🔘FOOD POISONING

 *Food  Poisoning* 

👉🏻 *Introduction* :-

Food - poisoning is an acute gastro-enteritis caused by the ingestion of the food or drink contaminated with either living bacteria or their toxins or inorganic chemical substances and poison delivered from the plant and animals

👉🏻 *Aetiology* :-

1- Poisoning due to bacterial & Toxic.

2- Poisoning due to vegetable origin

Mushrooms (Poisonous) Lathyrus sativa (Khesari dal)etc.

3- Poisoning due to Animal origin.

4- Chemical: Accidentally or intentionally added poisonous

chemical products 

on radio nucleotide.

👉🏻 *Food Poisoning is* *Characterised by-* 

1- Simultaneous illness of many persons at the same time.

2- History of common food intake by all patient.

3- Common signs & symptoms in all patient.

👉🏻 *Bacterial Food* *poisoning* :-

Bacterial Food

poisoning is of

three types

 1- Infection type

2- Toxic type

3- Botulish

👉🏻 *Infection type* 

Infection type of food poisoning result from ingestion of microorganism that multiply in the gastrointestinal tract.

e.g. Salmonella & Shigella group.

👉🏻 *Signs & Symptoms:-* 

1- Nausea

2- Vomiting

3- Abdominal pain

mucus

4- Watery diarrhoea stained with blood or

Diarrhea vs Dysentery

5-Muscular weakness

6-Fever

👉🏻 *Toxic type :-* 

Toxic type of food poisoning occurs by a strain of organism that produce enterotoxin, e.g. Staphylococci, proteus vulgaris,

Streptococcus viridians,Clostridium welchii etc.

Food such as milk, custard, egg & previously prepared meat dishes are the chief sources.

👉🏻 *Sign and symptoms :-* 

1- Salivation.

2- Acute gastroenteritis.

👉🏻 *Treatment* 

1- Gastric lavage

2- Liquid paraffin 15-30ml/day,

3- Lactulose 15ml/day

4- Glucose saline infusion to eliminate toxics from the system.

5- Antibiotics are given depending upon causative organism.

e.g. Salmonella group-Chloramphenicol 1-3gm daily four divided doses.

5- The rest of the treatment is symptomatic.

👉🏻 *Post-mortem* *appearances* :-

1- the mucosa of the alimentary canal is inflamed,congested & ulcerated.

2- Fatty degeneration of liver.

3- Internal organs may be congested.

4- the causative organism can be isolated from the blood viscera.

👉🏻 *Botulism* :-

Botulism type of food poisoning is caused by the ingestion of exotoxins of the clostridium botulinum contained in the

undercooked food, potted meats, tinned fish, canned acidic, vegetables & fruits etc.

Action: the toxic inhibits acetylcholine & paralyses the muscles by blocking the nerve impulse at the myoneural junction.

👉🏻  *Signs & Symptoms* :-

Dry throat

Difficulty in swallowing & speech

Diplopia

Constipation

Hypothermia

Respiratory insufficiency.

Urinary Retention

The patient is conscious till death

The gastrointestinal symptoms like nausea, vomiting, abdominal pain are rare in

botulism type of poisoning.

Diagnosis : Diagnosis of botulism can be made by the isolation of

the bacillus from food patients vomit, faeces or viscera.

*Fatal dose :* 5gm or even less.

 *Fatal period :* 24-48 hours.

 👉🏻 *Treatment* :-

1- Gastric lavage

2- Polyvalent botulism antitoxic (type A,B & E) one vial by slow 1.V.

in normal saline one vial I.M.

 It should be repeated at 2-4 hours

intervals I.V.

3- 50ml Botulism immune globulin (BIG) 1.V. daily. Till the patient

recovers.

4- Liquid paraffin 15-30ml/day, Lactulose 15ml/day.

5- maintain fluid

6- Artificial respiration. If needed.

👉🏻 *Post-mortem* *appearances* :-

1- Congestion & hemorrhage in kidney, liver & meninges

2- Degenerative changes in the liver & kidneys.

3-Histological examination of the organs may show thrombosis.

4- The causative organism can be isolated from viscera.

The golden rules for prevention of food

poisoning

1-Choose foods processed for safety.

2-Cook food thoroughly.

3-Eat cooked food immediately.

4-Store cooked food carefully.

5- Reheat cooked food thoroughly.

6-Avoid contact between

cooked and raw food.

7-Wash hands repeatedly

using lots of friction.

8-Keep all kitchen surfaces

always clean. Wash dishes

and cutting board after

contact with raw meat or

eggs.

9- protect foods from

insects, rodents and

other animals.

10-use safe water.