food poisoning

food poisoning, acute illness following the eating of foods contaminated by bacteria, bacterial toxins, natural poisons, or harmful chemical substances. It was once customary to classify all such illnesses as "ptomaine poisoning," but it was later discovered that ptomaines, the products of decayed protein, do not cause illness. The symptoms, in varying degree and combination, include abdominal pain, vomiting, diarrhea, headache, and prostration; more serious cases can result in permanent disability or death.

Bacterial Food Poisoning

In general, the bacteria that cause food poisoning do not affect the appearance, aroma, or flavor of food. The most common bacterial causes of food poisoning are Salmonella (see salmonellosis), staphylococcus, Escherichia coli, Listeria monocytogenes, Shigella, and Campylobacter jejuni. The symptoms may be caused by toxins produced by the bacteria. The most serious type of food poisoning caused by bacterial toxins is botulism, which results from toxins made by the bacterium Clostridium botulinum.

Salmonella, most notoriously spread via raw eggs, develops from 6 to 72 hours after exposure. Symptoms include severe diarrhea, fever and chills, vomiting, and abdominal cramps and usually last from three to five days. Staphylococcal food poisoning is actually caused by the potent toxins that they produce. Typical sources are unrefrigerated ham, poultry, potato or egg salad, and custards. Carriers and food handlers with staphylococcal skin infections are mainly responsible for the spread of staphylococcus toxin poisoning. The onset of symptoms from such poisoning (similar to those of Salmonella infection) occurs abruptly one to six hours after ingestion of the polluted food. The illness lasts from 24 to 48 hours; fatalities are rare.

Infection with a particular strain of the usually harmless E. coli began to appear in food poisoning cases from the 1980s on, typically in raw or undercooked ground meat. Onset of symptoms comes one to eight days after eating the contaminated food. Symptoms include bloody diarrhea, nausea, and sporadic vomiting, with or without fever. It can progress to kidney failure and death, especially in children.

Listeriosis, caused by the bacterium Listeria monocytogenes, is spread in soft cheeses, undercooked meats, and prepared foods from delicatessen counters. Its onset is abrupt. Symptoms vary with the person's immune status and may include fever, muscle aches, fatigue, and nausea. The illness is especially serious for the very young or for pregnant women, who may miscarry or transmit blood infections or meningitis to the baby. In adults, the disease can progress to central nervous system complications, endocarditis, or pneumonia, and is an especially serious threat to the elderly.

Shigella is spread by contaminated food or from person to person (principally via a fecal-oral route). New strains of bacteria of the genus Shigella have been associated with food poisoning from ground meat. Symptoms include watery diarrhea, abdominal cramps, and bloody mucus in the stools.

Campylobacter enteritis is caused by either of two species of the Campylobacter bacterium. The bacterium is ubiquitous in uncooked poultry. Symptoms (diarrhea, fever, chills, headache) arise 2 to 11 days after exposure and last one to two weeks. Although usually mild, the infection can cause Guillain-Barré syndrome, a weakness of the peripheral nerves that can lead to paralysis and death.

Treatment for most bacterial food poisoning includes rest, sedation, and replacement of fluid loss if necessary. Antibiotics usually are used only in severe cases. Preventive measures in the home include thorough cooking and prompt refrigeration of meats and eggs, washing and peeling fruits and vegetables (and avoiding uncooked produce entirely if a person has a compromised immune system), washing of cooking surfaces and utensils that may have been contaminated by uncooked foods, and careful handwashing after use of the toilet.

Since the 1970s the number of food poisoning cases in the United States has gradually increased, and beginning in the 1980s more virulent organisms and more serious cases of food poisoning with complications leading to miscarriage, kidney failure, or death were observed. Some experts have attributed this to overprescription of antibiotics and the routine use of antibiotics as growth enhancers and to treat disease in livestock, practices that encourage the development of drug-resistant bacterial variants. An increase in the consumption of uncooked fresh produce has also contributed to the increase in food-borne illnesses. The increase in the number and severity of food poisoning cases have led to concern about food inspection and preparation methods, and to consideration of irradiating high-risk foods to eliminate bacterial contamination. More stringent meat inspection procedures were put in place by the U.S. Dept. of Agriculture in 1996 in response to some of these concerns, and the Food and Drug Administration approved the irradiation of meat. The vast majority of food poisoning cases, however, involve fruits and vegetables, seafood, cheese, and products, such as juices or deli salads, made with them.

Food Poisoning by Natural Poisons and Metals

Nonbacterial food poisoning may occur after eating foods that contain a naturally occurring or acquired deleterious substance. Ingestion of poisonous mushrooms or toadstools (see mushroom poisoning) may be followed in a matter of several minutes to two hours by severe thirst, abdominal cramps, diarrhea, vomiting, sweating, dizziness, confusion, collapse, coma, and, occasionally, convulsions. Poisoning may occur also after the ingestion of immature or sprouting potatoes because of the presence of solanine, an alkaloid. Mussels and clams that have fed on poisonous plankton also are a cause of food poisoning, since the poisonous substance is not destroyed by cooking. Ergot poisoning, caused by ingestion of rye grain infected with that fungus, causes damage to the blood vessels and gangrene, as well as gastrointestinal and neurologic symptoms.

It is also possible to take into the body poisons such as arsenic, lead, or mercury via foods that have been accidentally contaminated or sprayed with preservatives and not properly cleansed before ingestion. Food stored in containers lined with cadmium has been known to cause poisoning. Typical symptoms of this sort of food poisoning (diarrhea, vomiting) may occur right away; the nervous system and respiratory systems may be affected with continued exposure.

Bibliography

See J. P. Monahan, Food Poisoning (1984); J. N. Hathcock, ed., Nutritional Toxicology (1989); D. O. Cliver, ed., Foodborne Diseases (1990).

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food poisoning

Acute gastrointestinal illness from eating foods containing toxins. These toxins may be poisons that occur naturally in plants and animals, chemical contaminants, or toxic products of microorganisms. Most cases are due to bacteria (including salmonella and staphylococcus) and their toxins (including botulism). Some strains of E. coli can cause severe illness. Chemical poisons include heavy metals (see mercury poisoning), either from food or leached out from cookware by acidic foods. Food additives may have a long-term cumulative toxic effect. See also fish poisoning; mushroom poisoning.