FOOD POISONING

Illness caused by consumption of food or water contaminated by certain pathogenic microorganisms. It usually affects large numbers of people after ingestion of communal food in homes, hospitals, hotels and parties.

Causes

  • Can be infective or toxic
  • Infective: by bacteria e.g. Salmonella typhimurium, Campylobacter jejuni, Bacillus cereus
  • Toxic: by toxins from Staphylococcus aureus and Clostridium botulinum

Clinical features

  • Nausea, vomiting
  • Intermittent abdominal pain (colic) with associated diarrhoea
  • Fever (especially if poisoning is the infective type)
  • Often self-limiting

Botulism

  • Paralysis of skeletal, ocular, pharyngeal and respiratory muscles

Differential diagnosis

  • Cholera, dysentery
  • Other causes of stomach and intestinal infections

Investigations

  • Good history and examination is important for diagnosis
  • Stool microscopy, C&S

Management

  • Establish the cause and treat accordingly
  • Give oral (ORS) or IV fluids (Normal saline) for rehydration as required
  • For pain, give paracetamol 1 g every 4-6 hours Child: 10 mg/kg per dose

If diarrhoea severe and persisting or bloody, high fever

  • Give an antibiotic for 3-7 days, depending on response:
    • Ciprofloxacin 500 mg every 12 hours
      Child: 10 mg/kg per dose
    • Or erythromycin 500 mg every 6 hours
      Child: 10 mg/kg per dose

Prevention

  • Heat cooked foods thoroughly before eating and avoid eating cold left-over cooked foods
  • Ensure adequate personal and domestic hygiene.