Food poisoning

Introduction to food poisoning Food poisoning refers to acute toxic diseases caused by eating foods that are not conducive to human health. Food poisoning usually occurs without knowing it. Food poisoning is caused by eating food contaminated with bacteria and their toxins, or by ingesting acutely toxic diseases caused by toxin-containing animals and plants such as poisonous mites and puffer fish. Deteriorating foods and polluted water sources are the main sources of infection. Unclean hands, tableware and infected flies are the main routes of transmission. There are many reasons for food poisoning. The most common and most common cause is food contamination by bacteria. Clinical manifestations of acute gastrointestinal symptoms such as above vomiting, diarrhea, abdominal pain, severe cases may be life-threatening due to dehydration, shock, circulatory failure. If vomiting or abdominal pain is obvious, oral administration of propantheline (Prubensin) or subcutaneous injection of atropine may be performed, or anisodamine may be administered. Those who can eat should be given oral rehydration. Severe vomiting can not eat or frequent diarrhea, given intravenous saline drops. basic knowledge The proportion of illness: 3% Susceptible people: no specific population Mode of infection: non-infectious Complications: dehydration shock

Cause of food poisoning

There are many reasons for food poisoning, which can be divided into the following categories:

Unsanitary food (26%):

There are many reasons for food poisoning. The most common reason is that food is contaminated by bacteria. According to the statistics of food poisoning in China in the past five years, bacterial food poisoning accounts for about 50% of the total food poisoning, while animal foods. It is the main food causing bacterial food poisoning. Among them, meat and cooked meat products rank first, followed by spoiled poultry, sick and dead meat, fish, milk, and leftovers.

There are several reasons why food is contaminated by bacteria:

1. Poultry and livestock are sick birds and sick animals before slaughter; 2. Cutlery, chopping boards and utensils are unclean, raw and cooked cross-infection; 3. Poor hygiene, breeding of mosquitoes and flies; 4. Food workers contaminate food with bacteria; Not fully heated before eating, not fully cooked.

The initiators of bacterial food poisoning include Salmonella, Staphylococcus, Escherichia coli, Botox, and Hepatitis virus.

Edible mildew food (20%):

Fungi grow and multiply in grains or other foods to produce toxic metabolites. Poisoning of toxic substances such as humans and animals is called fungal food poisoning. Poisoning occurs mainly through food contaminated by fungi, using common cooking methods. Heat treatment can not destroy the mycotoxin in food. The growth and reproduction of fungi and the production of toxins require a certain temperature and humidity. Therefore, poisoning often has obvious seasonality and regionality.

Eat toxic organisms (15%):

Food poisoning caused by ingestion of animal poisoning foods is animal food poisoning. There are two main types of animal poisoning foods; certain parts of animals or animals that naturally contain toxic components are used as foods, and ingestion causes poisoning reactions; A large number of edible animal foods with toxic components, such as eating squid, can also cause poisoning. In recent years, animal food poisoning in China is mainly puffer fish poisoning, followed by fish gallbladder poisoning.

Edible toxic plants (20%):

There are mainly three kinds: 1) Plants or their processed products that naturally contain toxic components are used as foods, such as tung oil, cannabis oil, etc.; 2 plants that fail to destroy or remove toxic components during food processing. As food, such as cassava, bitter almonds, etc.; 3 under certain conditions, improper consumption of a large number of toxic ingredients of plant food, edible fresh day lily, germinated potatoes, unsalted pickles or uncooked lentils, etc. Poisoning, usually caused by eating poisonous plants or toxic plant seeds, or improper cooking and processing methods, without removing the toxic substances in the plant, the most common plant food poisoning is bean poisoning, poisonous mushroom poisoning, cassava poisoning; Toxic mushrooms causing death, potatoes, mandala, ginkgo, bitter almonds, tung oil, etc. Most of the plant poisonings have no specific treatment. For some serious poisoning that can cause death, it is very important to eliminate the poison to the prognosis of the poisoned.

Ingestion of toxic chemicals (15%):

Mainly include: 1 eating food contaminated with toxic chemicals; 2 adding food additives that are not food-grade or forged or banned, foods for nutritional supplements, and food poisoning caused by excessive use of food additives 3; foods that cause chemical changes in nutrients due to storage, etc., such as rancidity caused by poisoning, food poisoning caused by chemical poisoning foods is chemical food poisoning, the characteristics of chemical food poisoning are: onset and eating time It is related to the amount of food. It usually occurs shortly after eating. It is often group-based. Patients have the same clinical manifestations. The remaining chemical foods, vomit, blood and urine can be detected in chemical poisons. When dealing with chemical food poisoning, Highlight a "fast" word! Timely processing is not only important for saving the lives of patients, but also for controlling developments, especially when group poisoning and chemical poisons are not known for a while.

Food poisoning prevention

1. Do a good job in food hygiene supervision and canteen hygiene. It is forbidden to eat sick and dead poultry or other degraded meat. It is best not to eat drunk shrimps, salted crabs, etc.

2, refrigerated food should be quality and fresh, animal food should be thoroughly heated before cooking, and should be fully heated before the meal.

3, cooking and cooking should be separated to avoid cross-contamination.

4, canned salted food, should be boiled for 6 to 10 minutes before eating.

5. It is forbidden to consume poisonous animals and plants such as poisonous cockroaches and puffer fish.

6. If the cook or the nurse has a Salmonella infection or a carrier, the worker should be removed from the work and returned to the original job after 3 times of negative stool culture.

Food poisoning complications Complications dehydration shock

Severe cases can lead to dehydration, acidosis, and even shock.

Symptoms of food poisoning Common symptoms Metabolic acidosis fever accompanied by abdominal pain, ... scapula with "simulation sputum" diarrhea lacrimal gland sweat gland and parotid gland ... food allergic liver cell cable stent collapse ramie is common in ...

First, the symptoms:

Although the causes of food poisoning vary and the symptoms vary, they generally have the following epidemiological and clinical features:

1. The incubation period is short, usually from a few minutes to a few hours. After ingesting toxic food, a group of patients appeared almost simultaneously in a short period of time, which was fierce and soon formed a peak, which was in epidemic;

2, the patient's clinical performance is similar, and mostly based on acute gastrointestinal symptoms;

3. The onset is related to the ingestion of certain foods. The patient has eaten the same kind of toxic food in the near future, the scope of the disease is consistent with the distribution of food, and the non-food is not sick. After stopping eating the food, there will be no new cases soon;

4, the general person is not infected. The incidence curve showed a sharp rise and fall, and there was no aftermath of the onset curve of infectious diseases.

5. There is obvious seasonality. Bacterial and toxic animal and plant food poisoning occurs in summer and autumn; botulism and nitrite poisoning occur in winter and spring.

Second, the signs:

Fever, shock, diarrhea, nausea and vomiting, abdominal pain, dehydration, metabolic acidosis, peripheral vascular signs.

Food poisoning check

Specimen collection In order to find pathogens, specimens should be collected from various aspects according to actual conditions: such as excrement, vomit, feces, surplus food, utensils, etc.

There are many bacteria that cause food poisoning clinically, such as Salmonella, Campylobacter jejuni, Staphylococcus, Vibrio parahaemolyticus, Bacillus cereus, pathogenic Escherichia coli, Proteus, Clostridium botulinum, Enterocolitis Yersin Bacteria, etc.

Fecal culture is important for clinical diagnosis, but sometimes fecal culture does not necessarily have pathogenic bacteria.

1. Salmonella is one of the main pathogens causing food poisoning. It is also the most common cause of food poisoning. Food poisoning caused by Salmonella Staphylococcus aureus is generally isolated from the patient's stool or vomit: mainly through food. Or enterotoxin test in feces for diagnosis, because the contaminated food is heated and the staphylococcus has been killed, if cultured, a negative result occurs, and the enterotoxin is not destroyed under heating, therefore, enterotoxin The test can be assisted by animal testing or enzyme-linked immunoassay.

2, food poisoning caused by Vibrio parahaemolyticus: mainly caused by the intake of aquatic products contaminated by Vibrio parahaemolyticus and pickles, the food poisoning caused by the bacteria is mainly diagnosed by bacteriology, but in the case of fecal culture Most cases turn negative on the second day, and only a few can be detected positive within 2 to 4 days. Therefore, fecal culture should be collected in suspicious cases in time to avoid affecting the positive detection rate.

3. Food poisoning caused by Campylobacter jejuni: It is caused by meat or milk contaminated by Campylobacter. The diagnosis of the disease is mainly based on bacteriological examination.

4. Food poisoning caused by Yersinia enterocolitica: specimens of food or feces are collected for bacterial culture.

5, food poisoning caused by Clostridium botulinum: mainly caused by exotoxin produced by Clostridium botulinum, usually should collect suspicious food on the spot for bacteriological testing or animal testing.

6. Clostridium botulinum poisoning in infants: It is mainly diagnosed by the detection of endotoxin in feces, and the results of fecal culture are mostly negative.

Diagnosis of food poisoning

diagnosis

It can be diagnosed based on medical history, clinical symptoms and laboratory tests.

Differential diagnosis

1, cholera and deputy heap disorder: for painless vomiting, first vomiting and vomiting, and no fever, stool is rice sputum water, because the incubation period can be as long as 6 days, it is rare in the short-term large number of patients, stool smear The diagnosis can be confirmed by fluorescence microscopy staining and culture to find Vibrio cholerae or Vibrio cholera.

2, acute bacillary dysentery: occasionally food poisoning outbreaks, generally less vomiting, often fever, urgency and heavy, feces mixed with pus, lower abdominal and left lower abdomen obvious tenderness, stool microscopic examination of red blood cells, pus cells and macrophages About half of the cells, stool culture, have dysentery bacilli growth.

3, viral gastroenteritis: is caused by a variety of viruses, characterized by acute enteritis, incubation period of 24 ~ 72h, mainly manifested by fever, nausea, vomiting, abdominal distension, abdominal pain and diarrhea, drainage can be loose, vomiting and diarrhea In severe cases, water, electrolytes and acid-base balance disorders can occur.

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