Food poisoning are acute intestinal infections caused by eating foods containing microorganisms and their toxins. Food poisoning are characterized by a sudden onset, bouts of nausea and repeated vomiting, diarrhea, cramping abdominal pain, fever and symptoms of intoxication. Diagnostics is carried out by bacteriological examination of vomit, gastric lavage, feces, food products. In case of food poisoning, gastric lavage, intake of enterosorbents, enzymes, probiotics, oral or parenteral rehydration is necessary.
General information
Food poisoning is a group of acute infectious diseases resulting from human poisoning with food containing exotoxins produced by conditionally pathogenic flora. Food poisoning occurs with the phenomena of acute gastroenteritis, intoxication and dehydration. Susceptibility to food poisoning is universal (80-100%); the incidence is widespread, second only to ARI in frequency. The danger of food poisoning is due to the frequency of mass outbreaks, the difficulty of detecting the source of infection, the possibility of developing infectious-toxic, dehydration shock and even death, especially among children and the elderly.
Causes
The causative agent of food infection can be microorganisms of various genera: Klebsiella, Enterobacter, Citrobacter, Serratia, Enterococcus, etc. These bacteria are very common in nature, the vast majority of them are part of the normal biocenosis of the human intestine. Since the clinical picture of toxicoinfection develops as a result of exposure not to the microorganisms themselves, but to toxic products of their vital activity, the pathogen as such is often not isolated. Conditionally pathogenic bacteria are able to change their biological properties (resistance to antibiotics and disinfectants, virulent characteristics) as a result of environmental factors.
The source and reservoir of infection are usually people and farm animals, poultry. Most often these are people suffering from bacterial diseases with active release of the pathogen (purulent diseases, sore throats, furunculosis), dairy cattle, patients with mastitis. A healthy carrier can also become a source of infection. For some genera of bacteria that can cause food toxicoinfection, soil and water, environmental objects contaminated with animal and human feces can serve as a reservoir.
Toxicoinfections are transmitted via the fecal-oral mechanism mainly by food. Microorganisms get into food products, where their active reproduction and accumulation takes place. Food toxicoinfection develops when a person eats foods in which a high concentration of microorganisms has formed. Toxicoinfections in the vast majority of cases occur when using animal products: meat, dairy products, confectionery with fatty creams, fish. Meat and semi-finished products from it (minced meat) are the main source of clostridial infection. Some methods of making semi-finished products and dishes, storage and transportation conditions contribute to the germination of spores and the reproduction of bacteria. Products affected by staphylococci are characterized by the absence of visible and taste differences from normal food. Various objects and objects, water sources, soil, dust can take part in the transmission of infection. The disease is characterized by seasonality: in the warm season, the frequency of toxic infections increases, since the air temperature promotes the active reproduction of bacteria. Toxicoinfections can occur both in the form of individual cases in everyday life, and in outbreaks with organized nutrition in collectives.
The natural susceptibility of people to these infections is high, as a rule, everyone who has eaten products affected by microorganisms becomes ill with varying degrees of severity. Persons with weakened protective properties of the body (children of the first years of life, the elderly, patients after surgery or who have undergone a long course of antibiotic therapy) are at special risk, they may have the most severe toxicoinfections. In the pathogenesis of toxicoinfections, the main role is played by toxins secreted by pathogens. Depending on the predominant type of toxins, the features of the clinical course also differ.
Symptoms of food poisoning
The incubation period of toxicoinfection rarely exceeds several hours, but in some cases it can be shortened to half an hour or lengthened to a day. Although the causative agents of toxicoinfection are quite diverse, the clinical picture of infection is usually similar. The disease usually begins acutely, with bouts of nausea and repeated vomiting. Enteritic diarrhea is characteristic with a frequency of defecation 10 times a day or more. There may be abdominal pain of a cramping nature, fever (usually lasts no more than a day), signs of intoxication (chills, body aches, weakness, headache). Rapid loss of fluid with vomiting and feces leads to the development of dehydration syndrome. Patients, as a rule, are pale, the skin is dry, the limbs are cold. There is pain during palpation in the epigastrium and near the navel, tachycardia, arterial hypotension. The disease usually lasts no more than 1-3 days, after which the clinical symptoms subside.
There are some features of the course of toxicoinfection, depending on the nature of the pathogen. When staphylococci are affected, a rapid acute onset is noted, gastrointestinal symptoms prevail, the temperature may remain normal or reach subfebrile figures, diarrhea may be absent. From the very first hours of the disease, convulsions and cyanotic skin may occur, but most often the acute clinic lasts no more than 1-2 days and does not cause serious violations of water-electrolyte homeostasis. Clostridial lesion is similar to that of staphylococcal infection, but it is more characterized by a lesion of the large intestine with diarrhea, blood may be present in the feces. Fever is usually not noted. Proteinaceous toxicoinfection is distinguished by fetid feces.
Toxicoinfections usually occur for a fairly short time and do not leave consequences. In rare cases: in severe cases, people with a weakened body may develop dehydration shock, sepsis, acute cardiovascular insufficiency.
Diagnostics
When diagnosing food poisoning, the pathogen is isolated from vomit, feces, gastric lavage. When the pathogen is detected, it is sown on nutrient media and its toxigenic properties are determined. However, in many cases, detection is impossible. In addition, not always detected microorganisms are the direct cause of toxicoinfection. The relationship of the pathogen with the disease is determined either by serological tests, or by isolating it from food and from persons who have consumed the same food as the patient.
Treatment
The primary therapeutic measure for food toxicoinfection is the fastest possible probing and gastric lavage (in the first hours of the appearance of clinical signs of poisoning). If nausea and vomiting are delayed, this procedure can be carried out later. Enterosorbents are used to get rid of intestinal toxins and produce a siphon enema. To prevent dehydration, the patient is given fractional small portions of rehydration solutions, sweet tea. The amount of fluid taken by the patient should compensate for its loss with vomiting and feces.
With the development of severe dehydration, intravenous administration of rehydration mixtures is performed. Therapeutic nutrition is recommended for patients with toxicoinfection during the acute period. In severe cases, antibacterial agents may be prescribed. After the cessation of vomiting and diarrhea, enzyme preparations (pancreatin, trypsin, lipase, amylase) are often recommended for the speedy restoration of digestion and probiotics or products containing bacteria necessary for the normalization of intestinal biocenosis.
Prognosis and prevention
In the vast majority of cases, the prognosis is favorable, recovery occurs on 2-3 days. The prognosis worsens with the development of complications, infectious and toxic shock. The general prevention of toxicoinfections consists in measures of sanitary and hygienic control at enterprises and farms whose activities are related to the manufacture, storage, transportation of food, as well as in catering establishments, canteens of children’s and production collectives. In addition, veterinary control over the health of farm animals is carried out. Individual prevention consists in observing the rules of personal hygiene, storage and culinary processing of food products. Specific prevention, due to the multiplicity of pathogen species and its widespread distribution in nature, is not provided.