Assessment and managment of Food poisoning.pptx

This is prepared for nursing students

1. Food poisoning

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

6. Clinical Manifestation ƒ Sudden onset of vomiting and watery diarrhea ƒFever and abdominal cramp ƒThe intensity of illness may require hospitalization. Diagnosis ƒ 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 ƒCulture –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 ƒStool, culture

7. Treatment Fluid and electrolyte replacement if fluid loss is significant particularly in severe cases Abx of choice cipro IV OR cefax & metro iv

8. 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.

9. Mode of transmission -Food ingestion in which preformed toxin is found. IP -12-36 hours, sometimes several days, after eating contaminated food.

10. Clinical Manifestations ƒIllness varies from a mild condition to very severe disease that can result in death within 24 hours. ƒSymmetric descending paralysis is characteristic and can lead to respiratory failure and death. ƒCranial 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. ƒNausea, vomiting, abdominal pain may proceed or follow the onset of paralysis. ƒDizziness, blurred vision, dry mouth, and occasionally sore throat are common.

11. Clinical Manifestations ƒ No fever ƒ Ptosis is frequent. ƒPapillary 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. ƒParalytic illus, severe constipation and urinary retention are common.

12. DX Appropriate History. ƒDemonstration of organisms or its toxin in vomitus , gastric fluid or stool is strongly suggestive of the diagnosis ƒWound 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.

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