Moulds / Molds in Food - Allergic Reactions
Sometimes it is very difficult to identify the food culprit that is causing health problems. An example of this difficulty is when moulds are present in food either as a result of the way the food is processed or because of contamination.
Flavour-enhancing moulds are added to traditional foods such as dry sausage, salami, Spanish ham, and French cheese in Central and Southern Europe (1).
In Northern Europe the addition of moulds to meat products is not permitted but there are studies that have found contamination by Penicillium, Cladosporium, and Eurotium molds in equipment and raw materials used during the manufacture of meat products. For example:
In order to determine the mycobiota in processing areas of fermented sausage and liver pâté, filamentous fungi were isolated from air, equipment and raw materials in the processing areas of two fermented sausage processing plants and two liver pâté processing plants. A total of 336 samples were examined. The diversity of filamentous fungi in the processing areas was high; at least 17 different genera were identified. The main isolated genera were identified as Aspergillus, Botrytis, Cladosporium, Epicoccum, Eurotium, Penicillium, Phaeoacremonium and Phoma.
Of these, Penicillium and Eurotium were the most important for contamination of fermented sausage, whereas Penicillium and Cladosporium were most important for liver pâté. In total Sixteen Penicillium species were identified. Sorensen et al concluded that Penicillium species are the most important contaminants of the meat products because of their high prevalence in the production environment, their presence on meat products and their toxinogenic properties (2).
Occupational respiratory diseases due to prolonged or repeated exposure to organic dust containing moulds (rhino conjunctivitis, asthma, hypersensitivity pneumonitis, and organic dust toxic syndrome) among food industry workers is well documented but food allergy to mould proteins is rare, with very few reports in the literature – two examples are given below:
Morriset et al, in 203, presented two cases of recurrent angioedema after eating dry fermented sausages. These type of sausages are coated with various Penicillium strains and testing showed positive reactions in both cases to Penicillium (3).
Bobolea et al, in 2009, presented the case of a 24-year-old man diagnosed with rhino conjunctivitis and asthma due to allergy to pollens, mites, and moulds at the age of 9 years. In the past year he had experienced two episodes of facial angioedema immediately upon eating a few slices of dry sausage, which he had previously tolerated. The symptoms subsided in less than 6 hours. He had avoided the sausage since and tolerated all other types of meat products. A range of tests were carried out. Skin prick tests were positive for grass pollen, house dust mites, and molds (Alternaria alternata, Penicillium notatum, Mucor racemosus, and Pullularia, Stemphylium, Helminthosporum, and Fusarium spp.), and negative for all the food allergens tested. The prick-by-prick test was positive for the outer sausage skin and negative for the sausage meat.
The microbiologists isolated Penicillium and Mucor spp. in the sausage skin. A further test led to angioedema of the lips, tongue, and soft palate within 5 minutes. The diagnosis was facial angioedema after dry sausage ingestion due to IgE-mediated allergy to Penicillium and Mucor spp. The man was advised to avoid all products commonly contaminated with moulds such as dry fermented sausages, Spanish ham, foie gras, and French cheeses such as Roquefort and Camembert (4).
If you eat fermented cheese or sausages and have problems you have been unable to link with a specific food it may be worth arranging for allergy tests to moulds.
REFERENCES
1. López-Díaz TM, Santos JA, García- López ML, Otero A. Surface mycoflora of a Spanish fermented meat sausage and toxigenity of Penicillium isolates. Int J Food Microbiol. 2001;68:69-74.
2. Sorensen LM, Jacobsen T, Nielsen PV, Koch AG. Mycobiota in the processing areas of two different meat products. Int J Food Microbiol. 2008;124:58-64.
3. Morisset M, Parisot L, Kanny G, Moneret-Vautrin DA. Food allergy to moulds: two cases observed after dry fermented sausage ingestion. Allergy. 2003;58:1203-4.
4. I Bobolea, P Barranco, J Jurado-Palomo, M Pedrosa, S Quirce. Allergy to Dry Fermented Sausage. J Investig Allergol Clin Immunol 2009; Vol. 19(4): 324-335.
1. López-Díaz TM, Santos JA, García- López ML, Otero A. Surface mycoflora of a Spanish fermented meat sausage and toxigenity of Penicillium isolates. Int J Food Microbiol. 2001;68:69-74.
2. Sorensen LM, Jacobsen T, Nielsen PV, Koch AG. Mycobiota in the processing areas of two different meat products. Int J Food Microbiol. 2008;124:58-64.
3. Morisset M, Parisot L, Kanny G, Moneret-Vautrin DA. Food allergy to moulds: two cases observed after dry fermented sausage ingestion. Allergy. 2003;58:1203-4.
4. I Bobolea, P Barranco, J Jurado-Palomo, M Pedrosa, S Quirce. Allergy to Dry Fermented Sausage. J Investig Allergol Clin Immunol 2009; Vol. 19(4): 324-335.