Food poisoning

Food poisoning is known to mankind since ancient times. Obviously, as soon as people began to eat food other than manna from heaven, their digestive system became vulnerable to all kinds of intoxication. It is known that the Byzantine emperor forbade the use of blood sausage, probably worried about the health of his subjects, Avicenna, Hippocrates and Alexander of Macedon were opposed to the absorption of raw fish. At the dawn of civilization, the definition of a product suitable for food was sometimes spent at the cost of life, sometimes food poisoning affected whole families and settlements. Toxicology as a science has passed a long and difficult path of development, today food poisoning is well studied, classified and diagnosed with timely diagnostics, is treatable

[1], [2]

Statistics of food poisoning

According to the World Health Organization, the number of food poisoning is increasing annually. It is extremely difficult to unite and constantly update general statistical information, since only a few countries are seriously engaged in counting and systematization of foodborne infections. WHO provides quarterly reports on foodborne infections, which in the epidemiological sense are more dangerous than toxic infections. According to information five years ago, more than 2 million people in the world die each year 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% per year.

The statistical data of American epidemiologists testify to 70 million people affected by foodborne toxic infections only in 2010, every hundredth case ends in a lethal outcome.

If we try to combine the information received from different sources, then this statistical picture emerges: 

• 90% of all toxic infections occur through the fault of a person.
• The main provoking factor is hygienic (unwashed hands, dirt, feces).
• 35-40% of food poisoning is caused by norovirus - a relatively new agent of the disease.
• 27-30% of cases of toxic infections are associated with salmonellosis.
• The first place among products provoking food poisoning is occupied by dairy and meat products (especially poultry meat and beef).
• The second place is occupied by fish and eggs (salmonellosis).
• The third place in the list of food poisoning provoking products are fruits and large-leaved vegetables.
• 45% of all food poisoning is unidentified, that is, it is impossible to establish their cause.
• Independent experts argue that the information submitted to WHO on the number of toxic infections is underestimated by about 2, 5-3 times.
• Most often (in 70%) of food etchings, children aged from birth to five years old die, mainly from dehydration.
• Only 20% of those affected by food poisoning seek medical help from doctors.
• According to data for 2011 in Ukraine, out of 12,000 food enterprises only 120 introduced a food safety management system.
• Throughout the world, 1.2 times more people die from toxic infections than from acute myocardial infarction.

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

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 contains toxins. Differentiation from foodborne infections lies in a completely different pathway of disease transmission. If the infection is contagious by nature, then the cause of the toxic infections is the presence of pathogenic or conditionally pathogenic microorganisms in food. Secondary cases of infection are possible only with the condition of repeated use of contaminated food. The characteristic of food poisoning is food contamination first of all, in the second place - violation of sanitary conditions of processing, preparation or storage of food products. Avoiding food poisoning is much easier than infection, as compliance with the rules of personal and food hygiene provides almost 100% guarantee of health from infection.

Despite some similarity of symptoms, food pathologies should not be considered such pathologies: 

• Intestinal fermentopathy.
• Food allergy.
• Avitaminosis, hypervitaminosis.
• The criminal nature of the toxic infection or the use of toxin by mistake.
• Binge eating.
• Alcohol intoxication.

The main characteristic signs of food poisoning are:

• Acute onset, rapid development of symptoms.
• Localization and clear tracking of the connection "poisoning - a specific area."
• The connection of mass poisonings with the consumption of a particular common dish.
• Rapid course of the disease, favorable prognosis (except for severe cases of botulism).

[3], [4], [5], [6], [7], [8]

Acute food poisoning

The acute form of food poisoning is rather a typical manifestation of the disease than a rarity. A characteristic feature of food toxicoinfection is a sudden manifestation, an acute onset and very obvious symptomatology. It is believed that acute food poisoning proceeds much easier and ends more quickly, without complications, than, for example, botulism, which can develop slowly, within 8-24 hours after the ingestion of the rod in the digestive tract. Acute symptoms are severe abdominal pain, colic, diarrhea, nausea and vomiting. Less common can be headaches, hyperthermia. Threatening symptoms are indomitable vomiting and diarrhea, a rapid increase in temperature to 38-40 degrees, a sharp dehydration of the body. Such cases require immediate hospitalization, since such acute food poisoning can result in a fatal outcome. Especially dangerous are severe toxic infections for young children from birth to 3 years old, for pregnant women, the elderly and those with myocardial infarction, for diabetics, for asthmatic diseases.

[9], [10], [11]

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 the toxic infection are bacteria and toxins, the provocateurs of the disease are also considered certain types of food. Food poisoning most often occurs due to the use of poor-quality, dirty, spoiled food. There is an unofficial rating of food that poses a potential danger in terms of foodborne diseases and food toxicoses: 

1. The leaders in the list of milk and meat, as well as products from them. All kinds of fermented yoghurt, yogurt, kefir, cottage cheese, cheese with poor heat treatment, non-observance of sanitary conditions are the main sources of bacterial toxic infections. Meat and meat products are also dangerous if they are purchased in dubious places from untested vendors. Do not forget that food poisoning is a gross violation of storage conditions, especially for milk. 
2. The second place in the list is occupied by mushrooms, which provoke diseases of non-microbial etiology. Poisoning with mushrooms 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 can be seeded with microorganisms, and eggs are the main source of salmonella. 
4. Unwashed or rotten, spoiled vegetables and fruits are a source of summer poisoning. 
5. Canned food - the main culprit of severe food poisoning - botulism. 
6. The seafood - oysters, mussels, mollusks, which most often cause edible toxicoses of non-microbial etiology, are the last ones with a squeak.

[12], [13], [14]

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 begins (PTI), the sooner it ends. Of course, any victim is concerned with the question - how long does food poisoning last.

The answer is that mild poisoning usually takes 2-3 days, but the process of normalizing the digestive tract can take a longer period - up to 2 weeks. It is not uncommon for cases when the toxicoinfection "starts" sharply, 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 attention is needed and how long the disease will last, only the doctor can tell. Botulism and fungal poisoning are most severe, the disease can develop longer (the incubation period is longer), this means a deep and comprehensive penetration of toxins into the body. Accordingly, if the mortal danger is past, the recovery will depend on the severity of the poison damage. Recovery may last for 3-4 weeks, and sometimes for a longer period.

Symptoms of food poisoning

Typical manifestations of food poisoning are sudden abdominal pain, nausea, vomiting and diarrhea. Thus, the body tries to remove pathogenic substances on its own.

Symptoms of food poisoning usually take place within two to three days without a trace, the most dangerous sign is dehydration - dehydration, especially in young children, whose weight is already so small. Dehydration is fraught with kidney failure and hypovolemic shock.

Threatening symptoms of a toxic infection are: 

• Vomiting and diarrhea that do not stop (indomitable).
• A sharp rise in temperature to 39-40 degrees.
• Falling blood pressure.
• Cessation of urination or dark urine.
• Ophthalmic disorders (double vision, fog).
• Diarrhea with blood.
• Increased secretion of saliva, foam from the mouth.
• Violation of coordination of movements, fainting.
• Paralysis, convulsions.
• Asphyxia.

Symptoms of food poisoning - this is the main and sometimes the only information that allows you to timely diagnose and help cope with intoxication. Particular attention to manifestations of the disease should be in case the child is injured. Young children are not able to accurately characterize their feelings, therefore visual signs and physiological manifestations of poisoning (vomiting, diarrhea, their frequency and intensity) should be controlled by 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 are sudden and acute.

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

• Salmonella is manifested by frequent vomiting, severe pain in the abdomen. Incubation lasts from a few hours to a day, so signs of food poisoning can develop gradually. For salmonellosis, a typical high temperature, sometimes reaching 40 degrees. In feces can be observed mucus and an admixture of blood. 
• Botulism is manifested by severe headache, weakness, frustration of the central nervous system, spasms of the larynx, paralysis. 
• Staphylococcus manifests itself more often after 30-40 minutes after eating contaminated food. Vomiting immediately becomes almost indomitable, body temperature rises rarely, but can be subfebrile. Characteristic weakness, a drop in blood pressure and lack of diarrhea (diarrhea occurs in only 35-40% of cases of toxic infection).
• Signs of food poisoning with proteins are characterized by diarrhea and colic, often the body temperature rises. Symptoms develop quickly, the legs also quickly and abate (1-2 days).

Manifestations of food poisoning, food toxicosis are the basic diagnostic information for the doctor, since bacteriological studies (crops) do not always reveal the true cause - the causative agent. This is due to the specific nature of the bacteriological material-vomiting or feces, because in addition to the alleged microorganism, there are a lot of "relatives" of opportunistic bacteria, among which the pathogenic agent of toxic infection hides skillfully.

Classification of food poisoning

Food poisoning (PO) in the international classification of diseases (ICD-10) is listed under the code AO-5 (other bacterial toxic infections). Diseases of bacterial etiology are distributed in this way: 

• Food poisoning caused by Staphylococcus - AO5.0 
• Botulism (botulism) - AO5.1 
• Necrotic enteritis caused by Clostridium perfringens - AO5.2 
• Vibrio parahaemolyticus (halophilic vibrio) - disease of the inhabitants of Asia, Japan, Latin America and Africa - AO5.3 
• Cereus - Bacillus cereus - AO5.4 
• Other, other specified bacterial toxic infections - AO5.8 
• Food poisoning of unspecified etiology - АО5.9

The systematization of nosologies continues, so far the following generalized classifications of food poisoning have been adopted in many countries: 

For etiological factors: 

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

Classification by pathogenesis:

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

Modern microbiology is still working on a single world classification of food poisoning, it is obvious that this process will be long. In the meantime, on the initiative of some scientists, it is suggested that toxicoinfections be removed from the list of toxic infections and included in the group of intestinal infections. This is due to the fact that the contact-household and waterway of infection of Klebsiella Citrobacter, anaerobes of Aéromonas and some other kinds of bacteria have been statistically proved.

[15], [16], [17]

Analyzes for food poisoning

From the timely and accurate diagnosis of PTI (food poisoning), it sometimes depends not only on the patient's health status, but also on life. Therefore, analysis of food poisoning plays an important role in the overall diagnostic complex. As a rule, many types of toxic infections remain outside the control and attention of the doctor - the victims are treated independently and do not seek help. However, in severe cases, when a person enters a hospital, he will have to undergo the following examinations: 

• UAC - a general blood test to determine a possible inflammatory process, concomitant toxic infections.
• The general analysis of urine for the exclusion of nephropathologies, which can develop against a background of severe intoxication.
• Bacterial culture of feces to determine or clarify the causative agent of the disease. In addition, coprological studies help determine how the process of digestion of food passes.
• Bacterial sowing to determine possible damage to the intestinal microflora.
• Biochemical analysis of the blood turn to detect possible abnormalities in the liver and other organs.
• Ultrasound of the abdominal cavity organs.
• Perhaps the appointment of retro manoscopy.
• If botulism is suspected, electromyography is used to determine the biopotential of the muscular system.
• It is rarely prescribed lumbar puncture, when obvious violations of the central nervous system are visible.

[18], [19], [20], [21], [22]

Treatment of food poisoning

As a rule, the treatment of food poisoning does not require hospitalization, except in cases when life-threatening symptoms appear.

Treatment of the disease - is such actions: 

1. Do not stop vomiting or diarrhea if they occur intermittently. On the contrary, vomiting needs to be activated with abundant drinking. This will help quickly bring the products of intoxication out of the body.
2. The patient needs to restore the water balance, so a copious drink will fulfill this task. Drink in small sips, the volume of liquid - at least 2 liters per day.
3. Toxins should be sorbed with Enterosgel or activated carbon (suspension). Coal is taken at the rate of 1 tablet for every 10 kilograms of body weight, 3 times a day.
4. It shows a diet for a week, it's better if the diet lasts 14 days.
5. With severe colic, antibiotics or antispasmodics are not acceptable, the only thing that is allowed to drink is the No-shpa tablet.

Treatment of food poisoning of heavier forms and species involves the help of a doctor. Perhaps dehydration will be stopped by the infusion method (intravenous administration of solutions). The appointment of antibiotic therapy is inappropriate, most likely, adequate treatment is carried out to restore the functions of the affected organs (kidneys, pancreas).

What to take when food poisoning?

Treatment of the disease, usually takes place at home, but this does not mean the possibility of self-treatment. What to take when food poisoning - should be decided by a doctor who takes into account the general anamnesis, the specificity of the disease and its appearance. As a self-help, which can be used as a temporary, primary measure, it is possible to take such drugs: 

1. Regidron, Hydrovit, Tourist, Normogidron (electrolytes and carbohydrates), or mineral water without gas to eliminate dehydration (dehydration).
2. Enterosgel, Enterol, activated carbon, Polysorb or other sorbents for detoxification.
3. Abundant drink - adults up to 2-2, 5 liters.

Etiotropic treatment, including antibiotics, is usually not required. Exceptions are 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 with food poisoning, especially if it comes to children under the age of 5, pregnant women, the elderly and those affected who have a history of serious chronic diseases.

Recovery after food poisoning

Often, cases where the digestive tract after a toxic infection for a long time is not restored. This is due to severe irritation of the intestinal wall and requires a more careful approach to treatment, possibly additional medical care. Recovery after food poisoning is basically compliance with the rules of nutrition, that is, dieting for food poisoning. The rules are simple - a fractional meal in the regime - every 1, 5 hours and a plentiful drink. The first month after intoxication shows the No. 1 diet according to Pevzner, and the second and third months will be followed by diet No. 5, which helps restore the liver and gallbladder function. As a rule, even the most severe cases of toxic infections pass for several months under condition

Fulfillment of medical recommendations and observance of a sparing, reasonable diet. Also effective is the "zigzag power" technique, when once a week the menu includes small portions of ordinary, non-dietary food. So the body "remembers" the normal mode of food intake and gradually restores the work of all its organs.

Prevention of food poisoning

Preventive measures, which can avoid food poisoning, are very simple and require only regularity and responsible attitude to their own health. Minimize the risk of foodborne diseases, reduce the severity and risk of the consequences of the disease will help to comply with the rules of personal and general sanitary hygiene.

Prevention of food poisoning is as follows: 

• Regularly wash your hands, literally after every visit to public places (markets, shops, hospitals, offices, transportation and so on). The fact that you need to wash your hands after every visit to the toilet should be known as saying "from the youthful nails." 
• Systematically ensure cleanliness in cooking areas. Not so important is the beauty in the kitchen, how much its purity. You need to wash all cutlery, dishes, more often to change kitchen towels and sponges. 
• Keep clean in the living area, as some types of bacteria perfectly coexist with household dust. 
• When buying food, pay attention to their storage conditions, terms of implementation, appearance.
• Do not buy products in spontaneous markets, in places not suitable for trade, not equipped with refrigeration.
• Observe the rules of food storage at home.
• Ruthlessly throw even slightly spoiled food. Do not allow it to be recycled.
• Observe the rules of heat treatment of products - boil milk, eggs - boil or cook, as well as meat, fish.
• Store cooked food no more than 1,5-2 hours in open form at room temperature.
• Store semi-finished products, raw foods separately from ready meals, preferably in a closed form, not allowing contamination.
• Do not eat fungi of a dubious kind, mushrooms growing along the trails, industrial facilities, bought in the spontaneous markets from unfamiliar sellers.
• Garbage baskets, buckets keep closed and clean them as often as possible.

Prevention of toxic infections is also the observance of the following preventive measures: 

1. Systematic monitoring of compliance with sanitary and hygienic standards. This concerns first of all personal hygiene (washing hands).
2. Hands should be washed not only after visiting public places, but before and after cooking, especially if raw meat, fish was prepared.
3. Vegetables, fruits, berries should be water treated. If the consistency of the product allows, it is better to burn it with boiling water.
4. Products should be stored properly - in closed form, in the cold.
5. The finished products should be stored separately from the raw.
6. The purchase of products in natural markets is fraught with food poisoning.
7. Virtually all products need to be subjected to heat treatment - roasting, baking, boiling.

Prevention is the main measure that will help protect yourself and your loved ones from foodborne disease. Food poisoning is 90% inattention, non-observance of sanitation by the person himself.

Investigation of food poisoning

The investigation of cases of food poisoning, especially of a massive nature, is extremely necessary for many reasons. The main reason is quite clear: prevention of the spread of infection and differentiation of poisoning from foodborne infection. Food poisoning is much faster localized and neutralized, it is not as dangerous in the epidemiological sense as intestinal infectious diseases, characterized by high contagiousness. According to the laws that nobody canceled, but did not update, unfortunately, also, literally every case of food poisoning is supposed to be investigated. This should be done by sanitary doctors, sanitary epidemiological stations, as well as by doctors who supervise the territorial section of the city, village and so on. The investigation of food poisoning includes three stages: 

1. Fixation of the fact of the disease.
2. Clarification of the true cause of the toxicoinfection, all epidemiologically dangerous conditions of infection, the definition of a possible causative agent or factor. 
3. Carrying out measures that at least localize the outbreak of food poisoning, as a maximum - it is neutralized.

Usually a medical doctor removes a potentially dangerous product for research in the laboratory. Also, feces and vomit masses are collected as a material for bacteriological inoculation. Blood, urine, too, are subject to analytical research, but already in the second turn. If the cause of the disease is the products of one batch, put up for sale in the store, the whole lot is seized, the sale is prohibited. In addition, all participants of a dangerous meal are questioned, even if they do not show symptoms of food poisoning.

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