Food Poisoning; risk factors, signs, diagnosis, management and prevention

Introduction

Food poisoning is a general term used to describe any illness caused by the consumption of food or water contaminated with bacteria and [or] their toxins, viruses or chemicals (natural toxins produced by certain plants and animals). The effect of the ‘poisoning’ is most often restricted to the gastrointestinal tract i.e. gastroenteritis, but it may also involve other systems of the body depending on the organism or the toxin implicated.

The symptoms, varying in degree and combination, include abdominal pain, vomiting. diarrhoea, and headache. Most of the illness are mild and improve without any specific treatment. With food poisoning, more serious cases can result in life-threatening neurologic, hepatic, and renal syndromes leading to permanent disability or death.

Some patients have severe disease and require hospitalization, aggressive hydration, and antibiotic treatment.

Risk factors

The most common contributory factors of food poisoning include;

  • Poor personal and environmental hygiene practices.
  • Poor food hygiene practice.
  • Leaving prepared food at temperatures that allow bacterial and other microbial growth.
  • Inadequate cooking or reheating.
  • Infections in food handlers.
  • Extremes of age i.e. the very young and very old are more susceptible.
  • Immunosuppressed/Immunocompromised people.
  • Cross contamination may occur when raw contaminated food comes into contact with other Foods, especially cooked foods, through direct contact or indirect contact on food preparation surfaces e.g. chopping boards. Utensils, hands etc.

Clinical Features

  • Abdominal pain, electrolyte loss may also cause painful abdominal cramps.
  • Diarrhoea; usually lasting less than 2 weeks.
  • Stool changes; bloody or mucoid if invasion of intestinal or colonic mucosa but profuse rice watery if non-invasive.
  • Abdominal bloating.
  • Fever and chills (common with invasive and systemic disease).
  • Headache.
  • Nausea and vomiting.
  • Weakness.

Diagnosis

  • History and physical examination.
  • Stool R/E.
  • Stool C/S.
  • FBC with differentials.
  • Blood C/S.
  • X-ray.

Medical Management

Because most cases of food poisoning are self- limiting, there is no specific treatment, management is thus symptomatic.

  • Adequate hydration and electrolyte replacement with ORS.
  • Intravenous Fluids for severely dehydrated patient.
  • Adsorbents (aluminum hydroxide).
  • Anti-secretory agents (e.g. bismuth subsalicylate).
  • Anti-peristalsis agent (e.g. loperamide).
  • If food poisoning is caused by a toxin, the appropriate antitoxin should be administered as quickly as possible (usually within 72hrs).

Nursing Management

Most patients with food poisoning are managed on outpatient basis; only severe cases are admitted for stabilization and observation. Management of these patients is supportive or symptomatic. These include;

  • Isolation and use of infection prevention protocols where necessary.
  • Serve Intravenous Fluids as ordered.
  • Observation for signs or improvement of deterioration.
  • Monitor Intake and output and balance according to your hospital protocols.
  • Personal hygiene and perianal care.
  • Promote rest and comfort.
  • Education on disease process, home care and prevention.

Prevention

  1. Wash hands thoroughly under running water before and during food preparation and after using the bathroom.
  2. Do not prepare food for others when sick.
  3. Cook meat, eggs, poultry, fish and other animal products thoroughly.
  4. Wash fruits and vegetable thoroughly with soap and under running water before using them.
  5. Vegetables and fruits can also be wholly immersed in vinegar or washed and then eaten.
  6. Refrigerate leftovers promptly (about 4hrs after preparation) do not let food stand at room temperature.
  7. Do not put cooked meat on a plate that has held raw meat. Wash food preparation surfaces and containers thoroughly and regularly.
  8. Throw away bulging or leaking cans, or any food that smells spoiled or rancid.
  9. Purchase pasteurized dairy productions or boil unpasteurized milk at a temperature of 68Oc for 30mins before consumption.
  10. Maintain good personal and environmental hygiene.
  11. Control vectors and pest.
  12. Do not cut fruits and vegetables on a cutting board that has been used for raw chicken or beef until the cutting board has been washed. Avoid contaminating surfaces and other foods with the juices of uncooked meats.
Photo by Verywell Health

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