FOOD POISONING

A sudden illness that occurs after ingestion of contamined food or drink. TYPES OF FOOD POISONING : -Chemical Food Poisoning -Biological Food Poisoning -Bacterial -Viral Things to be examined: Food Gastric Content Vomitus Serum Feces Signs and symptoms: Assess Fluid and Electrolytes Status Lethargy Rapid pulse rate Fever Severe Vomiting Severe Diarrhea Hypovolemic Shock Chemical Food Poisoning Ingestion of chemicals like: Pesticides Insecticides Detergents Heavy metals/ elements: Lead Copper Mercury Arsenic Zinc These metals can dissolve in acid foods such as fruit juices and produce fast-acting poisons in the body when ingested. Possible sources of contamination include residues migrating into foods contaminated water, glazed pottery, painted glassware and paints. Bacterial Food Poisoning It is considered as the most common form of food poisoning which comes from: 1. Shigella 2. Staphylococcal 3. Clostridial 4. Samonella 5. Botulism 6. Escherichia coli

1.

Shigella Causative Agent: Shigella sonnei Mode of transmission: Fecal-oral route Intubation period: 12hrs 7days Manifestations : Diarrhea - ranges from mild to severe. It is bloody in 25 to 50 percent of cases and usually contains mucus Fever Stomach cramps Rectal spasms Complications can include: severe dehydration seizures in small children rectal bleeding invasion of the blood stream by the bacteria Diagnostic exam: Stool Exam Treatment: A Shigella infection usually goes away on its own in five to seven days. Antibiotics, however, can shorten the course of the illness. A doctor can prescribe antibiotics after testing a stool sample for the presence of Shigellabacteria. Antidiarrheal medication should be avoided, as it can actually make the illness worse. Prevention: Frequent hand washing is key to preventing Shigella . People with Shigella should not prepare food for others for at least two days after diarrhea has stopped.

2.Staphylococcal Causative Agent: Staphylococcus aureus Sources: Meat, bakery products cream fillings salad dressings, milk; skin and resp. tract of food handlers Intubation Period: 30 mins - 7hr Manifestations: Vomiting, Nausea , abdominal cramping Diagnostic exam: Stool Culture Yields 100,000 enterotoxin-producing staphylococci. Treatment: Symptomatic Fluid and electrolyte replacement Antiemetics Prevention: Immediate refrigeration of foods, monitoring of food handlers. 3.Clostridial Causative Agent: Clostridium perfringens Sources: Meat or poultry dishes cooked at lower temperature Rewarmed meat dishes and gravies Improperly canned vegetables Intubation Period: 8- 24 hrs Manifestations: Vomiting, Nausea, Diarrhea, abdominal cramps and mid epigastric pain Diagnostic exam: Stool Exam ELISA test Treatment: Symptomatic Fluid and electrolyte replacement Prevention: Correct preparation of meat dishes Serving of foods immediately after cooking or rapid cooling of food. 4.Salmonella Causative agent:

Improperly cooked poultry, pork, beef, lamb and eggs Intubation Period: 8 to 48hrs Mode of transmission: It is transmitted by 5 fs Flies Fingers Food Feces Fomites Symptoms Fever and chills Nausea Vomiting Cramping Abdominal Pain Diarrhea Diagnostic exam: ELISA Test Stool exam Treatment: Symptomatic Fluid and electrolyte replacement Prevention: Hand hygiene Proper preparation of food Diagnosis: Stool Culture Treament: Symptomatic Fluid Replacement Antibiotics if Bacteremia occur Quinolones 5.Escherichia Coli Causative Agent: E coli serotype 0157:H7 Mode of transmission: Contamined beef, pork, milk, cheese fish water of fomites. Intubation Period: Varies by Strain: 8 hr 1 week Signs and Symptoms: Bloody stools Hemolytic uremic syndrome Abdominal cramping Profuse diarrhea Characteristics Hemolytic Uremic Syndrome (HUS).

Sources:

Salmonella typhimurium

Diagnostic Exam: Stool exam Management: Symptomatic Supportive Fluid and electrolyte replacement, IV therapy Antibiotics as prescribed Antidiarrheal agents Prevention: Correct preparation of food 6.Botulism A paralytic disease resulting from ingestion of toxin in food contaminated with clostridium botulinum. It can be associated with commercially prepared products and with products not adequately heated to destroy toxins before they are eaten. Causative Agent: Clostridium Botulinum Sources: Improperly Canned or preserved foods Home preserved vegetables and fruits Fish and meat (less commonly) Onset of symptoms: 12-36 hrs. Signs and Symptoms: GI Symptoms: Nausea and Vomiting Abdominal Pain Constipation Paralytic ileus Urinary retention CSN Symptoms: Headache Dizziness Muscular Incoordination Weakness Inability to talk or swallow Diplopia DOB Paralysis Delirium Coma Diagnostic exam: Client history Stool Culture of C.Botulinum Blood Studies >Serum may be positive for toxins Management: Trivalent botulism antitoxin (ABE)

Given as soon as diagnosis was made Physician may lavage the stomach to stop absorption of toxin. All patient are hospitalized to treat respiratory paralysis. Nothing is given orally until swallowing and respiratory difficulties pass. If respiratory paralysis occurs, tracheostomy and mechanical ventilation are implemented. PREVENTION: Teach clients the importance of discarding cans of food that are punctured or swollen or that have defective seals. Containers for home-canned foods must be sterilized by boiling for 20mins to destroy C. Botulinum spores before canning. Nursing Management for Food poisoning : Monitor the patients fluids status carefully. Plan care to allow uninterrupted rest periods for the patient. If the patient is nauseated, advise him to avoid quick movements, which can increase the severity of nausea. If the patient can tolerate oral fluids, replace lost fluids and electrolytes with broth, ginger, ale, and lemonade, as tolerated. Assess vital signs at least every 4 hours, weigh him daily, and record intake and output Teach the patient about gastroenteritis, describing its symptoms and varied causes. Teach the patient the proper preventive measures If dehydration occurs, administer oral and I.V. fluids as ordered. To ease anal irritation caused by diarrhea, clean the area carefully and apply repellent cream, such as petroleum jelly. Wash hand thoroughly after giving care to avoid spreading of infection, and use standard precaution whenever handling vomitus or stools.