Available information regarding the occurrence and public health significance of Escherichia coli and other sanitary indicator organisms in raw and commercially processed foods and water is reviewed. Some strains of E. coli are pathogens capable of eliciting diarrhea and cholera-like diseases in humans. These organisms have been incriminated in outbreaks of food- and waterborne gastroenteritis, in both the U.S. and other parts of the world. A table shows numbers of confirmed outbreaks in the U.S. from 1968 to 1976.

Food safety issues and increases in food borne illnesses have promulgated the development of new sanitation methods to eliminate pathogenic organisms on foods and surfaces in food service areas. Electrolyzed oxidizing water (EO water) shows promise as an environmentally friendly broad spectrum microbial decontamination agent. EO water is generated by the passage of a dilute salt solution (approximately 1% NaCl) through an electrochemical cell. This electrolytic process converts chloride ions and water molecules into chlorine oxidants (Cl2, HOCl/ClO-). At a near-neutral pH (pH 6.3-6.5), the predominant chemical species is the highly biocidal hypochlorous acid species (HOCl) with the oxidation reduction potential (ORP) of the solution ranging from 800 to 900 mV. The biocidal activity of near-neutral EO water was evaluated at 25 °C using pure cultures of Escherichia coli, Salmonella typhimurium, Staphylococcus aureus, Listeria monocytogenes, and Enterococcus faecalis. Treatment of these organisms, in pure culture, with EO water at concentrations of 20, 50, 100, and 120 ppm total residual chlorine (TRC) and 10 min of contact time resulted in 100% inactivation of all five organisms (reduction of 6.1-6.7 log10 CFU/mL). Spray treatment of surfaces in food service areas with EO water containing 278-310 ppm TRC (pH 6.38) resulted in a 79-100% reduction of microbial growth. Dip (10 min) treatment of spinach at 100 and 120 ppm TRC resulted in a 4.0-5.0 log10 CFU/mL reduction of bacterial counts for all organisms tested. Dipping (10 min) of lettuce at 100 and 120 ppm TRC reduced bacterial counts of E. coli by 0.24-0.25 log10 CFU/mL and reduced all other organisms by 2.43-3.81 log10 CFU/mL.

Contaminated water and food are major causes of malnutrition and mortality in the developing world, particularly among children. Infants are most vulnerable to diarrheal illnesses when introduced to fluids and foods as they are weaned from breastfeeding to a mixed diet. There is scant literature about the role of nutrition professionals in addressing this problem. Considerable progress has been made in identifying strategies to prevent diarrhea in children. Strategies include implementing low-technology methods of sanitizing water, emphasizing the benefits of breastfeeding, protecting prepared foods from unclean environments, and educating and motivating food preparers. Resolution of water and food safety problems requires a collaborative interdisciplinary approach among health professionals and involvement of community leaders. Dietetic professionals have the training to empower individuals and communities with skills to create a safe water and food environment.

The high number of people moving around by ferries and cruise ships in conjunction with great amounts of food and potable water transported (occasionally overloaded) and consumed by passengers constitute a possible risk for communicable diseases. Another issue of equally great importance is the food handlers who come from diverse origin and have a different mentality, habits, and background. In this paper an attempt is made to present comparatively EU and US legislation that could be potentially applicable to passenger ships food premises and potable water supplies. Moreover, food and water related hazards, not currently covered by EU legislation, were assessed together with US legislation and other guidelines for cruise ships.