Food Poisoning

Introduction

Food poisoning is illness that occurs when contaminated food or water is consumed. They might be
contaminated by either bacteria, toxins, viruses, or parasites.
First occurring symptoms vary in degree and severity, including vomiting, headache, diarrhea and
stomach cramps accompanied by abdominal pain. They can be more severe leading to syndromes
(neurological, renal & hepatic) which can be life-threatening if not treated quickly.
Food poisoning can occur cause of a food-borne disease outbreak due to evidence of food as the main
source and usually occurring in at least two patients with similar illness and gastrointestinal problems.
Around 76 million people suffer from food poisoning yearly. The highest numbers occur during summer
cause food that are not well reserved in cold refrigerators may be a main cause of the food-borne
disease, since it is vital to keep bacteria from growing.
Most of the illnesses and complications caused by food poisoning are mild and usually improve without
applying any specific treatments or therapies, however, some patients get severe diseases from food
poisoning and require hospitalization, hydration, and antibiotic medications.

Symptoms and Sign in Details

As Mentioned above, the typical symptoms of food poisoning are nausea, diahrrea, vomitting,
abdominal pain. Those symptoms may be accompanied with heart aches, muscle aches and notable
elevation of body temperature (fever). They generally start 4 - 36 hours after eating contaminated food

Additional specific signs can occur due to specific types of bacteria or parasites:

● Blurred vision, sensitivity to sunlight or any exposure to light in general, double vision, difficulty
speaking and swallowing, overall weakness accompanied with paralysis that spreads downward,
respiratory failure and death are severe signs related to the bacterial food poisoning caused by
the microorganism C. botulinum.

● Severe fever with bloody diarrhea and chills are symptoms related to Salmonella spp., and
Shigella spp.

● Diarrhea with little stool and big amounts of blood, known as Hemorrhagic colitis occurring up
to 3 days after eating food contaminated by the microorganism E. Coli.
 ● Liver functioning, neurological system, or the gastrointestinal tract disrupted, including delirium
(confusion), heart muscle problems, vision complications, kidney failure and death are signs and
complications of untreated Mushroom poisoning.

● Numbness around the mouth, sensation of hot as cold and cold as hot (impaired touch
sensation), itching, low blood pressure causing a slow heart rate are signs of ingestions of some
toxin called Ciguatera such as the barracuda.

Pathophysiology

Diarrhea is among the main symptoms that occur in food poisoning. The pathogenesis of diarrhea is
classified into two types in food poisoning: noninflammatory and inflammatory.

Non-inflammatory diarrhea is that more common type caused by enterotoxins in the small intestine.
Enterotoxins are secreted by the the mucosa of the small intestine, when bacterial invasion occurs. This
leads to bigger amounts of watery stools, with no blood, pus, or severe abdominal pain. Dehydration
may result in a very short period of time. The enterotoxins may occur before ingestion or produced in
the gut after ingestion. Enterotoxic Escherichia coli, Bacillus cereus and Staphylococcus organisms are
examples.

Inflammatory diarrhea is the other type of diarrhea caused by cytotoxins in the small intestine. They
appear on the mucosa of the intestine wall leading to invasion and destruction. Besides, the colon is
involved as well. This leads to a severely bloody diarrhea with mucoid and leukocytes (WBC) lost with it.
Patients suffering from inflammatory diarrhea get fever and may appear toxic. Less dehydration occurs
than the non-inflammatory as the volumes of the stool are not as much. A +ve stool Lactoferrin Test
shows and indicates inflammation, while leukocytes found in the stools shows colitis.

In the staphylococci poisoning, besides other similar types of food poisoning, vomiting is caused by a
toxin that acts on the CNS. The acetylcholine, which is a neurotransmitter, is inhibited resulting in the
involuntary action associated by vomitting.

Who are the most susceptible to Food Poisoning?

Morbidity* and mortality** risks are much higher in older individuals (around 65 years old) than in
youth. As the individual ages, a notable decrease in immunity and production of gastric acid occurs.
Malnutrition, excessive use of antibiotics and lack of exercise are other secondary reasons as well. The
elder patients are more likely to die from infection with E. coli and Salmonella than young patient as an
example.

*Morbidity is the quality of something being unhealthy and threatening.

**Mortality is the state of being subject to death

Patients who have chronic diseases are more prone to Food Poisoning as well. Examples are chronic
kidney failure, liver disease, or diabetes patients. Those patients are most likely taking a great deal of
antibiotics, antihistamines and steroidal medications.
Patients with sickle cell anemia and with red blood cells in addition to pregnant women and people with
inherited weak immunity systems.

Physical Examination of Patients

● Testing hydration, how dry the mouth is, examining the amount of axillary sweat and urine
output indicate whether the patient has mild or severe dehydration. Some occurrence of
the previously mentioned items can indicate the presence of mild hydration. In addition to
orthostasis and hypotension which indicate severe volume depletion.

● A rectal examination is performed to directly visualize the stool, test blood existence in it, and
palpate the rectal mucosa for the occurance of any lesions.
 Three Types of Bacteria that Directly Cause Food Poisoning

1- E. Coli

Causes

The E. Coli bacteria usually occurs in contaminated impure water, improperly cooked hamburger
meat, raw unpasteurized milk, apple juice or cider. One can also get the infection working with cattle. It
can be spread from one person to another.

Symptoms and Complications

Usual symptoms include acute-onset watery diarrhea that starts from 1 to 2 days after ingestion of the
bacteria. Vomiting and abdominal cramps may be present as well. It can only last for1 or 2 days.

Complications are rare at most times. The most common complication is called “Hemolytic
Uremic Syndrome”. Susceptible patients get hemolytic anemia; which is a low red blood cell count,
thrombocytopenia; a low platelet count and renal failure. That syndrome occurs in infants than in
eldery. It begins to appear 5 to 10 days after the appearing of symptoms like diarrhea.

Treatment

Patients with Hymolytic Uremic Syndrome are the only kinds of patients that need critical medical
assistance for treatment of E. Coli, while normal ones only require supportive treatment. There is no
solution except drinking large amounts of water and watching for complications.
No medications should be taken for the treatment of this type of food poisoning or for constipation.
This medicine would keep the intestines from getting rid of the germ. If a patient is seriously
dehydrated, fluids are put into the veins with an IV.
2- Salmonella spp.

Causes

Salmonella spp. can occur in beef, poultry, eggs, and diary products. It is caused by invasion of the
intestine without any toxin production.

Symptoms and Complications

Quite gastroenteritic severe symptoms like the onset of moderate-to-large amount of diarrhea can
occur. Patients get fever and most likely bloody diarrhea as well. After 6 hours to 2 days of ingestion of
the contaminated food, vomitting and abdominal pain occurs. Mild fever and headache can also occur in
some cases. It can all last till 12 days after the appearance of the symptoms.
Serious complications may include septicaemia (blood poisoning).

Treatment

Antidiarrheals like loperamide (Imodium) relieve cramping, but may prolong the peroid of time
in which patient is susceptible to diarrhea associated with the infection.
Antibiotics may be used as well if there are any suspections that the bacteria has entered the
bloodstream.
3- Shigella spp

Causes

It can occur in raw potatoes, egg salad, lettuce, vegetables, milk, ice cream, and water. Those
bacterial organisms invade epithelial cells producing toxins.

Symptoms and Complications

Onset of bloody diarrhea, cramps and tenesmus. Fever may start in 12 to 30 hours after ingestion of
the germ. The symptoms are usually limited to 3 to 7 days.
Complcations include Polymorphonuclear leukocytes (PMNs) and blood & mucus in stool.

Treatment

Oral rehydration is a main method for treatment of the Shigella infection. Trimethoprim-
sulfamethoxazole (TMP-SMX) or ampicillin may be used for severe cases, too.