Download FOOD POISONING

FOOD POISONING
Food poisoning is an acute gastro - enteritis
caused by ingestion of food or drink
contaminated with either living bacteria or
their toxins or inorganic chemical substances
and poisons derived from plants and animals.
Clinical features:
*Abdominal pain
* Vomitting & or diarrhoea
* With or without fever
Epidemiological features:
Features of food poisoning outbreaks:
* Sudden occurrences of an illness in a group of
people
* History of ingestion of common food
* Similar signs and symptoms
* Short incubation period
* Absence of secondary cases
Causes of food poisoning
Non bacterial
1. Mushroom
poisoning
2. Chemical
poisoning
Bacterial
1. Salmonella
2. Clostridium
3. Staphylococcus
4. Bacillus cereus
5. Botulism
Mushroom poisoning:
Causes: Eating fungi like Amanita phylloides instead of
edible mushroom or eating sprouting potatoes which
contains excess of alkaloid Solanine.
Symptoms: Abd. Pain, vomitting, diarrhoea, sweating,
miosis, diplopia, muscular incoordination, convulsion,
coma.
Antidote: Atropine.
Chemical poisoning:
* Contaminated by fertilizers, pesticides (agricultural /
industrial).
* Food contaminated @ metallic poisons due to faulty cooking.
* Contamination from storage such as use of cheap enamel
dishes or galvanized pans.
Salmonella Food Poisoning:
Inflammatory diarrhoea
Causative
agent
Salmonella
Reservoir
Source /
Food
Poultry, Pigs, Milk & milk
*typhimurium Rats & mice, products, egg,
pork, poultry,
* enteritidis
* cholera-suis Temporary
contaminated
* gallinorum human
carrier
meat,
contaminated
with rat urine,
human carrier
I. P.
12 –
24
hours
Clinical
features
D,V, AP, F
Clostridium Food Poisoning:
Causative
Reservoir
agent
* 5 strains of * Dust &
Cl. welchii
soil, faeces
– reservoir
of spores
* Type C
severe form
(enteritis
necroticans)
Source /
Food
*Reheated
stale cooked
food – meat,
fish, poultry.
* Prior to
ingestion
spores
germinate.
I. P.
Clinical
features
6 – 24
*D
hours
(explosive)
(peak 10 – , AP, V
14 hours)
* No fever
Staphyllococcal Food Poisoning:
Causative
agent
Reservoir
* Staph
aureus
* Enterotoxin
(heat stable)
& resist
boiling for 30
mins
* Preformed
intradietetic
toxin
Animal:
Mastitis of cow
Source /
Food
Milk & milk
products
Salads
Human: Boils & Custards
pyogenic skin
Ice-cream
lesions, nasal & Curd
throat carriers.
I. P.
Clinical
features
1 – 6 * V, D,AP
hours
* In
severe
cases –
blood &
mucus
* No
fever
Bacillus cereus Food Poisoning:
Causative
agent
* Gram
positive
Aerobic
* Spore
forming motile
bacilli
* Produces 2
distinct
enterotoxin –
emetic form &
enteric form
Reservoir Source /
Food
Food
* Cereal
grains –
based diet,
mainly
Contaminat
cereals
ed fried rice
- emetic
* Soup,
sauce enteric
I. P.
Clinical
features
* Emetic * V form: 1-6 emetic
hrs
* D, AP * Enteric enteric
form: 1224 hrs
Botulinum Food Poisoning:
Causative agent
Reservoir Source / Food
* Clostridium
botulinum
* Strictly
anaerobic
* Blocks release
of acetyl choline
by exotoxin
* Type A, B, E
(preformed toxin)
– intradietetic
Dust &
soil,
intestinal
tract of
animals
& enters
food as
spores
I. P.
Canned food,
12 –
smoked fish,
36
pickled fish,
hrs
tinned
vegetable food,
home made
cheese etc. (low
acid food)
Clinical
features
Diplopia,
blurring
vision,
paralysis,
ptosis,
dysarthria,
muscle
weakness,
Constipation
No F, GIslight
Condition very fatal; death 4 – 8 days, due to resp / cardiac failure
Guanidine hydrochloride - to reverse neuromuscular blockade.
Vibrio parahemolyticus Food Poisoning:
Causative Reservoir Source /
agent
Food
* Gram
negative
* nonagglutinati
ng group
I. P.
Clinical
features
Sea food
Improperly 12 - 18 D (blood
like shell
cooked sea hrs
mucus),
fish, crabs, foods
AP, V, F
lobsters
Campylobacter food poisoning:
Causative Reservoir Source /
agent
Food
C. Jejuni
(most
common),
C. coli,
C. Laridis
Poultry,
raw milk.
I. P.
Poultry, raw 3 to 5
milk,
Days
raw meat and
mushrooms
Clinical
features
V, D
(bloody),
AP, F
* They are known to cause epidemics of food poisoning in
nurseries, paediatric wards, and communities in developing
countries.
* Disease is usually self - limiting with complete recovery in 5 7 days.
E coli O157 food poisoning:
Causative
agent
Reservoir
Source /
Food
I. P.
Clinical
features
E. coli O157 : Mud, beef,
Beef, raw
3 to 4 D
H7 – most
raw milk, raw milk, raw
Days (bloody),
common
apple juice
apple juice
AP
form of all
EHEC
* While most food poisoning events are short lived and
resolve spontaneously, 2 - 7% of individuals develop
Haemolytic uraemic syndrome about a week after onset
of diarrhoea
Prevention and Control of Food Poisoning
* To Eat Freshly cooked and hot food
* Strict supervision on the whole cycle of meat
processing
* Milk should be pasteurized or boiled
* Protection of Foods:
- In storage & processing
- Food items should not be left overnight in warm
pantries
- Not eaten items should be kept immediately in cold
storage to prevent bacterial multiplication and toxin
production
* Food Handlers:
- Periodical examination
- Suffering from boils, ulcers throat or eye
infections – Not allowed
- Suffered from enteric fever or diarrhoea in recent
past – Not allowed
- Personal hygiene & clean habit.
* Environmental care:
- Clean & dry kitchen & dining hall
- Utensils & equipment: wash @ soap & hot water
- Rodent & insect control
- Periodic surveillance of food establishments
Investigation of food poisoning:
* Verification of diagnosis – clinical & laboratory
* Confirmation of existence of an epidemic
* Collection of data: location, place, no. of people
affected
* Secure complete list: Nature of food eaten in last
few days, time of onset, symptoms, personal
data (age, occupation etc.), no. of deaths.
* Assessment of environmental factors: kitchen,
dining hall & their sanitations, storage of food
grains & cooked food, presence of rodents.
* Interrogation & examination of food handlers,
hygiene, habits
* Lab report: Vomitus, stool of patients for culture,
sample of suspected food, serological test of
blood for antibody titre, urine & stool culture of
food handlers & kitchen employees.
* Data analysis, * Formulation of etiolo…. Testing
……* Report writing.