*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.
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