Food poisoning is a common, usually mild, but sometimes deadly illness. Typical symptoms include nausea, vomiting, abdominal cramping, and diarrhoea that come on suddenly (within 48 hours) of consuming a contaminated food or drink. Depending on the contaminant, fever and chills, bloody stools, dehydration, and nervous system damage may follow. These symptoms may affect one person or a group of people who ate the same thing (this would be called an outbreak).
The Centres for Disease Control and Prevention estimates that in the United States alone, food poisoning causes about 76 million illnesses, 325,000 hospitalisations and up to 5,000 deaths each year. One of the most common bacterial forms of infection, the salmonellae organisms, account for one billion dollars in medical costs and lost work time.
Worldwide, diarrhoeal illnesses are among the leading causes of death.
Food poisoning causes
More than 200 known diseases can be transmitted through food. Those are just the ones we know about. The CDC estimates unknown or undiscovered agents cause 81% of all food-borne illnesses and related hospitalisations. Many cases of food poisoning are not reported because people suffer mild symptoms and recover quickly. Also, doctors do not test for a cause in every suspected case because it does not change the treatment or the outcome.
The known causes of food poisoning can be divided into two categories: infective agents and toxic agents.
Infective agents include viruses, bacteria, and parasites.
Toxic agents include poisonous mushrooms, improperly prepared exotic foods (such as barracuda), or pesticides on fruits and vegetables.
Food usually becomes contaminated from poor sanitation or preparation. Food handlers who do not wash their hands after using the bathroom or have infections themselves often cause contamination. Improperly packaged food stored at the wrong temperature also promotes contamination.
Food poisoning symptoms
Symptoms of food poisoning depend on the type of contaminant and the amount eaten. The symptoms can develop rapidly, within 30 minutes, or slowly, worsening over days to weeks. Most of the common contaminants cause nausea, vomiting, diarrhoea, and abdominal cramping. Usually food poisoning is not serious, and the illness runs its course in 24-48 hours.
Viruses account for most food poisoning cases where a specific contaminant is found. Toxic agents are the least common cause of food poisoning. Illness is often an isolated episode caused by poor food preparation or selection (such as picking wild mushrooms).
When to seek medical care
Contact your doctor if any of the following situations occur:
Nausea, vomiting, or diarrhoea lasts for more than two days; the ill person is younger than three years; the abdominal symptoms are associated with a low-grade fever; symptoms begin after recent foreign travel; other family members or friends who ate the same thing are also sick; you cannot keep any liquids down; you do not improve within two days even though you are drinking large amounts of fluids; you have a disease or illness that weakens your immune system (for example, HIV/AIDS, cancer and undergoing chemotherapy, kidney disease); you cannot take your normal prescribed medications because of vomiting; you have any nervous system symptoms such as slurred speech, muscle weakness, double vision, or difficulty swallowing.
Go to the nearest hospital‘s emergency department if any of the following situations occur:
You pass out or collapse, become dizzy, light-headed, or have problems with your vision; a fever higher than 101°F occurs with the abdominal symptoms; sharp or cramping pains do not go away after 10-15 minutes; your stomach or abdomen swells; the skin and/or eyes turn yellow; you are vomiting blood or having bloody bowel movements; you stop urinating, have decreased urination, or have urine that is dark in colour; you develop problems with breathing, speaking, or swallowing; one or more joints swell or a rash breaks out on your skin; the ill person or caretaker considers the situation to be an emergency.
Exams and tests
If you visit a doctor or a hospital emergency department because you think you may have food poisoning, a thorough examination will be performed; including measurements of blood pressure, pulse, breathing rate, and temperature will be done. The doctor will perform a physical exam, which screens for outward signs and symptoms of your illness. They will assess how dehydrated you are and examine your abdominal area to make sure your illness is not serious.
The doctor may need to do a rectal examination. The doctor performs this test by inserting a lubricated and gloved finger gently into your rectum. The purpose is to make sure there are no breaks in your rectal wall. A sample of your stool is taken and tested for blood and mucus. In some cases, a sample of stool or vomit can be sent to the laboratory for further testing to find out which toxin caused the illness. In a majority of cases, a specific cause is not found.
A urine sample helps assess how dehydrated you are and indicates possible kidney damage.
Blood tests may be performed to determine the seriousness of your illness. An x-ray of the abdomen or a CT scan may be taken if the doctor suspects your symptoms may be caused by another illness.
Food poisoning treatment: Self-care at home
Short episodes of vomiting and small amounts of diarrhoea lasting less than 24 hours can usually be cared for at home.
Do not eat solid food while nauseous or vomiting but drink plenty of fluids.
Small, frequent sips of clear liquids (those you can see through) are the best way to stay hydrated.
Avoid alcoholic, caffeinated, or sugary drinks, if possible. Over-the-counter rehydration products made for children such as Pedialyte and Rehydralyte are expensive but good to use if available.
Sports drinks such as Gatorade and Powerade are fine for adults if they are diluted with water because at full strength they contain too much sugar, which can worsen diarrhoea.
After successfully tolerating fluids, eating should begin slowly, when nausea and vomiting have stopped. Plain foods that are easy on the stomach should be started in small amounts. Consider eating rice, wheat, breads, potatoes, cereals (low-sugar cereals), lean meats, and chicken (not fried) to start. Milk can be given safely, although some people may experience additional stomach upset due to lactose intolerance.
Most food poisonings do not require the use of over-the-counter medicines to stop diarrhoea, but they are generally safe if used as directed. It is not recommended that these medications be given to children. If there is a question or concern, you should always check with your doctor.
Medical treatment
The main treatment for food poisoning is putting fluids back in the body (the process of rehydration) through an IV and by drinking. You may need to be admitted to the hospital. This depends on the severity of the dehydration, your response to therapy, and your ability to drink fluids without vomiting. Children, in particular, may need close observation.
Anti-vomiting and diarrhoea medications may be given.
The doctor may also treat any fever to make you more comfortable.
Antibiotics are rarely needed for food poisoning. In some cases, antibiotics would worsen the condition. Only a few specific causes of food poisoning are improved by using these medications. The length of illness with traveler‘s diarrhea (shigellae) can be decreased with antibiotics, but this specific illness usually runs its course and improves without treatment.
With mushroom poisoning or eating foods contaminated with pesticides, aggressive treatment may include pumping the stomach (lavage) or giving medications as antidotes. These poisonings are very serious and may require intensive care in the hospital.
Prevention
Safe steps in food handling, cooking, and storage are essential to avoiding food-borne illness. You cannot see, smell, or taste bacteria, which may be on any food.
Follow these food safety guidelines to keep contaminants away.
Safe shopping; buy cold foods last during your shopping trip. Get them home fast; never choose torn or leaking packages; do not buy foods past their ‘sell-by‘ or expiration dates; keep raw meat and poultry separate from other foods; place refrigerated or frozen items in the shopping cart last, right before heading for the checkout counter; unload perishable foods first and immediately refrigerate them. Place raw meat, poultry, or fish in the coldest section of your refrigerator; check the temperature of your appliances. To slow bacterial growth, the refrigerator should be at 40°F, the freezer at 0°F; cook or freeze fresh poultry, fish, ground meats, and variety meats within two days; keep everything clean!; wash hands before and after handling raw meat and poultry; sanitise cutting boards often in a solution of one teaspoon chlorine bleach in one quart of water; do not cross-contaminate. Keep raw meat, poultry, fish, and their juices away from other food. After cutting raw meats, wash hands, cutting board, knife, and counter tops with hot, soapy water; make sure thawing juices do not drip on other foods; never leave food out more than two hours (or more than 1 hour in temperatures above 90°F); use cooked leftovers within four days.
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