Food poisoning

Seminar

1. Basil Wilson

2. Definition : Food   poisoning  is a general term for health problems arising from eating contaminated food . Food toxicology deals with substances found in food that might be harmful to those who consume sufficient quantities of the food containing such substances.

3. Epidemiology Worldwide , food-borne diseases are a major health burden leading to high morbidity and mortality. Global burden of infectious diarrhoea involves 3-5 billion cases and nearly 1.8 million deaths annually, mainly in young children , caused by contaminated food and water. Two million deaths occur every year from contaminated food or drinking water

4. CLASSIFICATION OF FOOD-BORNE ILLNESSES 1. Food-borne infections - caused by consuming foods or liquids contaminated with bacteria, viruses, or parasites. These pathogens cause infection by: o Invading and multiplying in the lining of the intestines and/or other tissues o Invading and multiplying in the intestinal tract and releasing a toxin ( bacteria only) 2 . Food-borne intoxications - caused by consuming foods or beverages already contaminated with a toxin. Sources of toxins are as follows : o Certain bacteria (pre-formed toxins) o Poisonous chemicals o Natural toxins

5. Causes of Food Poisoning : Transmitted through food. U nknown agents causes 68% of all food borne illness and related hospitalisations . Many cases of food poisoning are not reported. M ain causes- 1) Infectious agents include viruses, bacteria and parasites. a. Viruses : Rotavirus, Hepatitis A virus b. Bacteria : Salmonella, V. cholerae , E.coli , Botulism

6. c. Parasites : Trichinella spiralis d. Protozoan : Entamoeba histolytica , Giardia lambli 2) Other toxic agents, which includes a). Chemicals: Pesticides , heavy metals, gasoline b). Plants : Mushrooms ( Amanita muscaria ) c). O thers : Puffer fish( Fugu rubripes ), Ciguatera 3) Poor sanitation and preparation. 4) Improper packing and storage

7. BACTERIA A rod-shaped, gram negative, non-motile bacteria, that does not form spores. S. enteritidis  are considered facilitative anaerobes. Salmonella enteriditis Incubation: 12- 36 hours Symptoms: abdominal cramps, headache, fever, nausea, diarrhea Foods: poultry, meat, eggs and egg products, sliced melons Sources: water, soil, insects, animals, and humans

8. BACTERIA A Gram-positive, rod-shaped C. botulinum  is an anaerobic spore-former, which produces oval, subterminal  endospores.  Produces several exotoxins. Clostridium botulinum Incubation: 4 hours to 8 days Symptoms: vomiting; constipation; difficulty with vision , speaking; paralysis, death Foods: baked potatoes, garlic/ oil mixtures, low-acid canned foods Sources: present on almost all foods, soil, water

9. BACTERIA E. Coli is a common kind of bacteria that lives in the intestines of animals and humans and most are harmless. The most dangerous strain of E. Coli is called 0157:H7 because it produces a very powerful poison in foods or drinks. Eating unwashed greens such as spinach, or green onions or undercooked beef can cause the infection. Escherichia coli Incubation: 3-4 days Symptoms: diarrhea, vomiting, mild fever Foods: undercooked ground beef, unpasteurized cider Source: Human and bovine intestinal tract

10. BACTERIA Clostridium perfringens  is a rod-shaped Gram-positive Has an optimal growing temperature of 37 C. Non-motile pathogen that produces endospore. Is a pathogen responsible for many gastrointestinal illnesses with severity ranging from mild enterotoxaemia to fatal gas gangrene. Clostridium perfringens Incubation: 10- 12 hours Symptoms: abdominal pain, nausea, diarrhea Fever, headache, vomiting usually absent Foods: Stews, gravies, beans Sources: soil, animal and human intestinal tracts

11. BACTERIA Found in the human respiratory tract and on the skin. It is a common cause of skin infections (e.g. boils), respiratory disease (e.g. sinusitis), and food poisoning. Often produce potent protein toxins, and expressing cell-surface proteins that bind and inactivate antibodies. Staphylococcus aureus Incubation: 1 to 7 hours Symptoms: nausea, retching, abdominal cramps, diarrhea Foods : reheated foods, dairy products, protein foods Source: skin, hair, nose, throat, infected sores, animals

12. BACTERIA A Gram-positive, rod-shaped, facultative anaerobes, beta hemolytic bacterium. Some strains are harmful to humans and cause food borne illness. Bacillus can produce protective endospores. Its virulence factors include cereolysin and phospholipase C. Bacillus cereus Incubation: 30 min. to 6 hours Symptoms: nausea, vomiting, watery diarrhea Foods: rice products, starchy foods, casseroles, puddings, soups Source: soil and dust, cereal crops

13. VIRUSES A form of viral hepatitis transmitted in food. HAV is present in the feces of infected persons and is most often transmitted through consumption of contaminated water or food. Hepatitis A Incubation: 10-50 days Symptoms: sudden fever, vomiting, jaundice Foods: water (ice), shellfish , fruit juices, vegetables Source: human intestinal/ urinary tracts

14. VIRUSES It is a genus of double-stranded RNA virus in the family Reoviridae . Is the most common cause of severe diarrhea among infants and young children. Rotavirus Incubation: 1-3 days Symptoms: vomiting, diarrhea, mild fever Foods: ready-to-eat, water and ice Sources: human intestinal tract, water

15. FUNGI Usually spoil foods, sometimes illness Sweet, acidic foods Some produce aflatoxins (peanuts) Gorgonzola, Brie, Camembert cheeses, mushrooms Molds

16. FUNGI Spoil food Produce CO 2 and alcohol Prefer sweet, acidic foods jellies, syrup, honey, fruit juice Yeasts

17. PARASITES A nematode parasite Responsible for the disease trichinosis. It is sometimes referred to as the "pork worm" due to it being found commonly in undercooked pork products. Trichinella spiralis Incubation: 2-28 days Symptoms: flu-like, swelling around eyes, extreme sweating, hemorrhaging Foods: undercooked pork Source: domestic pigs, bear, walrus

18. PROTOZOAN A flagellated protozoan parasite Colonizes and reproduces in the small intestine Causing giardiasis. Remains to the lumen of the small intestine. Anaerobes. Giardia lamblia Incubation: 3-25 days Symptoms: fatigue, nausea, gas, weight loss, abdominal cramps Foods: water, ice, raw vegetables Source: beavers, bears, dogs, cats, humans

19. Symptoms of Food Poisoning Abdominal Cramps Diarrhea (may be Bloody) Fever and Chills Headache Nausea and vomiting W eakness Dizziness Sweating Tearing of eyes Excessive Salivation Mental confusion Stomach pain Partial Loss of speech and vision Muscle weakness Dry mouth and difficulty in swallowing Muscle paralysis from head down to the body

20. The main objective is adequate rehydration and electrolyte supplementation. This can be achieved with either an oral rehydration solution (ORS) or intravenous solutions ( eg , isotonic sodium chloride solution, lactated Ringer solution). General Principles of Treatment Oral Rehydration Therapy Oral rehydration is achieved by administering clear liquids and sodium-containing and glucose-containing solutions. A simple ORS may be composed of 1 level teaspoon of salt and 4 heaping teaspoons of sugar added to 1 liter of water.

21. Non Specific Antidiarrhoeal Agents Botulinum antitoxin to neutralize toxins from  C. botulinum   ( only given within the first 72 hours ). Amitriptyline to control the numbness and tingling from ciguatera poisoning . Apomorphine or ipecac syrup to cause vomiting and help rid the body of toxins . Atropine for mushroom poisoning . Diphenhydramine and cimetidine for fish poisoning

22. Mannitol for nerve-related symptoms of ciguatera poisoning Antisecretory agents, such as bismuth subsalicylate (Pepto-Bismol), may be useful. The dose is 30 mL every 30 minutes, not to exceed 8-10 doses . Diphenoxylate with atropine ( Lomotil ) the initial dose for adults is 2 tablets 4 times a day ( i.e , 20 mg/d). The dose is tapered as diarrhea improves . Loperamide (Imodium) is available over the counter as 2-mg capsules and as a liquid (1 mg/5 mL). It increases the intestinal absorption of electrolytes and water and decreases intestinal motility and secretion. The dose in adults is 4 mg initially, followed by 2 mg after each diarrhea stool, not to exceed 16 mg in a 24-hour period.

23. Prevention of FOOD POISONING Wash hands frequently after using restroom, shaking hands, and before eating . Eat only pasteurized dairy products and eggs . Avoid tap water and ice if uncertain about quality. Recognize high-risk foods: creams, custards, eggs , berries, lettuce (salads), undercooked fish and shellfish .

24. Prevent food handlers from working while ill Avoid salads and all raw fruits that you do not Peel Do not eat solid foods during vomiting and diarrhea . Tea with lemon and ginger to treat symptoms . Wash and sanitize all surfaces and equipment used for food preparation Protect kitchen areas and food from insects, pests and other animals

25. Separate raw meat, poultry and seafood from other foods Use separate utensils such as knives and cutting boards for handling raw foods Choose foods processed for safety, such as pasteurized milk Wash fruits and vegetables, especially if eaten raw Do not use food beyond its expiry date

26. THANK YOU 