2. chemical contaminants (heavy metals and
organic compounds)
bacterial growth in the food before
consumption (staphylococcus aureus and
botulism) and a food-borne infection
(salmonellosis).
3. Staphylococcal Food Poisoning (intoxication)
Definition
An intoxication (not infection) of abrupt and
sometimes violent onset.
Infectious agent (Toxic agent)
Several enterotoxins of staphylococcus aureus,
stable at boiling temperature. Staphylococci
multiply in food and produce the toxins.
4. Mode of transmission-
By ingestion of a food product containing
staphylococcal enterotoxin.
Foods involved are particularly those that come in
contact with food handlers hands, either without
subsequent cooking or with inadequate heating or
refrigeration, (e.g. salad, sandwiches, sliced meat
and meat products, pastries, etc.).
Incubation period-
30 minutes to 8 hours, usually 2-4 hours
5. Salmonellosis
Definition
A bacterial disease commonly manifested by an acute enterocolitis.
Infectious agent
Salmonella typhimurium and Salmonella enteritidis are the two most
commonly reported.
Mode of transmission:-
ingestion of organisms in food derived from infected food animals or
contaminated by feces of an infected animal or person.
Raw and under-cooked eggs and egg products, raw milk and its
products, contaminated water, meat and its products, poultry and its
products.
Consumption of raw fruits and vegetables contaminated during slicing.
Incubation period from 6 72 hours, usually about 12-36 hours
7. Clinical Manifestation
影
Sudden onset of vomiting and watery diarrhea
Fever and abdominal cramp
The intensity of illness may require hospitalization.
Diagnosis
影
Group of cases with characteristic acute predominantly
upper gastrointestinal symptoms and the short interval between
eating a common food item and the onset of symptoms.
CBC- leukocytes
Culture staphylococcal recovery (10 5 )organisms per gram of food)
or detection of enterotoxin from an epidemiologically implicated food
item confirms the diagnosis.
Blood culture initially
Stool, culture
8. Treatment
Fluid and electrolyte replacement if fluid loss
is significant particularly in severe cases
Abx of choice cipro IV OR cefax & metro iv
9. Botulism
Definition
A paralytic disease that begins with cranial nerve
involvement and progresses caudally to involve the
extremities.
Infectious agent (Toxic agent)
Toxin produced by Clostridium botulinum (Neurotoxin)
Occurrence- Worldwide occurrence. Home-canned
foods,
particularly vegetables, fruits and less commonly with
meat and fish.
10. Mode of transmission-Food ingestion in which
preformed toxin is found.
IP -12-36 hours, sometimes several days, after
eating contaminated food.
11. Clinical Manifestations
影
Illness varies from a mild condition to very severe
disease that can result in death within 24 hours.
影
Symmetric descending paralysis is characteristic
and can lead to respiratory failure and death.
影
Cranial nerve involvement marks the onset of
symptoms; usually produces diplopia, dysphagia.
Weakness progresses, often rapidly, from the head
to involve the neck, arms, thorax and legs; the
weakness is occasionally asymmetric.
影
Nausea, vomiting, abdominal pain may proceed or
follow the onset of paralysis.
影
Dizziness, blurred vision, dry mouth, and
occasionally sore throat are common.
12. Clinical Manifestations
影
No fever
影
Ptosis is frequent.
影
Papillary reflexes may be depressed: fixed or
dilated pupils are noted in half of patients.
The gag reflex may be suppressed; deep tendon
reflexes may be normal or decreased.
影
Paralytic illus, severe constipation and urinary
retention are common.
13. DX
Appropriate History.
Demonstration of organisms or its toxin in vomitus, gastric
fluid or stool is strongly suggestive of the diagnosis
Wound culture
RX
1. Hospitalize the patient and monitor closely.
3. Intubation and mechanical ventilation may be needed.
4. Antitoxin administration after hypersensitivity test to horse
serum.
5. Emesis and lavage if short time after ingestion of food to
decrease the toxin.