Soup poisoning

In most cases, soup poisoning is provoked by the rapid multiplication of pathogenic microorganisms in the dish - in particular, Staphylococcus aureus and Escherichia coli. Toxic infection is most often caused by low-quality products with expired shelf life, or those that have been stored in improper conditions, or prepared with violations of sanitary and hygienic standards.

It is also not uncommon for poisoning to occur after consuming toxic plants and mushrooms added to a dish through ignorance or carelessness. [1]

Epidemiology

For most people, soup poisoning is not fatal and leads only to the appearance of temporary malaise and digestive disorders. However, the danger of such intoxication should not be underestimated. According to statistics, more than 600 million people suffer annually as a result of the use of low-quality products on our planet. At the same time, more than 420 thousand people die. European statistics has such figures: for 23 million poisoned - 5 thousand deaths.

The most dangerous dishes experts consider those that are dressed with sour cream or mayonnaise, cooked on the basis of canned food, raw meat or fish.

Most often poisoning develops as a result of faulty soup preparation technology. For example, a person uses the same knife and cutting board to cut meat and vegetable products, and stores the already cooked soup next to raw preparations, or even outside the refrigerator.

The most common causes of death are bacterial intoxications: salmonellosis, staphylococcus, streptococcus, E. Coli, etc. Such lesions have common symptoms such as diarrhea and vomiting, leading to dehydration and failure of water-electrolyte balance, resulting in death.

Poisoning by specific poisons contained in mushrooms, plants, chemical impurities is not excluded.

Causes of the soup poisoning

Soup poisoning is a digestive disorder that occurs after a person has consumed a spoiled or poor-quality first course. Food poisoning also includes salmonellosis, dysentery, escherichiosis, and other pathologies provoked by pathogenic microorganisms.

Microbes are present everywhere, but the important factor is their species and quantity. If you do not observe hygienic rules, improperly cook and store food, eat stale and poor quality food, all the signs of intoxication occur.

Specialists divide food toxic lesions into two subgroups:

• poisoning from soups containing inherently poisonous, inedible components (mushrooms, plants);
• poisoning from originally edible soups that were either improperly prepared or improperly stored.

The second subgroup is considered to be more common.

People can suffer as a result of adding dirty vegetables and greens, poor quality water, sour milk, spoiled fermented milk products, spoiled meat or fish to the first dish. In children, the most common cause of poisoning is unwashed hands and generally failure to observe basic hygiene recommendations. [2]

Risk factors

Soup poisoning occurs when a spoiled or initially low-quality product enters the body. Intoxication can occur in one person or several people at once after consuming a sour dish. The most common cases of poisoning occur in the summer heat, after vacationing in summer cottages, when eating in public canteens, cafes in case of non-compliance with the rules of preparation and storage of food products.

A person could be poisoned:

• any soup if you didn't wash your hands before eating it;
• any soup poured into an unwashed pot or plate;
• when using poor quality water for cooking or unwashed vegetables and herbs;
• when adding sour cream or mayonnaise to the soup, as well as fresh herbs without subsequent boiling (the shelf life of such a dish is significantly reduced);
• if the soup wasn't fully cooked.

At increased risk of poisoning are:

• toddlers under the age of 5;
• the elderly, people with weakened immune defenses;
• people suffering from diseases of the digestive organs, diabetes mellitus or renal pathologies.

Pathogenesis

Sometimes after eating certain dishes and products, an acute digestive disorder develops, associated with the entry of opportunistic and pathogenic bacteria into the gastrointestinal tract, as well as toxic substances produced by them. Microorganisms begin to actively multiply, toxins are absorbed into the general circulatory system, and general malaise, weakness, headache are added to digestive problems. The mucosa of the digestive organs is irritated, their function is impaired.

Poisoning with soup is predominantly bacterial. But the presence of pathogenic flora in the first dish is not necessarily the cause of intoxication, since a healthy adult organism is able to actively resist toxicoinfection. In environmental conditions, under the influence of increased temperature or ultraviolet rays, most microbes die.

However, there are exceptions. Representatives of opportunistic flora, which got into the soup, in the process of life begin to release toxic substances. It turns out that poisoning with soup can occur as a result of the action of toxins already present in the food, and under the influence of bacteria that are activated in the intestine. For this reason, food intoxication is often called toxicoinfection.

You can get soup poisoning if:

• not adhering to the basic rules of cooking the dish;
• It is wrong to store soup that has already been cooked;
• ignore hand washing before eating;
• use potentially poisonous mushrooms or herbs in the cooking process;
• Do not shelter food from insects.

The term for keeping many foods fresh is quite short, and often even a few hours spent at room temperature is often enough for a dish to go bad.

Specialists distinguish such categories of soup poisoning, which depends on the causative agent:

• staphylococcal poisoning;
• clostridial;
• poisoning caused by parahaemolytic vibrios;
• caused by waxy bacilli.

A separate category includes specific poisonings: salmonellosis, botulism, mixed intoxications (enterococcal, etc.). In addition, it is possible to be poisoned by soup that contains toxic components of non-bacterial etiology - for example, mushroom poisons, synthetic fertilizer particles, etc.

Symptoms of the soup poisoning

The clinical picture in soup poisoning is most often represented by the following symptoms:

• Nausea is a manifestation of any food intoxication. Vomiting is caused by the body's attempts to remove the "wrong" food from the gastrointestinal tract on its own. That is why problem food is in the stomach for a long time (as they say, "the stomach stands"), after which there is nausea, turning into vomiting attacks. In this case, vomiting can bother even against the background of an empty stomach: the vomiting mass in this case consists of gastric and bile secretion, a large amount of mucus, and sometimes - the contents of the intestine.
• Elevated temperature is usually accompanied by chills, general malaise, trembling fingers. Certain types of soup poisoning, caused by salmonellosis or botulism, occur with an increase in temperature values up to 40°C. If the poisoning is not severe, the indicators are often normal.
• General malaise is expressed in the appearance of pain in the head, unpleasant sensations of brokenness in the body, weakness and apathy. Some people experience low blood pressure, which can be explained by a weakening of vascular tone. There is tissue hypoxia, deterioration of brain nutrition, which is manifested by dizziness, lethargy, blurring of consciousness, drowsiness.
• Pain - sharp, spastic - is noted in the projection zone of the stomach and intestines, often accompanied by diarrhea.
• Stools are predominantly liquid, abundant, watery, sometimes stinky.

Most patients after soup poisoning show signs of dehydration - lack of fluid in the body. The condition is manifested by dry mucous membranes, blurred consciousness, drowsiness, thirst.

Initial manifestations of soup poisoning are detected in a few hours, less often - 1-2 days after consumption of the problematic dish. The onset is predominantly acute, dominated by disorders of the digestive organs. The main signs occur sequentially:

• lowers blood pressure;
• Temperature rises (not always);
• there is nausea, often with gagging;
• diarrhea with frequent urges to defecate;
• begin to worry about pain and intestinal cramps due to toxic effects on the mucous tissues of the digestive organs;
• protein, carbohydrate and water-salt metabolism.

If these signs appear, it is important to provide the patient with qualified help as soon as possible. If the necessary measures are not taken, the person will be aggravated metabolic disorders, seizures will appear, loss of consciousness is possible.

Mushroom soup poisoning

The main causes of mushroom soup poisoning are as follows:

• ignorance and lack of experience when picking mushrooms, getting into the dish initially poisonous species;
• improper culinary processing of conditionally edible mushrooms;
• violations in the process of preparation and storage of mushroom soup.

Signs of mushroom poisoning make themselves known in an hour and a half to two hours after their consumption:

• nausea, vomiting;
• weakened pulse;
• elevated body temperature;
• symptoms of acute gastroenteritis;
• coldness in the extremities;
• severe abdominal pain, diarrhea.

Poisoning by fly agaric or false mushrooms is characterized by delirium, hallucinations, development of an inadequate state.

In severe poisoning - for example, pale grebe - there is severe salivation and sweating, anuria, slight constriction of the pupils, signs of heart failure, respiratory failure. If the necessary help is not rendered, the person falls into a coma, and death occurs.

If edible canned mushrooms that have been improperly stored are used to make soup, botulism can develop, a serious illness that is manifested by nausea, double vision, cramps, diarrhea, pain in the head and abdomen, and difficulty breathing. At the first sign of such symptoms, you should seek medical attention immediately.

Pea soup poisoning

Poisoning, or food toxicoinfection, occurs due to spoilage, improper storage or insufficient heat treatment of the components of the dish. It is often caused by staphylococcus aureus (if the soup was made with meat), salmonella, E. Coli, proteins, botulism (if the soup was based on canned food or sausage).

A spoiled dish can be recognized by its characteristic unpleasant smell, the appearance of bubbles on the surface, as well as by its thick consistency and sour taste. If such soup is still eaten, the same day there is nausea, general weakness, unpleasant taste and dry mouth, rubber and abdominal pain. In weakened patients, there is a darkening of the eyes, tremors in the body, pain in the head, fainting. This condition requires urgent medical attention with further treatment in the infectious disease department of the hospital.

Peas are a vegetable protein product. It spoils quickly if the soup is left at room temperature for a long time. And in the refrigerator, the shelf life of the dish is limited to 1-2 days. This should be taken into account and try to prepare pea soup with the calculation for 1-2 meals.

Fish soup poisoning

Systematic use of fish dishes is very beneficial to health, as it normalizes the cardiovascular system, activates brain activity, prevents the development of atherosclerosis and vascular thrombosis. But sometimes such an uncomplicated dish, such as fish soup, can cause the development of adverse effects.

Poisoning is most often due to the use of stale fish (especially fish heads), improper storage of the finished product. The disorder may be manifested by such disorders:

• cholera-like intoxication;
• paralytic poisoning;
• histamine-like intoxication.

The development of toxic process is noted in case of non-compliance with the temperature regime and terms of storage of fish products. Victims experience gastrointestinal pain, urges to vomit, diarrhea, thirst, muscle pain, cramps, abdominal cramps.

Complications and consequences

Severe soup poisoning can lead to the development of a number of adverse effects:

• Disturbance of the balance of intestinal microflora and, as a consequence, frequent digestive disorders, regular stool problems.
• Septic condition in the form of a systemic inflammatory response to the generalization of infection. Such a critical disorder can occur if severe soup poisoning occurred against a background of weakened immune defense, or other infectious pathologies.
• Infectious-toxic shock is caused by the entry of a large number of toxic substances into the bloodstream. Severe soup poisoning can lead to damage to the cardiovascular system.
• Hypovolemia, decreased circulating blood volume combined with decreased cardiac output cause dysfunction of many organs. There is respiratory distress, blurred consciousness, which in severe cases ends in death.

The danger of complications is assessed depending on the type of intoxication, on the number of pathogenic flora that has penetrated the digestive system.

Diagnostics of the soup poisoning

The diagnosis of food poisoning is established on the basis of clinical symptoms, information obtained during the collection of epidemiologic anamnesis (group poisoning, failure to comply with the rules of heat treatment and storage of food, etc.), the results of laboratory diagnosis.

The main technique for laboratory confirmation of the diagnosis is bacteriological analysis of vomit and fecal matter, soup residues, etc.

If a bacterial component is detected, its recognition as the causative agent of food poisoning should be rigorously argued. For this purpose, a differentiation should be made, taking into account clinical, laboratory and epidemiologic information with other intestinal infections, and the etiologic involvement of the suspected pathogen should be proved by isolation of the same bacteria from biomaterial from patients, from the food product, etc. The bacterial component of the food poisoning should be recognized.

To assess the degree of damage to the body, ultrasound, gastroduodenoscopy, less often - radiography and encephalography, ECG (as indicated).

Differential diagnosis

The clinical picture of soup poisoning can easily be mistaken for manifestations of some other pathologies and intoxications. Most often differential diagnosis has to be made with viral and bacterial intestinal infections. In this case, the first point in the diagnosis is a thorough questioning of the patient. If he points to the use of poor-quality or stale food, then you can immediately suspect food poisoning, because infectious diseases develop not in the stomach, but in the intestinal cavity.

If soup poisoning is acute and has a stormy clinic, there is usually no time to deal with the establishment of the causative factor and classification type of toxic lesion. It is necessary to act quickly, so treatment has to be prescribed without waiting for the results of laboratory diagnosis. If there are many patients with similar poisoning, then initiate an epidemiologic study.

In general, differentiation is made with these pathologies:

• acute diarrheal infections (escherichiosis, salmonellosis, other food toxic infections, shigellosis, cholera);
• poisoning from chemicals, toxic substances, mushrooms;
• Acute therapeutic abdominal pathologies.

In elderly patients differentiate poisoning with myocardial infarction, which is often accompanied by abdominal syndrome, as well as with hypertensive crisis.

Treatment of the soup poisoning

Treatment for soup poisoning should begin as early as possible, at the first signs of discomfort. The patient should induce the gag reflex, cleanse and flush the stomach. It is optimal to give him to drink 2-3 cups of water, and then press the root of the tongue with a finger. Such rinsing should be repeated until only water comes out, without food residue. Important: if the soup poisoned a small child (up to 2 years old), then such a measure with inducing vomiting is contraindicated. An ambulance should be called immediately.

After cleansing the stomach, measures should be taken to eliminate toxic substances from the body and eliminate pathologically symptoms of poisoning. To do this, the patient is given enterosorbing drugs that bind and remove toxins from the digestive system. The most available and widespread are the following such drugs:

• activated charcoal - take up to 30 g per appointment as soon as possible after the first signs of poisoning (usually within half an hour);
• Enterosgel (in the form of paste or capsules: paste - 1 tbsp. Three times a day, capsules - 2 pcs. Three times a day);
• Smecta (3-6 sachets per day), Polysorb (0.1-0.15 g/kg 2-3 times a day);
• Lactofiltrum (three tablets three times a day).

It should be borne in mind that enterosorbents, in addition to toxic components, can remove medications from the body. Therefore, you should not take sorbents immediately after other medications. A break of 1-2 hours should be made between receptions. With prolonged use of sorbents can cause the development of constipation.

Medications for symptomatic treatment are selected individually, depending on the clinical picture of soup poisoning. Most often prescribed:

• antispasmodics, if the patient complains of abdominal pain of a spastic nature;
• preparations containing bismuth, if there are signs of irritation of the walls of the digestive organs.

When symptoms of dehydration appear, rehydration agents are prescribed. The most common of them is Rehydron. The solution is taken often and a little bit at a time, every 10-15 minutes, 1 tbsp. This preparation can be bought in a pharmacy, or prepared independently, dissolving in 1 liter of warm water 1 tsp. Salt, the same amount of baking soda, as well as one tablespoon of sugar.

In the absence of efficacy from the current therapy, the patient is prescribed intravenous infusion: the patient is placed on inpatient treatment. Drip infusion of glucose solutions, Trisol, saline is indicated.

If necessary, the treatment regimen is supplemented with antiemetics and antidiarrheals:

• Cerucal (10 mg up to 3 times a day);
• Loperamide (up to 2-12 mg/day);
• Motilium (1 tablet three times a day).

Until the full recovery of the body after soup poisoning, the patient is prescribed a special therapeutic diet. Thus, in the first 24-48 hours it is desirable not to eat at all, and drink only water, rehydration solutions and herbal teas. Further, as the condition normalizes, begin to introduce food. At first it is viscous rice porridge without oil, dry cookies, breadcrumbs.

Herbal treatment

Folk medicine offers its own methods of treatment for non-serious soup poisoning:

• Drink a decoction of dill or fennel with honey. Dill or fennel can be taken as fresh or dried, or even in the form of seeds. To prepare the remedy take 1 tbsp. Finely chopped fresh dill, or 1 tsp. Dried, or ½ tsp. Seeds, pour 200 ml of boiling water, cover with a lid and insist for 20 minutes. Then add 1 tsp. Honey and drink the remedy half an hour before meals or on an empty stomach, three times a day.
• Take an infusion of marshmallow root. Take 1 tsp. Crushed rhizome, pour 100 ml of boiling water, cover with a lid and insist for half an hour. Then the remedy is filtered, add a little honey. Take 1 tbsp. 4 times a day (children - 1 tsp.).
• Drink ginger tea. Pour 1 tsp. Grated ginger root 200 ml of boiling water, insist for 20 minutes. Drink every 20-30 minutes, 1 tbsp. L.
• Drink as much water as possible during the day with the addition of lemon juice, as well as green tea, strong black tea, infusion of rose hips and rowanberries, decoction of rice or flax seed.

Folk healers explain: treatment with herbal remedies will be much more effective if you abstain from eating for the initial 24-48 hours.

Prevention

There is no specific prevention of soup poisoning: there are no vaccines that can prevent the development of intoxication after the use of poor-quality or spoiled product. First of all, it is necessary to adhere to the technology of food preparation, comply with the conditions and terms of storage of preparations and finished products.

Catering workers and people who come into contact with food and already cooked dishes must regularly check their health and undergo laboratory tests for infectious agents. In the absence of a valid sanitary book, a person may not start work and must be suspended from work until a doctor's report is issued.

The food storage and preparation area should be clean. It is important to control the absence of rodents, insects (in particular cockroaches and flies).

In the kitchen there should be separate boards and knives for cutting meat, vegetables, fish, which will not only avoid poisoning, but also prevent accidental ingestion of excess product in the dish. At the end of cooking, boards and knives should be washed and additionally treated with boiling water.

It is necessary to control the temperature in the refrigerator, regularly check the term of suitability of products. Do not use non-potable water for cooking soup, leave the cooked dish in warm weather on the window or stove for a long time.

Known products should be used for cooking. Particular care should be taken when adding unknown mushrooms and plants to the soup.

Forecast

In most cases, mild soup poisoning passes by itself on the background of supportive nonspecific symptomatic measures and compliance with the diet. During 12-24 hours, the temperature normalizes, the rest of the pathological symptoms are resolved by the end of 1-3 days.

Many patients show signs of digestive system disturbances. These include abdominal pain and cramping, nausea, vomiting and/or diarrhea. An outbreak of food poisoning is indicated if there are at least two people with the same clinical picture who have eaten the same soup (or other food or drink).

A severe course of intoxication can lead to the development of complications. Lethal outcome in soup poisoning of an initially healthy person can be noted only in isolated cases - that is, extremely rare.

List of authoritative books and studies related to the study of food poisoning

1. "Foodborne Diseases: Case Studies of Outbreaks in the Agri-Food Industries" - by Clive Blackburn (Year: 2016)
2. "Food Safety: The Science of Keeping Food Safe" - by Ian C. Shaw, Bernard F. N. Greb (Year: 2017)
3. "Foodborne Pathogens: Microbiology and Molecular Biology" - by Pina M. Fratamico (Year: 2018)
4. "Foodborne Infections and Intoxications" - by Claudio O. Romaña (Year: 2013)
5. "Food Safety Management: A Practical Guide for the Food Industry" - by Yasmine Motarjemi (Year: 2013)
6. "Handbook of Foodborne Diseases" - by Y. H. Hui (Year: 2019)
7. "Food Safety: Emerging Issues, Technologies and Systems" - by Steven C. Ricke (Year: 2015)
8. "Food Poisoning and Foodborne Diseases" - by Colin Cleveland, Gillian A. Hill (Year: 2007)
9. "Food Microbiology and Laboratory Practice" - by M. Shafiur Rahman (Year: 2003)
10. "Toxicology and Risk Assessment: Principles, Methods, and Applications" - by Stephen M. Roberts, Robert C. James, Phillip L. Williams (Year: 2015)

Literature

• Luzhnikov, Yelkov: Medical Toxicology. National manual. GEOTAR-Media, 2014.
• Ivashkin, Lapina, Bogdanov: Gastroenterology. National guide. GEOTAR-Media, 2013.