Food poisoning

2. FOODPOISIONING
 Also known as food borne illness
 It is any illness resulting from the consumption of
contaminated food , pathogenic bacteria , viruses or
parasites that contaminates food, as well as chemical
or natural toxins such as poisonous mushrooms.
 Most cases of food poisoning are from clostridium
botulinum and other bacteria such as Staphylococcus
or E. coli.
 Causes of food poisoning due to microbes, bacteria,
viruses, protozoa, parasites, fungi, plants, fish,
chemical additives

3. Common germs causing food
poisioning
 Clostridium botulinum
 Campylobacter enteritis
 Cholera
 E. coli enteritis
 Fish poisoning
 Staphylococcus aureus
 Salmonella
 Shigella

4. CLOSTRIDIUM BOTULINUM
 Clostridium consists of gram positive anaerobic, spore
forming bacilli which are responsible for 3 major diseases.
 Tetanus(cl.tetani),gas gangrene(cl.septicum,cl.fallax),food
poisoning(cl.botulinum).
 Clostridium botulinum-8types A,B,C,C2,D,E,F&G.
 A,B&E account for almost all cases of human botulism.
 F&G are very rare in humans.
 C&D are associated with botulism in mammalian animals
&birds.

5.  Source : results from consumption of contaminated preserved
food,canned meat and meat products , vegetables and fish.
 Wound botulism results from wound infection with
cl.botulinum.
 Infant botulism most probably is caused by contaminated
honey.
 Toxins : cl.botulinum produce a powerful exotoxin which is
produced intracellularly and is released only on the death and
autolysis of organism.
 Lethal dose:1-2 microgram
 Sunlight or heating at 80’C for 30 min or 100’C for 10 min
denatures the active toxin.

6. CLINICALFEATURES
 Symptoms start within 2 - 6 hours after
eating the food.
 Initial signs & symptoms of botulism may be
GI & can include abdominal pain, nausea,
vomiting & diarrhea.
 most common serious complication of food
poisoning is dehydration — a severe loss of
water and essential salts and minerals
 Pt may also present initially with only
neurologic signs & symptoms due to
cholinergic blockade.
 Visual disturbance, dysarthria, dysphagia &
dry mouth are 4 most specific neurologic
symptoms.

7. Additional non specific neurologic symptoms:
 Malaise
 Generalized weakness
 Head ache, dizziness & paresthesia.
 Oculo bulbar symptoms: blurring of vision , lateral rectus
palsy , ptosis , dilated pupils.

8. MODEOFACTION
 Botulinum toxin(heavy & light chain)
 toxin absorbed
 binds to pre synaptic nerve terminal
 pre synaptic blockade

9. DIAGNOSIS
 Laboratory analysis
 Tensilon test
 Electromyography
 History

10. General principles of
treatment
1. Oral rehydration therapy
 It is preferred in mild dehydration 3-5% or
moderate dehydration 6-10%
 In mild dehydration 50ml/kg should be
administered over a period of 2-4hrs which
should contain 50-90meq/l of sodium.
 From moderate dehydration 100ml/kg is
administered
 Later hydration status should be assessed if
found normal ,maintenance therapy can began.

11. 2. Maintenance therapy
 1ml for diarrheal stool
 10ml/kg for every watery stool passed
 2ml/kg for each episode of vomiting
3.Intravenous rehydration
 It is necessary when dehydration is severe(>10%
fluid loss)
 20ml/kg boluses of ringer’s lactate,NS
 Solution is administered until pulse , perfusion
and mental status returns to normal.

12. Non –specific anti diarrheal agents
 Agents such as kaolin –pectin
 Anti motility drugs
 Anti-secretary drugs

13. Treatment of botulism
 Monitoring of respiratory status
vital capacity
peak expiratory flow
pulse oxymetry
 Attempt to evaluate GI tract of spores and toxin with
help of
activated charcoal
emesis
gastric lavage
catharsis

14. BOTULINUM ANTITOXIN
Trivalent botulinum anti toxin types A,B and E is an equene
globulin
GUANIDINE HCl
It shows low efficacy and high incidence of ADR
Dose-15-40mg/kg/day until improvement occurs
PENICILLIN
Benefit in wound botulism, penicillinG is preferred.
HUMAN –DERIVED BOTULISM IMMUNE GLOBULES
It’s a pentavalent types A,B,C,D and E harvested by plasma
pheresis from donors who received multiple
immunizations.

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