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Food Poisoning


What is food poisoning?

Food poisoning is a general term that refers to gastrointestinal illnesses (usually diarrhea and/or vomiting) caused by food that is contaminated with:
bacteria,
parasites,
viruses, or
toxic substances.

The actual cause of most individual episodes of food poisoning, however, never is pursued (for example, a culture is not done) since most episodes are mild or moderate in severity and are over in a few hours to a few days. In fact, the diagnosis of food poisoning usually is made only presumptively, based on the affected individual's symptoms and the circumstances. Even in outbreaks of suspected food poisoning that involve many people, when careful studies are done, a specific cause is found no more than half of the time.

What are the types of food poisoning?

Most frequently, food poisoning may be due to infection caused by bacteria, viruses, parasites, and infrequently, prions (transmissible agents that induce abnormal folding of brain protein as in the case of Mad Cow disease).

More than 200 infectious causes exist. Sometimes it is not the bacteria that causes the problem but the toxin that bacteria produce in the food before it is eaten. This is the case with Staphylococcal food poisoning and with botulism.

Other illnesses may involve chemical toxins that are produced in certain foods that are poorly cooked or stored. For example, scombroid poisoning occurs due to a large release of histamine chemical from the fish when it is eaten. It causes facial swelling, itching, and difficulty breathing and swallowing - just like an allergic reaction. Scombroid poisoning is sometimes confused with a shellfish allergy.

How Food Poisoning Occurs

Presence of bacteria in the water.
The raw materials for the food may contain toxins.
Premises where the food is prepared may contain micro organisms or toxins.
Food handlers may have some infectious diseases
Some animals like dogs, rats may contaminate the food.
If prepared food is kept in the room temperature for a long time and heated again can make a chance for food poisoning.

What are the signs and symptoms of food poisoning?

Food poisoning most commonly causes:

abdominal cramps,
nausea or vomiting and
Diarrhea.

This can cause significant amounts of fluid loss and with nausea and vomiting; it may be difficult to replace that fluid, leading to dehydration. In developing countries where infectious epidemics cause diarrheal illnesses, thousands of people die because of dehydration.

As noted in the section above, other organ systems may be infected and affected by food poisoning. Symptoms will depend upon what organ system is involved.

Are food poisoning and stomach flu the same thing?

They may or may not be, depending if the causative agent is transmitted by contaminated food, or if the agent is transmitted by non-food mechanisms such as body secretions. Most health care practitioners equate stomach flu to viral gastroenteritis (gastro=stomach + entero= intestine + itis= inflammation). Stomach flu is a non specific term that describes an illness that usually resolves within 24 hours and is caused commonly by the adenovirus, Norwalk virus or rotavirus, most commonly found in children.

If numerous cases of "stomach flu" occur in a situation where many people have been eating, it certainly may be considered food poisoning. Norwalk virus is responsible for many cases of food borne illness outbreaks on cruise ships.

When should the doctor be called for food poisoning?

With a clear fluid diet and rest, most infections resolve on their own within 24 hours. A health care practitioner should be contacted if the vomiting and diarrhea are associated with one or more of the following symptoms:

fever,
blood in the stools,
signs of dehydration including lightheadedness when standing, weakness, decreased urination,
diarrhea that lasts longer than 72 hours, and/or
Intractable vomiting that prevents oral hydration.

How is food poisoning diagnosed?

Most times, the diagnosis of food poisoning is made by history and physical examination. Often, the patient volunteers the diagnosis when they come for medical care. For example, "I got sick after eating potato salad at a picnic" or "I drank a raw egg protein shake".

Travel history may be helpful to see if the patient had been camping near a stream or lake and the potential for drinking contaminated water, or if they have travelled out of the Country recently and have eaten different foods than they normally do.

Routine blood tests are not usually ordered unless there is concern about something more than the vomiting and diarrhea. In patients with significant dehydration, the health care practitioner may want to check electrolyte levels in the blood as well as kidney function.

How is food poisoning diagnosed?

Most times, the diagnosis of food poisoning is made by history and physical examination. Often, the patient volunteers the diagnosis when they come for medical care. For example, "I got sick after eating potato salad at a picnic" or "I drank a raw egg protein shake".

Travel history may be helpful to see if the patient had been camping near a stream or lake and the potential for drinking contaminated water, or if they have travelled out of the Country recently and have eaten different foods than they normally do.

Routine blood tests are not usually ordered unless there is concern about something more than the vomiting and diarrhea. In patients with significant dehydration, the health care practitioner may want to check electrolyte levels in the blood as well as kidney function.

What is the treatment for food poisoning?

Maintaining good hydration is the first priority when treating food poisoning. Hospitalization may be appropriate if the patient is dehydrated or if they have other underlying medical conditions that become unstable because of the fluid or electrolyte imbalance in their body.
Medications may be prescribed to help control nausea and vomiting. Medications to decrease the frequency of diarrhea may be indicated but if food poisoning is suspected, it is best to consult with the health care practitioner before taking OTC medications such as loperamide (Imodium), because it may cause further problems for the patient.
Except for specific infections, antibiotics are not indicated in the treatment of most bacterial and viral food poisoning.

Are there any home remedies for food poisoning?

The key to home care is being able to keep the affected person hydrated. Oral rehydration therapy with water or a balanced electrolyte solution such as Electral or ORS is usually adequate to replenish the body with fluids. A person can lose a significant amount of fluid with each diarrheal bowel movement, and that fluid has to be replaced to rehydrate. Patients that show any signs of dehydration such as decreased urination, dizziness, or dry mucous membranes, especially in the young or elderly, should see a health care practitioner.

How long does food poisoning last?

Most cases of food poisoning last about 1 to 2 days and symptoms resolve on their own. If symptoms persist for longer than that, the affected person should contact their health care practitioner.

How can food poisoning be prevented?

Prevention of food borne illness begins at home with good food preparation technique.

Foods should be cooked thoroughly. This especially applies to eggs, poultry, and meat. A meat thermometer can be used to measure the internal temperature of a meat dish.
Leftovers should be refrigerated immediately so that bacteria and viruses do not have time to start growing.
Wash fruits and vegetables well before eating. This removes dirt, pesticides, chemicals, or other infectious agents used on, or exposed to, the foods in the fields or storage facilities.
Wash hands routinely before and after handling food will help prevent the spread of infection.
Clean counters and other areas that are used to clean, prepare, and assemble foods thoroughly. Cross contamination of food is common and can cause food poisonings. For example, a cutting board and knife used to cut raw chicken should be washed thoroughly before cutting up fruit and vegetables to prevent the spread of Salmonella.
In restaurants, meals are prepared by others; health inspectors check restaurants routinely and their reports on sanitary practices are usually available online. Make certain that the food ordered is thoroughly cooked, especially meats such hamburger.