Food poisoning

Food poisoning has been known to mankind since ancient times. Apparently, as soon as people began to eat food other than manna from heaven, their digestive system became vulnerable to all kinds of intoxications. It is known that the Byzantine emperor forbade the consumption of blood sausage, probably worrying about the health of his subjects, Avicenna, Hippocrates and Alexander the Great were against eating raw fish. At the dawn of civilization, determining whether a product was fit for food was sometimes done at the cost of life, sometimes food infections affected entire families and settlements. Toxicology as a science has come a long and difficult way of development, today food poisoning is quite well studied, classified and, if diagnosed in a timely manner, can be treated

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Food poisoning statistics

According to the World Health Organization, the number of food poisonings is growing annually. It is extremely difficult to combine and constantly update general statistical data, since only a few countries seriously deal with the calculation and systematization of food toxic infections. WHO provides quarterly reports on food infections, which in an epidemiological sense are more dangerous than toxic infections. According to information from five years ago, more than 2 million people in the world die annually as a result of food poisoning. Of these, more than 75% are children under 14 years old. The approximate dynamics of the increase in the number of diseases is 10-12% annually.

Statistics from American epidemiologists indicate that 70 million people suffered from food poisoning in 2010 alone, with every hundredth case ending in death.

If we try to combine the information obtained from different sources, we get the following statistical picture:

• 90% of all toxic infections occur due to human fault.
• The main provoking factor is hygiene (unwashed hands, dirt, feces).
• 35-40% of food poisoning cases are caused by norovirus, a relatively new pathogen.
• 27-30% of cases of toxic infections are associated with salmonellosis.
• The first place among products that provoke food poisoning is occupied by dairy and meat products (especially poultry and beef).
• Second place is occupied by fish and eggs (salmonellosis).
• Fruits and large-leafed vegetables are in third place on the list of foods that cause poisoning.
• 45% of all food poisonings are unidentified, meaning their cause cannot be determined.
• Independent experts claim that the data submitted to the WHO on the number of toxic infections is underestimated by approximately 2.5-3 times.
• Most often (70%) children between the ages of birth and five die from food poisoning, mainly from dehydration.
• Only 20% of food poisoning victims seek medical help from doctors.
• According to data for 2011, out of 12,000 food enterprises in Ukraine, only 120 have implemented a food safety management system.
• Worldwide, 1.2 times more people die from toxic infections than from acute myocardial infarction.

It is obvious that food poisoning statistics remain a difficult issue, which is associated with insufficient monitoring and recording of the real picture of the disease in countries of Asia, Latin America, Africa and some other countries.

Characteristics of food poisoning

Food poisoning is a non-contagious disease caused by eating a product contaminated with bacteria, less often - a product that initially contained toxins. Differentiation from food infections lies in a completely different way of transmitting the disease. If the infection is contagious by nature, then the cause of toxic infections is the presence of pathogenic or opportunistic microorganisms in food. Secondary cases of infection are possible only if contaminated food is consumed again. The characteristic of food poisoning is food contamination first of all, and secondly - violation of sanitary conditions for processing, cooking or storing food products. It is much easier to avoid food poisoning than infection, since compliance with the rules of personal and food hygiene provides an almost 100% guarantee of health from infection.

Despite some similarity in symptoms, the following pathologies should not be considered food poisoning:

• Intestinal fermentopathy.
• Food allergy.
• Avitaminosis, hypervitaminosis.
• Criminal nature of toxic infection or consumption of toxin by mistake.
• Overeating.
• Alcohol intoxication.

The main characteristic signs of food poisoning are:

• Acute onset, rapid development of symptoms.
• Localization and clear tracing of the connection “poisoning – specific territory”.
• The connection between mass poisonings and the consumption of a specific common dish.
• Rapid progression of the disease, favorable prognosis (except for severe cases of botulism).

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Acute food poisoning

Acute food poisoning is a typical manifestation of the disease rather than a rarity. A characteristic feature of food toxicoinfection is a sudden manifestation, acute onset and very obvious symptoms. It is believed that acute food poisoning is much easier and ends faster, without complications, than, for example, botulism, which can develop slowly, within 8-24 hours after the stick gets into the digestive tract. Acute symptoms are sharp abdominal pain, colic, diarrhea, nausea and vomiting. Less often, there may be headaches, hyperthermia. Threatening symptoms are uncontrollable vomiting and diarrhea, a rapid increase in temperature to 38-40 degrees, and severe dehydration. Such cases require immediate hospitalization, since such acute food poisoning can end in death. Severe toxic infections are especially dangerous for small children from birth to 3 years of age, for pregnant women, the elderly, and those who have had a myocardial infarction, for diabetics, and for those with asthma.

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Food poisoning

Food poisoning is impossible without the participation of the product in the pathological process. Therefore, in addition to the fact that the culprits of toxicoinfection are bacteria and toxins, certain types of food are also considered to be provocateurs of the disease. Food poisoning most often occurs due to the consumption of poor-quality, dirty, spoiled food. There is an unofficial rating of food products that pose a potential danger in terms of food toxicoinfections and food toxicosis:

1. Milk and meat, as well as products made from them, are at the top of the list. All kinds of fermented baked milk, yogurt, kefir, cottage cheese, and feta cheese, if poorly cooked and if sanitary conditions are not observed, are the main sources of bacterial toxic infections. Meat and meat products are also dangerous if they are purchased in dubious places from unverified sellers. It should not be forgotten that food poisoning is also a result of gross violations of storage conditions, especially for milk.
2. The second place in the list is occupied by mushrooms that provoke diseases of non-microbial etiology. Mushroom poisoning is considered a seasonal disease, which is most often diagnosed in the autumn.
3. Fish and eggs are also dangerous: fish often contain toxins or may be contaminated with microorganisms, and eggs are the main source of salmonella.
4. Unwashed or rotten, spoiled vegetables and fruits are the source of summer poisoning.
5. Canned food is the main culprit of severe food poisoning - botulism.
6. Last on the list are seafood – oysters, mussels, mollusks, which most often cause food toxicosis of non-microbial etiology.

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How long does food poisoning last?

The duration of the disease directly depends on the type of toxic infection and the severity of its symptoms. It is believed that the more acute the disease (PTI) begins, the sooner it ends. Of course, any victim is concerned about the question of how long food poisoning lasts.

The answer is that mild poisoning usually passes in 2-3 days, but the process of normalizing the digestive tract may take a longer period - up to 2 weeks. There are often cases when toxic infection "starts" acutely, the symptoms develop rapidly. If vomiting and diarrhea become uncontrollable, accompanied by an increase in body temperature and neurological signs (impaired coordination, visual impairment, paresthesia), immediate medical care is needed and only a doctor can say how long the disease will last. Botulism and mushroom poisoning are the most severe, the disease can develop longer (the incubation period is longer), this means deep and comprehensive penetration of toxins into the body. Accordingly, if the mortal danger has passed, recovery will depend on the severity of the poisoning. Recovery can take 3-4 weeks, and sometimes even longer.

Symptoms of food poisoning

Typical symptoms of food poisoning are sudden abdominal pain, nausea, which turns into vomiting and diarrhea. In this way, the body tries to remove pathogenic substances on its own.

Symptoms of food poisoning usually disappear within two or three days without a trace, the most dangerous sign is dehydration, especially in small children, whose weight is already low. Dehydration is fraught with kidney failure and hypovolemic shock.

The threatening symptoms of toxic infection are:

• Vomiting and diarrhea that do not stop (uncontrollable).
• A sharp increase in temperature to 39-40 degrees.
• Drop in blood pressure.
• Stop urinating or dark urine.
• Ophthalmological disorders (double vision, fog).
• Diarrhea with blood.
• Increased salivation, foam at the mouth.
• Impaired coordination of movements, fainting.
• Paralysis, convulsions.
• Asphyxia.

Symptoms of food poisoning are the main and sometimes the only information that allows you to make a timely diagnosis and help cope with intoxication. You need to be especially attentive to the manifestations of the disease if a child is affected. Small children are not able to accurately describe their feelings, so visual signs and physiological manifestations of poisoning (vomiting, diarrhea, their frequency and intensity) should be under the control of adults. The dynamics of changes in symptoms is an indicator of either recovery or a direct indication of the need for emergency medical care.

Signs of food poisoning appear suddenly and acutely.

Typical symptoms of food poisoning include vomiting and diarrhea. The clinical picture of the disease is directly related to the type of pathogen:

• Salmonellosis is manifested by frequent vomiting, severe abdominal pain. Incubation lasts from several hours to a day, so signs of food poisoning can develop gradually. Salmonellosis is characterized by high temperature, sometimes reaching 40 degrees. Mucus and blood may be observed in the feces.
• Botulism manifests itself as severe headache, weakness, central nervous system dysfunction, laryngeal spasms, and paralysis.
• Staphylococcus most often manifests itself 30-40 minutes after eating contaminated food. Vomiting immediately becomes almost uncontrollable, body temperature rarely rises, but can be subfebrile. Weakness, a drop in blood pressure and the absence of diarrhea are characteristic (diarrhea occurs in only 35-40% of cases of toxic infection).
• Signs of food poisoning with proteus are characterized by diarrhea and colic, often with an increase in body temperature. Symptoms develop quickly, but also subside quickly (1-2 days).

Manifestations of food toxicoinfection, food toxicosis are fundamental diagnostic information for the doctor, since bacteriological studies (cultures) do not always allow to identify the true cause - the pathogen. This is explained by the specificity of the bacteriological material - vomit or feces, because in addition to the supposed microorganism, they contain a lot of opportunistic bacteria "native" to the body, among which the pathogenic provocateur of food toxicoinfection skillfully hides.

Classification of food poisoning

Food poisoning (FP) in the international classification of diseases (ICD-10) is listed under the code AO-5 (other bacterial toxicoinfections). Diseases of bacterial etiology are distributed as follows:

• Food poisoning caused by Staphylococcus - AO5.0
• Botulism – AO5.1
• Necrotic enteritis due to Clostridium perfringens – AO5.2
• Vibrio parahaemolyticus (halophilic vibrio) is a disease of residents of Asia, Japan, Latin America and Africa – AO5.3
• Cereus - Bacillus cereus – AO5.4
• Other, other specified bacterial toxicoinfections – AO5.8
• Food poisoning of unspecified etiology - AO5.9

The systematization of nosologies continues; at present, the following general classification of food poisoning has been adopted in many countries:

By etiological factors:

1. Microbial food poisoning.
2. Non-microbial food poisoning.
3. Toxic infections of unknown etiology.

Classification by pathogenesis:

1. Microbial food poisoning – toxic infections, staphylococcal toxicosis and botulism, mycotoxicosis, mixed toxic infections.
2. Non-microbial food poisoning:
   1. Poisonous foods include mushrooms, some types of fish, caviar and milt.
   2. Products that have become toxic under the influence of various factors are potatoes (solanine), almonds, apricot kernels, cherries (amygdalin), raw fresh beans (fazin).
   3. Violation of food processing technology and their production of histamine.

Modern microbiology is still working on a unified world classification of food poisoning, it is obvious that this process will be long. In the meantime, at the initiative of some scientists, it is proposed to remove toxic infections from the list of toxic infections and include them in the group of intestinal infections. This is due to the fact that contact-household and waterborne infection by Klebsiella Citrobacter, anaerobes Аеromonas and some other types of bacteria have been statistically proven.

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Tests for food poisoning

Not only the patient's health, but also his life sometimes depends on timely and accurate diagnosis of PTI (food toxic infection). Therefore, tests for food poisoning play an important role in the overall diagnostic complex. As a rule, many types of toxic infections remain beyond the control and attention of a doctor - victims treat themselves and do not seek help. However, in severe cases, when a person is admitted to hospital, he will have to undergo the following examinations:

• OAC – a general blood test to determine a possible inflammatory process associated with toxic infection.
• General urine analysis to exclude nephropathologies that may develop against the background of severe intoxication.
• Bacterial culture of feces to identify or clarify the pathogen. In addition, coprological studies help determine how the process of digestion of food occurs.
• Bacterial culture to determine possible disturbance of intestinal microflora.
• Biochemical analysis of blood reversion to identify possible abnormalities in the functioning of the liver and other organs.
• Ultrasound of abdominal organs.
• Retromanoscopy may be prescribed.
• If botulism is suspected, electromyography is prescribed to determine the biopotential of the muscular system.
• Lumbar puncture is extremely rarely prescribed when obvious CNS dysfunction is evident.

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Treatment of food poisoning

Generally, treatment for food poisoning does not require hospitalization unless life-threatening symptoms occur.

Treatment of the disease involves the following actions:

1. You cannot stop vomiting or diarrhea if they occur intermittently. On the contrary, vomiting should be activated by drinking plenty of fluids. This will help quickly remove intoxication products from the body.
2. The patient needs to restore the water balance, so drinking plenty of fluids will accomplish this task. It is necessary to drink in small sips, the volume of liquid is not less than 2 liters per day.
3. Toxins should be absorbed using Enterosgel or activated carbon (suspension). Carbon is taken at a rate of 1 tablet for every 10 kilograms of body weight, 3 times a day.
4. The diet is shown for a week, it is better if the diet lasts 14 days.
5. In case of severe colic, taking antibiotics or antispasmodics is not allowed; the only thing that is allowed to be taken is a No-shpa tablet.

Treatment of food poisoning of more severe forms and types requires the help of a doctor. Dehydration may be stopped by infusion (intravenous administration of solutions). Prescribing antibacterial therapy is inappropriate, most likely adequate treatment is carried out to restore the functions of the affected organs (kidneys, pancreas).

What to take for food poisoning?

Treatment of the disease, as a rule, takes place at home, but this does not mean the possibility of self-medication. What to take for food poisoning should be decided by a doctor, taking into account the general anamnesis, the specifics of the disease and its type. As self-help, which can be used as temporary, primary measures, it is possible to take the following drugs:

1. Regidron, Hydrovit, Gastrolit, Normohydron (electrolytes and carbohydrates), or still mineral water to eliminate dehydration.
2. Enterosgel, Enterol, activated carbon, Polysorb or other sorbents for detoxification.
3. Drink plenty of fluids – for adults up to 2-2.5 liters.

Etiotropic treatment, including antibiotics, is usually not required. The exception is severe cases of botulism, salmonellosis or persistent diarrhea, vomiting. But these situations should be supervised by a doctor and only he can decide what to take for food poisoning, especially if we are talking about children under 5 years of age, pregnant women, elderly people and those victims who have a history of serious chronic diseases.

Recovering from food poisoning

There are frequent cases when the digestive tract does not recover for a long time after toxic infection. This is due to serious irritation of the intestinal walls and requires a more careful approach to treatment, possibly additional medical care. Recovery after food poisoning is mainly about following the rules of nutrition, that is, a diet for food poisoning. The rules are simple - fractional meals in the regime - every 1.5 hours and plenty of fluids. The first month after intoxication, diet No. 1 according to Pevzner is indicated, the second and third months will not be superfluous to follow diet No. 5, which helps restore the function of the liver and gallbladder. As a rule, even the most severe cases of toxic infections pass in a few months, provided

Following doctor's recommendations and following a gentle, reasonable diet. The "zigzag diet" method is also effective, when small portions of regular, non-dietary food are included in the menu once a week. This way the body "remembers" the normal eating regime and gradually restores the functioning of all its organs.

Prevention of food poisoning

Preventive measures that can help avoid food poisoning are very simple and require only regularity and a responsible attitude towards your own health. Compliance with the rules of personal and general sanitary hygiene will help minimize the risk of foodborne diseases and reduce the severity and danger of the consequences of the disease.

Prevention of food poisoning consists of the following:

• Wash your hands regularly, literally after every visit to public places (markets, shops, hospitals, offices, transport, etc.). The fact that it is necessary to wash your hands after every visit to the toilet should be known, as they say, "from a young age."
• Systematically ensure cleanliness in food preparation areas. It is not so important how beautiful the kitchen is, but how clean it is. All cutlery and dishes should be washed, and kitchen towels and sponges should be changed more often.
• Keep your living space clean, as some types of bacteria live well with household dust.
• When buying food products, pay attention to their storage conditions, expiration dates, and appearance.
• Do not purchase food products at spontaneous markets, in places not suitable for trade, or not equipped with refrigeration units.
• Follow the rules for storing food at home.
• Throw away even slightly spoiled food without mercy. Do not allow it to be reprocessed.
• Follow the rules for heat treatment of food products - boil milk, boil or fry eggs, as well as meat and fish.
• Store prepared food for no more than 1.5-2 hours in an open container at room temperature.
• Store semi-finished products and raw foods separately from ready-made dishes, preferably in a closed container, preventing contamination.
• Do not eat mushrooms of dubious appearance, mushrooms growing along highways, industrial facilities, or those bought at spontaneous markets from unknown sellers.
• Keep trash cans and buckets closed and empty them as often as possible.

Prevention of toxic infection also includes compliance with the following preventive measures:

1. Systematic monitoring of compliance with sanitary and hygienic standards. This concerns, first of all, personal hygiene (hand washing).
2. Hands should be washed not only after visiting public places, but also before and after preparing food, especially if raw meat or fish was prepared.
3. Vegetables, fruits, berries should be subjected to water treatment. If the consistency of the product allows, it is better to pour boiling water over it.
4. Products should be stored properly - closed and in a cool place.
5. Prepared foods should be stored separately from raw foods.
6. Buying food at spontaneous markets can lead to food poisoning.
7. Almost all foods need to be heat treated – fried, baked, boiled.

Prevention is the main measure that will help protect yourself and your loved ones from food poisoning. Food poisoning is 90% due to carelessness and failure to observe sanitation by the person himself.

Food poisoning investigation

Investigation of food poisoning cases, especially mass cases, is extremely necessary for many reasons. The main, quite understandable reason is to prevent the spread of infection and differentiate poisoning from food infection. Food poisoning is localized and neutralized much faster, it is not as dangerous in the epidemiological sense as intestinal infectious diseases, which are highly contagious. According to the laws that have not been repealed, but unfortunately have not been updated either, literally every case of food poisoning must be investigated. This should be done by sanitary doctors, sanitary and epidemiological stations, as well as doctors supervising the territorial area of the city, village, etc. The investigation of food poisoning includes three stages:

1. Recording the fact of illness.
2. Finding out the true cause of toxic infection, all epidemiologically dangerous conditions of infection, determining the possible pathogen or factor.
3. Carrying out measures that will at least localize the outbreak of food poisoning, and at most neutralize it.

Usually, the sanitary doctor confiscates a potentially dangerous product for laboratory testing. Feces and vomit are also collected as material for bacteriological culture. Blood and urine are also subject to analytical testing, but only secondarily. If the cause of the disease was products from one batch put up for sale in a store, the entire batch is confiscated and sale is prohibited. In addition, all participants in the dangerous meal are questioned, even if they do not show symptoms of food poisoning.

Currently, all regulations are constantly updated, but are based on outdated recommendations, so the need for the prompt creation of a new legislative document taking into account the current epidemiological situation is absolutely obvious.