Food intoxication (пищевые токсикоинфекции, تسمم الطعام )

Food intoxication (пищевые токсикоинфекции, Food poisoning, foodborne infections, foodborne disease, تسمم الطعام) is an acute infectious disease caused by consuming contaminated food or water containing pathogenic microorganisms (bacteria, parasites, viruses) or harmful chemical substances, it is characterized by signs and symptoms ranging from mild to severe such as abdominal pain, abdominal cramps, nausea, vomiting, headache, excessive sweating, palpitation, decreased urine output, perspiration, diffuse cold skin, and diarrhea.

Foodborne disease is often caused by bacteria and their toxins (endotoxins and exotoxins). Less commonly, Food poisoning can be caused by parasites, viruses, or harmful chemicals. The most common pathogens that cause foodborne illness in the United States and Great Britain are: Escherichia coli, Salmonella, Clostridium perfringens, Campylobacter, Klebsiella, Proteus, Enterobacter, serratsii, Streptococcus, and Staphylococcus aureus.

Classification

1. Gastric form (gastric flu or stomach flu)
2. Gastroenteric form (Gastroenteritis)

Pathogens – Conditionally pathogenic flora: Staphylococcus, Clostridium, Klebsiella, Proteus, Enterobacter, serratsii, citrobacteria, Streptococcus and others.

Epidemiology

Source of infection – infected person, bacterial carrier, infected animals.

Transmission

Foodborne disease is transmitted by ingestion of pathogenic microorganisms, microbial toxins or harmful chemicals (pesticides) through contaminated food or water or when contaminated fecal particles from an infected host are somehow ingested by another host (fecal oral route).

Here is a list of the top toxic ingredients to avoid: Artificial trans fats, Sodium Benzoate, Potassium Benzoate, butylated hydroxyanisole (bha), butylated hydroxytoluene (bht), sodium nitrates, sodium nitrites, artificial colours, monosodium glutamate, etc.

Clinical picture

Duration of symptoms and clinical manifestations is relatively shorter than with salmonellosis.

Incubation period ranges from few hours to 2 days, it is characterized by an acute onset of less severe clinical symptoms with rapid regression of symptoms.

Common symptoms include:

Intoxication syndrome expressed moderately, symptoms usually develop suddenly and progresses quickly. Patients often present with subfebrile fever, headache, sweating, palpitation and diffuse cold skin. In most cases, the body temperature rises up to subfebrile levels (less than or equal to 38°C ).

Gastrointestinal syndrome:

More than 90% of patients with food poisoning suffer of gastrointestinal symptoms ranging from mild to severe. Patients often present with manifestations of early-onset food poisoning such as abdominal pain and cramps, tenesmus, nausea, vomiting, moderate to severe diarrhea having more than 5 loose stools within 12 hours, the passing of dark brown, watery and foul-smelling stool.

Complications

• Dehydration

Lab diagnostics – not indicated

Treatment

Most patients recover within a few hours; however, in most cases, the recovery period ranges from a few hours to a few days (at max 2-3 days), without having to take drugs or medications.

Classical treatment

Pathogenic:

Rehydration therapy

Enteral rehydration by the nasogastric route is an effective treatment for children with gastroenteritis, Children who received enteral rehydration solutions containing glucose, nutrients and electrolytes had significantly briefer stays in hospitals. by introducing solutions like – “Peroral”, “Оралит”, “Regidron”, “Глюкосолан”, “Цитроглюкосолан”.

Oral rehydration therapy (ORT) is another treatment option commonly used to treat dehydration especially due to diarrhea. It is the most effective and least expensive treatment for acute gastroenteritis (severe diarrhea). Drink lots of fluids (breastmilk, formula milk and water) with the use of Oral Rehydration Salts or Oral Rehydration Solutions (ORS) that contain the right mix of sugar, salt, potassium and other minerals to help replace lost fluids after diarrhea.

In severe dehydration, when adequate oral fluid intake (oral rehydration) is not feasible due to vomiting, prompt intravenous rehydration (cholera replacement fluid 5 4 1 or Ringer’s lactate solution) is usually started; however, it is vital to monitor patients who are receiving IV rehydration hourly. ORS solution can be administered via nasogastric tube if intravenous therapy is not possible at the treatment facility.

Symptomatic treatment to treat symptoms of foodborne illness: typical symptomatic drugs include:

• Antispasmodics (Benadryl, Anafranil, etc.) which help reduce abdominal pain by inhibiting the action of acetylcholine and stopping the transmission of parasympathetic nerve impulses,
• Drugs acting as enzymes
• Probiotics

Etiotropic therapy is used to treat generalized form of foodborne disease, typical Etiotropic drugs include: chloramphenicol, ampicillin, and others.

Verified by: Dr.Diab (January 7, 2017)

Citation: Dr.Diab. (January 7, 2017). Food intoxication. Medcoi Journal of Medicine, 6(2). urn:medcoi:article15875.