Food poisoning - Causes, symptoms and treatment. MF.

Food poisoning( PTI) is a disease caused by infection not by bacteria proper, but by toxins that are formed as a result of the life of bacteria outside the human body - mainly in food. There are a large number of bacteria capable of producing toxins. Many toxins can persist in contaminated products for a long time, and some can withstand various treatments, including boiling for several minutes. A characteristic feature of food toxic infections are outbreaks, when a large number of people fall ill in a short period of time. Usually this is due to the joint use of the infected product. In this case, absolutely all people who eat contaminated food are infected.

The main causative agents of foodborne disease

The main bacteria, whose toxins are capable of causing foodborne toxic infections:

• Staphylococcus aureus - Staphylococcus aureus - is capable of producing a toxin that affects the intestine. Staphylococcus aureus is widely distributed in the environment and is perfectly preserved and multiplies in food products, which are for it a nutrient medium. If the dishes are left after cooking at room temperature( especially salads with mayonnaise, cream cakes, etc.), then they create the most favorable conditions for the reproduction of staphylococci and the production of toxin.
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• Bacillus cereus - the disease is usually associated with the use of dishes from rice( raw rice is often seeded Bacillus cereus).The causative agent multiplies in dishes left after cooking at room temperature. The toxin Bacillus cereus is heat-stable, and the boiling of the dish does not destroy it.
• Clostridium perfringens. This food toxicoinfection is associated with eating dishes from insufficiently boiled meat, poultry and legumes. The disease usually lasts no more than a day and passes without treatment.

Symptoms of food poisoning

To get the toxin into the blood, it takes several hours, sometimes minutes. Therefore, the incubation period( the time from the onset of infection to the first manifestations of the disease) is extremely short-no more than 16 hours.

For foodborne infections, an increase in body temperature up to 38-39 ° C, accompanied by chills, weakness, headache is characteristic. However, this kind of intoxication is not always met - sometimes the temperature rises slightly or remains normal.

The most typical manifestations of foodborne toxic infections are vomiting and diarrhea. These symptoms can appear separately from each other or simultaneously. Vomiting is usually accompanied by nausea and, as a rule, brings relief. Diarrhea copious watery - up to 10-15 times a day, accompanied by cramping pains in the peripodal region.

Then signs of dehydration are added to the general picture of the disease. The initial sign of fluid loss is dry mouth;with a more severe course of the disease, the pulse rate increases, blood pressure decreases, voice hoarseness, cramps of the hands and feet appear. When there is a spasm, you need to immediately call an ambulance team.

Prevention of foodborne disease

Prevention is to comply with the rules of personal hygiene: you must not forget about the "golden" rule - wash your hands before eating. It is not recommended to eat foods that have expired, even stored in the refrigerator, since many toxins can persist at low temperatures. Thoroughly wash vegetables and fruits. Particular care should be taken when traveling to developing countries, where acute intestinal infections( including food-borne diseases) are extremely common. On such trips it is recommended to eat freshly prepared hot dishes, avoid raw vegetables, salads, uncooked fruit, drink only boiled or disinfected water, do not drink ice-cream.

Desmol( bismuth subsalicylate) is an effective remedy for the prevention of travelers' diarrhea. The drug is taken internally at 524 mg( 2 tablets) 4 times a day. Its reception for 3 weeks is safe.

Dehydration in foodborne disease

Perhaps the most dangerous consequence of PTI is dehydration, which occurs as a result of a significant loss of fluid due to diarrhea and vomiting.

There are 4 degrees of dehydration.

1 degree: loss of fluid is 1-3% of body weight.

Only dry mouth, skin and mucous with normal humidity are felt. Hospitalization is usually not required. However, do not forget about the need to fill the lost volume with a plentiful drink. In the presence of severe nausea and vomiting, it is necessary to drink liquid on a tablespoon every 2-3 minutes.

2 degree: fluid loss is 4-6% of body weight.

With the 2nd degree of dehydration, the following symptoms are observed:

• Severe thirst;
• Mucous mouth, nose - dry;
• There may be some blue lips, fingertips;
• Roughness of voice;
• Convulsive twitching of hands and feet.

The appearance of seizures is caused by the loss of electrolytes - substances that play an important role in many processes in the body, including in the process of muscle contraction and relaxation.

• There is also a slight decrease in the turgor.

Turgor - is the degree of elasticity of the skin, it depends on the amount of fluid in the tissues. The turgor is defined as follows: two fingers form a skin fold - most often on the back surface of the hand, the front surface of the abdomen or on the back surface of the shoulder;then let go and watch the time of spreading. In normal and with the first degree of dehydration, the fold is straightened out instantly. With the 2nd degree of dehydration, the fold can be straightened in 1-2 seconds.

• The amount of urine released decreases slightly.

It is possible to fill the lost fluid with the 2nd degree of dehydration through the mouth. However, in case of seizures, urgent medical attention should be sought.

3 degree: fluid loss - 7-9% of body weight.

• The patient's condition is severe.
• Turgor is significantly reduced - the fold is straightened in 3-5 seconds.
• Skin is wrinkled.
• Convulsive contractions of the muscles of the hands and feet.
• The amount of urine released is significantly reduced.

Dehydration of the 3rd degree requires immediate hospitalization.

4 degree: loss of 10% or more fluid. In fact, it is a terminal state. It occurs very rarely - mainly with cholera.

With food poisoning, dehydration of the 3rd and 4th degree does not occur.

Dysbacteriosis in food toxic infection

Copious fluid stool for several days can lead to a violation of the quantitative and qualitative composition of bacteria living in the intestine - dysbacteriosis. Most often the dysbacteriosis is manifested by chronic diarrhea and requires special treatment.

Diet for food poisoning

An important component of treatment is a diet. With the preservation of diarrhea, a therapeutic diet No. 4 is recommended, which is characterized by a low content of fats and carbohydrates with a normal protein content and a sharp restriction of any irritants of the gastrointestinal tract. Also excluded are foods that can cause flatulence( increased formation of gases in the intestine).

Recommended products:

• wheat crumbs, thinly sliced ​​and not heavily roasted;
• soups with low-fat meat or fish broth with the addition of cereals: rice, semolina or egg flakes;as well as finely ground boiled meat;
• lean soft meat, poultry or fish cooked;
• low-fat freshly made curd;
• eggs no more than 2 per day in the form of boiled soft-boiled or steam omelet;
• porridge on the water: oatmeal, buckwheat, rice;
• vegetables are only boiled when added to soup.

Products to be excluded:

• bakery and flour products;
• soups with vegetables, on a strong fat broth;
• fatty meat, meat pieces, sausages;
• greasy, salted fish, canned food;
• whole milk and other dairy products;
• hard-boiled eggs, fried eggs;
• millet, barley, pearl gruel;pasta;
• beans;
• vegetables, fruits, berries in raw form;as well as compotes, jam, honey and other sweets;
• coffee and cocoa with milk, carbonated and cold drinks.

After normalization of the chair, you can go to the therapeutic diet number 2.It is somewhat milder than diet number 4.In addition, the diet adds:

• bread yesterday's pastries or dried. Uncomfortable bakery products, biscuits;
• meat and fish can be cooked by the piece;
• sour-milk products, including cheese;
• eggs, except hard-boiled eggs;
• vegetables: potatoes, zucchini, cauliflower, carrots, beets, pumpkin;
• mature fruits and mashed berries;
• creamy caramel, marmalade, marshmallow, pastille, jam, honey & gt; .

Treatment of foodborne toxic infections

Treatment is mainly to replenish the lost fluid. It is necessary to understand that with diarrhea and vomiting, not only water is lost, but also the necessary trace elements, therefore it is wrong to replenish the liquid with water. For this, the "Regidron" preparation is used, a powder containing all the necessary substances. The contents of the package are dissolved in 1 liter of boiled water, it is necessary to start drinking the solution as early as possible.

At 1 degree of dehydration the volume of injected liquid is 30-50ml / kg of body weight. At 2 degrees - 40-80ml / kg of body weight. The rate of replenishment of the liquid must be at least 1-1.5 liters per hour;drink slowly in small sips.

If you have vomiting, you should try to drink on a tablespoon in 2-3 minutes. If indomitable vomiting does not allow drinking liquid, you need to call a doctor.

In addition to the liquid sorbents are used - substances that bind poisonous toxins and remove them from the body. Activated carbon, Smecta, Enterosgel, Polyphepum, etc. are suitable for this. Sorbents are taken 3 times a day.

To reduce pain, it is recommended to take a no-shpa 1 tablet 3 times a day.

NB!Antibiotics for foodborne disease are not prescribed, because the cause is not a bacterium, but a toxin.

It is very important to remember that in case of food poisoning, imodium( loperamide) should not be taken. This drug causes a significant slowdown in the excretion of the contents of the intestine, which can lead to more toxin poisoning and worsening of the course of the disease.