PRESENTED BY:-

MISS HEERAMANI HANSDAH

M.SC. NURSING 1ST YEAR
 INTRODUCTION:
 Food poisoning is an acute inflammatory disease
of the gastrointestinal tract, caused by the
ingestion of food contaminated with either toxin
producing bacteriae or by their preformed toxins or
chemical substances or other poisonous food
substances. Clinically it is characterized by short
incubation period, pain in the abdomen, vomiting
and/or diarrhoea, with or without fever.
DEFINITION:
Food poisoning is an acute gastroenteritis
caused by ingestion of food or drink
contaminated with either living bacteria or
their toxins or inorganic chemical
substances and poisons derived from plants
and animals.
CHARACTERISTICS:
 The history of the ingestion of the
common foods
 Attack of many persons at the same time

 Similarity of signs and symptoms in the

majority of cases
TYPES OF FOOD POISONING:

Food poisoning may be of two types

a) Non-bacterial
b) Bacterial
 Non-bacterial:
 It is caused by chemicals
such as arsenic, certain plant
and sea foods.
 The contamination of the
food by the chemicals such
as fertilizers, pesticides,
cadmium, mercury etc.
 Bacterial
 It is caused by the ingestion of foods
contaminated by living bacteria or their toxins.
 The conventional classification of bacterial food
poisoning into the toxic and infective types is
becoming increasingly blurred with the
knowledge that in some types, both
multiplication and toxin production are
involved;
1. SALMONELLA FOOD POISONING

It is the common form of food

poisoning. There is increasing
incidences of food poisoning
because of

i. An increase in community
feeding

ii. Increase in international trade

in human food
 Cont...
iii. A higher incidence of
salmonellosis in farm animals

iv. Widespread use of

household detergents
interfering with sewage
treatment

v. Wide distribution of prepared

foods.
CAUSATIVE AGENTS

The species most often

incriminated in human
outbreaks are;
S.typhimurium,
S.cholera-suis,
S.enteritidis
 SOURCE
I. Salmonellosis is primarily a
disease of animals.

II. Man gets the infection from

farm animals and poultry-
through contaminated
meat, milk and milk
products custards, egg and
egg products.
 Cont...
III. Rates and mice are another
source; they are often heavily
infected and contaminate
foodstuffs by their urine and
faeces.

IV. Temporary human carriers

can also contribute to the
problem.
INCUBATION PERIOD

 The incubation period is 12- 24 hours

commonly
 MECHIMISM OF FOOD POISONING
 The causative organisms, on
ingestion multiply in the intestine
and give rise to acute enteritis and
colitis.
 The onset is generally sudden with
chills, fever, nausea, vomiting and
a profuse watery diarrhoea which
usually lasts 2-3 days.
2.STAPHYLOCOCCAL FOOD POISONING

It is about as common as salmonella

food poisoning.
CAUSATIVE AGENT
 Enterotoxins of certain strains of coagulase
positive Staphylococcus aureus.
 At least 5 different enterotoxins have been
identified and a sixth may exist.
Cont...
 Toxins can be formed at optimum
temperatures of 35 degree to 37 degree C.
 These toxins are relatively heat stable and
resist boiling for 30 minutes or more.
 SOURCE
 Staphylococci are ubiquitous in nature
and are found on the skin and in the nose
and throat of men and animals.
 They are a common agent of boils and
pyogenic infection of man and animals.
 Cont...
 Cows suffering from masititis have been
responsible for outbreaks of food
poisoning involving milk and milk
products.
 The foods involved are salads, custards,
milk and milk products which get
contaminated by staphylococci.
INCUBATION PERIOD
 Incubation period is from 1-6 hours.

 The incubation period is short because of

preformed toxin.
 MECHANISM OF FOOD POISONING
 Food poisoning results from ingestion of toxins
preformed in the food in which bacteria have
grown.
 Since the toxin is heat resistant, it can remain
in food after the organisms have died.
 The toxins act directly on the intestine and
CNS.
 SIGN AND SYMPTOMS:
 The illness becomes
manifest by the sudden
onset of vomiting,
abdominal cramps and
diarrhoea.
 In severe case mucus and
blood may appear.
 Cont…
 Unlike salmonella food
poisoning, staphylococcal
food poisoning rarely causes
fever.
 Death is uncommon
4.BOTULISM

Most serious but rare. It kills two-thirds of its

victims
CAUSATIVE AGENT
Exotoxin of Clostridium botulinum
generally type A,B and E.
 SOURCE
 The organism is widely distributed in soil, dust
and the intestinal tract of animals and enters
food as spores.
 The food most frequently responsible for
botulism are home reserved foods such as home
canned vegetables, smoked home-made cheese
and similar low acid foods.
 INCUBATION PERIOD
Incubation period is between 12 to 36 hours
 MECHANISM OF FOOD POISONING
 The toxin is preformed in the food under
suitable anaerobic conditions.
 It acts on the parasympathetic nervous system.

 Botulism differs from other forms of food

poisoning in that the gastrointestinal
symptoms are very slight.
 SIGN AND SYMPTOMS
 The prominent symptoms
are dysphagia, diplopia,
ptosis, dysarthria, blurring
of vision, muscle weakness
and even quadriplegia.
 Fever is generally absent,
and consciousness is
retained.
 Cont…
 The condition is frequently fetal.

 Death occurring 4-8 days later due to

respiratory or cardiac failure.
3.CL.PERFRINGENS FOOD POISONING

 It is less common type of the food

poisoning.
 There is rapid recovery no any death due to
this type of the poisoning.
CAUSATIVE AGENT:
Clostridium (Cl.) perfringens (welchii)
 SOURCE
 The organism has been found in faeces of
humans and animals, and in soil, water and air.
 The majority of outbreaks have been associated
with the ingestion of meat, meat dishes and
poultry.
 Cont...
 The usual story is that the
food has been prepared and
cooked 24 hours or more
before consumption and
allowed to cool slowly at room
temperature and then heated
immediately prior to serving
 INCUBATION PERIOD
Incubation period is between 6 to 24
hours, with a peak from 10 to 14 hours
 MECHANISM OF FOOD POISONING
 The spores are able to survive cooking, and if the
cooked meat and poultry, and if the cooked meat
and poultry are not cooled enough, they will
germinate.
 The organisms multiply between 30 degree and
50 degree C and produce a variety of toxins, such
as alpha toxin, theta toxin etc.
 CLINICAL SYMPTOMS
 The most common symptoms are diarrhoea,
abdominal cramps and little or no fever, occurring
8 to 24 hours after consumption of the food.
 Nausea and vomiting are rare.
 Illness is usually of short duration, usually 1 day
or less.
 Recovery is rapid and no deaths have been
reported.
5.BACILLUS CEREUS FOOD POISONING
 Bacillus cereus is an aerobic,
spore-bearing, motile, gram
positive rod.
 It is dried and processed foods.

 The spores can survive cooking

and germinate and multiply
rapidly when the food is held at
favourable temperatures.
DIAGNOSIS
Diagnosis can be confirmed by isolation of
100000 or more B.cereus organisms per
gram of epidemiologically incriminated
food. Treatment is symptomatic.
DIFFERENTIAL DIAGNOSIS

Food poisoning may be mistaken for

cholera, acute bacillary dysentery and
chemical (arsenic) poisoning.
INVESTIGATION OF THE FOOD
POISONING
 Secure complete list of the people involved
and their history
 Laboratory investigation

 Animal Experiments

 Blood for the antibodies

 Environmental study
 PREVENTION AND CONTROL
FOOD HYGINE:
a. Purchase of food:
 Select fresh meat and
vegetable.
 Purchase food from hygienic,
reliable and reputable sources
to ensure quality.
 Do not patronise unlicensed
hawkers or food stalls selling
cooked food.
 Cont...
 Read and follow the storage
instructions, and pay attention to
the "use by" or "best before" date on
food labels when buying prepacked
food.
 Do not buy any food that is
abnormal in appearance, for
example: canned food in rusty,
expanded or dented cans.
 b.Handling of food:

 Food should be thoroughly

washed before storage or
cooking.
 Meat and seafood must be
thoroughly cooked.
 Food should be consumed as
soon as it is served.
 Cont...
 Hot food should be eaten
when it is still hot and cold
dishes should be stored in the
refrigerator until
consumption.
 Use different sets of chopping
blocks and knives for cutting
raw and cooked food.
 c.Storage of food
 Raw and cooked food should be stored
separately to avoid cross
contamination.
 Place cooked food in the upper
compartment of refrigerator.
 Cooked food, unless consumed at
once, should be kept below 4oC or
above 63oC.
 Cont...
 Do not store food under
room temperature to avoid
multiplication of bacteria.
 Leftover food should be
stored in the refrigerator
and re-heated thoroughly
before consumption.
Cont...
 Refrigerator should be
cleaned properly and
regularly and its temperature
should be kept below 4oC.
 Do not store excessive
amount of food in the
refrigerator to avoid
affecting cold air circulation.
 PERSONAL HYGIENE
 Wash hands with soap and water after
going to the toilet and before handling
food.
 Anybody who suffers from diarrhoea or
vomiting should not handle or touch any
food to avoid bacteria contaminating the
food.
 Bandage wounds with waterproof
plasters before handling any food.
 ENVIRONMENTAL HYGIENE
 Put all rubbish & food remains
into a dustbin and cover it up
tightly.
 Dustbin must be emptied
frequently and regularly.
 Clean the kitchen frequently and
regularly to prevent harbouring
rats and insects.
MANAGEMENT OF FOOD POISONING

 A sudden illness due to the ingestion of

contaminated food or drink
 Treat fluid and electrolyte imbalances
 Control nausea and vomiting
 Provide clear liquid diet and progression of
diet after nausea and vomiting subside
SUMMARY