This allows the labs to identify the common sources of waterborne or foodborne illness quickly. The results from these tests are then entered into a central database known as PulseNet, which is used by federal food safety regulatory laboratories, the CDC, and public and local health agencies to compare DNA fingerprints and identify diseases and illnesses with a common source. If an illness is identified, the necessary steps are taken to ensure the source of the contamination is contained, and the spread of the illness is restricted. 

Causes  

Microbes that contaminate water and food include a range of parasites, bacteria, and viruses. Some of them are found all over the world, and others are regional. At the same time, some are rare, and others are very common. These microbes are responsible for causing symptoms in people who’ve been exposed or those who are more susceptible. Regional bacteria strains might not cause symptoms in people who are accustomed to them. However, when exposed to someone new to them, they may make them sick. While the affected food and water may smell, taste, and look normal, they can cause illnesses that range from self-limited and mild to severe. 

According to data provided by the CDC or Centers for Disease Control and Prevention, the leading cause of waterborne and foodborne illnesses is a virus called Norovirus. This virus is very contagious and easily contaminates water and food and is also easily spread amongst people. 

Several strains of bacteria also feature in the list of contaminants. They include: 

  • Clostridium 
  • Campylobacter 
  • Salmonella 
  • Listeria 
  • Shiga toxin-producing Escherichia coli (STEC) 
  • Yersinia 
  • Vibrio 

The parasite Toxoplasma, listeria, Salmonella, and Norovirus are also considered the most common causes of death caused by food poisoning. While Norovirus only causes a mild illness, the fact that it affects a lot of people makes it one of the top killers. 

Click on one of the links highlighted below for more details on these and other microbes that have been implicated in waterborne and food illnesses: 

  • Bacterial toxins 
  • Viruses 
  • Parasites 
  • Bacteria 

Worth Noting: There are lots of other non-infectious causes of illnesses caused by consuming water or food like poisoning from fish that’s been contaminated with toxins. However, these causes are beyond the focus of this article. 

Bacteria  

  • Salmonella tend to contaminate poultry eggs, raw meat, and other foods. Symptoms of Salmonella poisoning start to develop within 12-72 hours after infection and last for 4 to 7 days. The good thing is that the infection generally resolves with supportive care or even without treatment. However, in people like the elderly or very young, diarrhea may become so bad that they might require hospitalization. For people who are gravely ill, there’s a danger that the illness may spread to their blood, putting them at risk. Such cases need to be addressed promptly to guarantee the safety of the patient. Salmonella serotype Typhimurium and Salmonella serotype Enteritidis are the most common in America. Other cases of Salmonella are travel related. Salmonella typhi, which is quite prevalent in developing countries, is what causes typhoid fever. 
  • Campylobacter is also quite common. Campylobacter jejuni has been implicated in several outbreaks recently. Illnesses causing bloody or watery stools may start to develop 2-5 days after one has been infected and generally last a week. The illness is generally caused by consuming contaminated water, undercooked or raw poultry, or unpasteurized milk or cheese. Complications related to the illness include reactive arthritis and Guillain-Barre syndrome. Cases of Campylobacter related illnesses typically increase in spring and fall. Fortunately, supportive care is usually enough to treat the condition. However, some prolonged or severe cases may require the use of antibiotics. 
  • E. coli – short for Escherichia coli, these are common bacteria found in the digestive tract of animals and humans. While most strains do not cause problems, some produce a toxin called Shiga toxin, which causes bloody diarrhea and potentially serious infections that are easily spread from sources like undercooked meat or one person to the other. These are called Shiga-toxin-producing STEC or E. coli. There is one strain of the bacteria designated O157: H7 that’s quite severe and which has been implicated in a couple of outbreaks. The elderly and very young are usually the most affected by the complications of STEC-related infections such as HUS or hemolytic uremic syndrome. 
  • Listeria monocytogenes – These bacteria are found in unpasteurized milk, soft cheeses, fruits, hot dogs, vegetables, and uncooked meats. The interesting thing about these bacteria is that they still thrive even at refrigeration temperatures. The illnesses caused by this type of bacteria can be quite serious in people with weak immune systems. At the same time, they can be passed from an expectant woman to their developing baby, causing a miscarriage.  
  • Vibrio – Is the most common type of illness-causing bacteria in the world. Vibrio vulnificus, on the other hand, is mostly found in contaminated seafood like raw oysters and in warm seawater. This strain can be quite deadly and is especially a threat to people with weakened immune systems or liver disease. The bacterium Vibrio cholerae is what causes cholera. 
  • Yersinia – This strain of bacteria is found in seafood, unpasteurized milk, and undercooked pork. It’s often linked to chitlins, a dish that’s prepared using the intestines of hogs and which is often served during holidays, which explains why there is an increase of illnesses during winter. The infection is also known to cause reactive arthritis in some people.  
  • Shigella – of the different types of species in existence, there are several that have been known to produce toxins and can cause hemolytic uremic syndrome and reactive arthritis. Shigella dysenteriae is responsible for causing dysentery, severe fever, and bloody diarrhea. 

Viruses  

  • Norovirus – this virus is responsible for most gastroenteritis cases in America, causing over 50 percent of all food poisoning illnesses. The virus is resistant to disinfectant and is extremely contiguous, considering that it is easily spread by touching contaminated surfaces, from person to person, or through contaminated water and food. Norovirus is one of the main causes of food poisoning-related illnesses in restaurants, on cruise ships, and in confined spaces. While most patients feel better in 1-3 days, there is still a risk of serious illness and severe dehydration in the elderly, young children, and people suffering from underlying conditions. People who experience severe dehydration may require hospitalization. Since it is not a bacterium, antibiotics cannot be used to treat infections. 
  • Rotavirus – This virus generally affects children and people with compromised immune systems. It is known to cause severe dehydration and diarrhea. 
  • Hepatitis A – While the number of hepatitis A cases in America is decreasing, infections are still prevalent in some parts of the world. Hepatitis infections can be acquired from shellfish, sewage-contaminated water, and undercooked vegetables and other foods. Luckily, there is a vaccine that helps prevent infection. 

Parasites  

Common parasites that cause waterborne and foodborne illnesses include: 

  • Toxoplasma gondii – Toxoplasma gondii is a single-cell parasite that is ingested when one consumes contaminated water or food, especially undercooked venison, pork, or lamb. It can also be acquired by transmission from pregnant women to their developing babies, handling contaminated cat litter, and, in rare cases, during a blood transfusion or organ transplantation. Most people who get infected aren’t aware of it; when signs and symptoms are present, they tend to be flu-like and mild. In most cases, their immune systems will develop protection against the severe form of the infection. Infants born to infected mothers and people with weakened immune systems are most vulnerable to contracting serious infections. 
  • Giardia duodenalis – This parasite is one of the most common causes of waterborne illnesses. It can also contaminate food and is also easily passed from one person to the other. Infected persons may have a few intermittent symptoms. 
  • Cryptosporidium parvum – Also known as crypto, this parasite can be found in both water and food; infections can become persistent and severe in people with compromised immune systems.  
  • Entamoeba histolytica – this parasite is acquired by consuming contaminated food or water and can be easily spread through contact with infected persons.  

Other possible parasitic causes: 

  • Microsporidia – Infection from contaminated water can lead to chronic diarrhea in people with compromised immune systems. 
  • Cyclospora cayetanensis – found in contaminated water or food. Known to cause watery diarrhea 
  • Cystoisospora belli – found in contaminated water or food. Very common in tropical areas 
  • Taenia saginata and Taenia solium – beef and pork tapeworms from undercooked or raw meat, contaminated water or food  
  • Trichinella spiralis – This parasite is responsible for causing trichinosis. Even though it is rare in the U.S. is now being seen with undercooked wild game and pork; cysts of this parasite have been known to lodge in the muscles of the host. 

Toxins  

Other sources of waterborne and foodborne illnesses include toxins produced by some specific types of bacteria, which include:  

  • Staphylococcus aureus – These bacteria have been known to produce toxins that cause acute symptoms of vomiting and nausea within a couple of hours of consuming food that’s contaminated. 
  • Clostridium botulinum – Mostly found in contaminated food, the toxin produced by these bacteria have been known to cause paralysis and are fatal. Home-canned foods with low acids are the perfect breeding ground for this strain of bacterium. Fortunately, the toxins are easily destroyed by heat. 
  • Clostridium perfringens – this strain of bacteria may contaminate raw poultry and meat, and the associated diseases are linked to consuming food that’s not stored, cooked, or heated properly. The bacteria produce heat resistant spores, which means that once cooked food has cooled down, the bacteria can start growing again. When ingesting, the bacteria produce a toxin that causes acute infections with symptoms of diarrhea and intestinal cramping (but with no vomiting or fever). Symptoms take about 8-12 hours to develop and last for less than 24-hours. Just like with other causes of waterborne and food illnesses, infections can be severe, especially in people with weak immune systems.  

Signs and symptoms  

Viruses and bacteria tend to cause severe illnesses, while parasites cause intermittent or chronic illnesses. Each infection has its own incubation period ranging from several days to several hours after consuming contaminated water or food. At the same time, the length of illness ranges from days to several weeks. 

Common symptoms and signs include:  

  • Vomiting 
  • Nausea 
  • Dehydration 
  • Abdominal pain 
  • Watery diarrhea that is either frequent, intermittent and in some instances, bloody 

Other symptoms and signs include: 

  • Weight loss 
  • Double vision 
  • Fever 
  • Difficulty swallowing 
  • Headache 
  • Muscle weakness; some toxins can cause paralysis 

In more severe cases, an illness may progress to include: 

  • Hemolytic uremia syndrome (kidney failure) 
  • Joint pain, symptoms of reactive arthritis 
  • Sepsis 

It is worth keeping in mind that some cases of waterborne and food illnesses can be fatal. 

Lab Tests 

The initial tests for individuals suspected of having waterborne or foodborne illnesses often start with a stool examination. This may include:  

  • A stool culture – used to detect several commonly encountered bacteria. 
  • Stool antigen tests – includes individual tests capable of detecting Cryptosporidium, Shiga toxin-producing E. coli (STEC), Entamoeba histolytica, or Giardia. 
  • Ova and Parasite (O&P) – generally ordered to spot and identify parasites. 
  • Stool white blood cells (WBC) – this test is used to check the presence of white blood cells in stool. If present, this may indicate a more severe infection involving bacteria or some type of parasite. Special staining tests may be required to identify specific types of parasites in stool samples. 
  • Rotavirus antigen testing – mostly ordered to detect traces of rotavirus. 
  • Individual molecular tests (RT-PCR or reverse transcriptase-polymerase chain reaction) – This test is sometimes performed to detect specific microbes like Norovirus. 
  • G.I. pathogens panel – The G.I. pathogens panel is used to identify the presence of pathogenic (multiple disease-causing) microbes in stool samples. 

Several other tests may be performed as a follow up to or in conjunction with a stool test. Some of these tests include:  

  • Complete blood count (CBC) – A CBC may be ordered to see if the amount of white blood cells in the bloodstream has increased. Increased values are a sign of bacterial infection. 
  • Antibody testing of blood samples for hepatitis A or specific bacteria, sometimes ordered to help confirm a patient’s diagnosis. 
  • Blood culture – A blood culture may be ordered to detect if infections of a bacterial nature have spread into the blood. 

Additionally, specific nutrient media for cultures and specialized techniques may be required to identify and detect some microbes. As such, healthcare practitioners must know potential exposures and request for specialized testing. 

Tests: Stool Culture, Ova and Parasite Exam, Shiga toxin-producing E. coli, Gastrointestinal Pathogens Panel, Comprehensive Metabolic Panel, Complete Blood Count, Blood Culture 

Conditions: Norovirus, Reactive Arthritis, Sepsis, Liver Disease, Travelers’ Diseases, Diarrhea, Guillain-Barr© Syndrome, HIV Infection and AIDS