In a modern civilized society, perhaps, there is no person who has never heard that hands must be washed before eating. It is also necessary to wash vegetables, berries, fruits before use. They can contain dangerous bacteria and other pathogenic microscopic creatures that, once in the human body, cause very serious he alth problems, including food poisoning. However, this condition can also occur in those people who fanatically observe all the rules of hygiene. To do this, it is enough for them to eat dishes prepared in violation of sanitary standards. The type of food does not always indicate that it is contaminated with microorganisms, so people do not have any concerns.
Currently, a number of state medical organizations have developed and approved clinical guidelines, food toxic infections which are considered depending on the type of their pathogen. The submitted documents are for doctorsa practical guide that helps to correctly diagnose and prescribe the necessary course of therapy. Consider what types of such infections exist, how to protect yourself from them, how to treat them.
General provisions
Food poisoning is also called bacterial food poisoning, or bacteriotoxicosis. This condition must be distinguished from food intoxication (poisoning with toxic substances, such as mushrooms). Food poisoning is a condition that is caused only by pathogenic microbes and the substances they secrete that have entered the human body in such quantities that the immune system cannot cope.
This phenomenon has a good seasonality. Thus, bursts of food bacteriotoxicosis in most regions of our country are observed in the warm months of the year (from May to September), when conditions appear for bacteria that contribute to their active life. In southern countries, this disease is equally dangerous all year round, which our tourists should take into account.
Susceptibility to food bacteriotoxicosis is almost 100%, but it can manifest itself with varying degrees of severity, depending on the type of microbe and the strength of the patient's immunity.
This disease is especially dangerous for young children. If they are not provided with medical assistance in time, a fatal outcome is possible.
Food bacteriotoxicosis can be observed in isolated cases (if one person ate a product contaminated with microbes) or massively (if a whole group of people were fed low-quality food).
Viewspathogens
Dangerous are almost all pathogenic microorganisms that can cause disease in humans. The most common cause of foodborne illness is bacteria:
- Staphylococci.
- Clostridia (C. Perfringens, C. Botulinum, C. Difficile).
- Cereus.
- Citrobacter (collected in soil, sewage).
- Enterobacteria (Salmonella, pathogenic E. coli and plague bacilli).
- Proteus bacteria.
- Parahemolytic vibrios (live in s alt water).
Depending on the type of microbe, there are several ICD-10 foodborne disease codes, each caused by a specific microbe:
- A 05.0 - Staphylococcus aureus.
- A 05.1 - C. Botulinum (botulism).
- A 05.2 - C. Perfringens (necrotic enteritis).
- A 05.3 - C. perfringens (parahemolytic vibrios).
- A 05.4 - Bacillus cereus (cereus).
- A 05.8 - other food bacterial poisonings specified.
ICD-10 foodborne disease code, unspecified – A 05.9.
Each of these microbes has its own characteristics.
So, representatives of the staphylococcus family can be found on the mucous membranes and skin of a person, as well as on various household items used by an infected person. The most dangerous is Staphylococcus aureus. This is one of the few types of bacteria that can also be infected by airborne droplets.
Clostridia feel great in various productsfood (sausage, sushi, smoked ham, as well as in the soil, in the silt of reservoirs. Botulism bacilli are often found in freshwater fish.
Sereus can be found in meat, dairy products, baby food, spices and soups, and vegetables.
Citrobacters are also found in meat products (minced meat, semi-finished products), in dairy products, where they actively multiply.
Enterobacteria are present in the soil, and on various plants, and in the body of animals, as well as humans. They can seed meat products (sausages, sausages, minced meat), fish, vegetables. Mucus and a bitter taste can be a sign of spoilage.
Proteus bacteria are found in vegetables, meat, fish, usually without signs of unsuitability for consumption.
Parahemolytic vibrios are microbes that many people ignore because they believe that no bacteria can exist in s alt water. However, the aforementioned vibrios cause very serious food poisoning. Cases of infection with them after eating s alted anchovies, frozen shrimp, squid have been registered.
Although bacteriotoxicosis is synonymous with foodborne illness, it can also be caused by certain fungi (not mushroom plants) that enter the stomach with food and release dangerous toxins.
Clavicepspurpurea are extremely dangerous, which can be contracted by eating something from the grain. The symptoms are as follows: damage to the nervous system, colic, diarrhea, vomiting, hallucinations, convulsions, abdominal pain. With this pathology in pregnant women in the later stages,premature birth, and early miscarriage.
No less dangerous is the fungus Fusarium sporotrichiella, which develops on grain that has overwintered under the snow. Acute poisoning within a day ends in death.
Routes of infection
It depends on the characteristics and lifestyle of a particular microbe how it can enter the human body and cause food poisoning.
The main route is fecal-oral. This means that microbes enter the body of their victim through the mouth when eating insufficiently thoroughly washed fruits, vegetables, herbs, and berries. On these products, you can find many different bacteria that live in the soil and on plants, as well as those that are excreted from the body of a sick person or animal with feces.
Microbes get on fruits and vegetables with the help of flies, ants and other insects. However, this path is not prevailing, since in order to get food poisoning, a person must immediately "eat" a lot of bacteria. Otherwise, he develops not food poisoning, but an intestinal disease (bacteria penetrate the stomach, then into the intestines, begin to multiply there, which is accompanied by signs characteristic of each ailment).
More common routes of infection leading to food poisoning are as follows:
- Eating prepared food contaminated with microbes. They get on this food from a sick person, for example, a cook, a seller.
- Violation of the rules for their storage, processing and preparationproducts, for example, when s alting fish. In many foods (and in s alty ones too), microbes breed well, forming huge colonies. This is especially true for the warm months of the year.
- Insufficient heat treatment of meat, eggs, milk. Microbes get into them from sick animals.
- River or sea fish, seafood (even frozen and then cooked). Microbes get into them from the water, which is their habitat.
- Foodborne illness in young children occurs after playing in the sandbox if they put dirty hands in their mouths.
- In hospitals, especially in maternity hospitals, outbreaks of staphylococcus infection are often observed, which is transmitted only from infected people through tools, household items and airborne droplets.
- Drinking water from open sources that have bred millions of bacteria.
Pathogenesis of food poisoning
The disease can appear within half an hour after infection. In some cases, the incubation period lasts up to 24 hours. Such lightning-fast development is due to the fact that hundreds of thousands of microbes simultaneously enter the human body. They do not need time to form colonies - they begin their active pathogenic activity immediately.
In this case, not only inflammation of the mucous membranes of the stomach and intestines occurs, but also the release of a huge amount of toxins that seep into the blood, with the current of which they are carried throughout the body. Many of these toxic substances disrupt membranesblood cells, leading to their death. As a result, the blood no longer performs its main function - transporting oxygen to the cells of the organs and taking carbon dioxide from them. This leads to oxygen starvation.
Part of the toxins penetrate the brain and / or spinal cord, where they block the transmission of nerve impulses.
Cytotoxins secreted by staphylococci and some other bacteria block protein synthesis. This leads to disruption of biochemical processes in the body.
Thermolabile and thermostable poisonous substances that have accumulated in the intestines cause disruption of enterosorption, which is manifested by diarrhea.
Symptoms of food poisoning
The main symptom of the disease is its sudden and acute onset. The patient has the following general symptoms that are characteristic of infection with most types of bacteria:
- Severe, very sharp, cramping, cutting, stabbing abdominal pains.
- Diarrhea (more than 20 times a day).
- Vomiting.
- Nausea that does not subside after the release of vomit.
- Rise in temperature or chills, feeling cold.
- Increased salivation.
- Cold sweat.
- Pale skin.
- Headache.
- Unstable blood pressure.
- Tachycardia.
- Pain in the muscles.
- Difficulty breathing.
- Retention of urination.
When these signs appear, you need to call an ambulance. It is especially important to follow this recommendation if a child has been poisoned. The child's body is extremely difficult to tolerate toxic infections. Babies have very little of their own strength to fight bacteria, so it is vital for them to start treatment without delay. Otherwise, food poisoning threatens to develop into infectious-toxic shock.
Types, forms and stages
Similarly to the ICD-10 codes, the types of food poisoning are also differentiated. The classification is based on which pathogen caused the poisoning. Each microorganism affects human he alth in its own way, as it releases toxins of different chemical composition.
Therefore, when infected with various pathogens, there are both general and specific symptoms of food poisoning.
Thus, when infected with botulism pathogens that produce a very strong toxin, the patient's nerve impulses are blocked, which is manifested by the following symptoms:
- Paralysis
- Ptosis.
- Difficulties in moving the tongue, swallowing, pronunciation of words.
- Wobbling walk.
The person's temperature drops, diarrhea may not be.
When infected with staphylococci, diarrhea may also be absent, but vomiting is more frequent. Patients complain of unbearable headache, pain in the eyes, muscle weakness, cramping pain in the abdomen.
When infected with Proteus, vomiting and diarrhea are present, and the feces have a very fetid odor.
Penetration of Salmonella into the body is manifested by diarrhea (green stools, fetid, watery). Other symptoms: temperature jumps to 41 degrees, there aredizziness and convulsions.
When infected with Escherichia, all the main symptoms listed above are observed. A distinctive feature - diarrhea can be with blood.
Food poisoning has only one form - acute.
Differentiation at the stage in this disease is somewhat different from what we have in other diseases. Most types of food poisoning with proper treatment in 2-3 days ends with a complete recovery. Only Clostridium Botulinum infections can take up to 2 weeks to heal.
If therapeutic measures are not carried out correctly or not at all, food poisoning can turn into toxic shock. Its outcome depends on the type of microbe. For example, with Proteus poisoning, death occurs in 1.6% of cases, and with poisoning with Clostridium Botulinum, the toxin of which is 300,000 times stronger than rattlesnake venom, 70% of patients die.
The outcome of food poisoning depends on several factors:
- How quickly and correctly the assistance was provided.
- Type of exciter.
- The strength of human immunity.
Typically, adult patients recover in 2-3 days.
The situation is more complicated for children. Their weak body is more difficult to tolerate infection, requires longer treatment. Often a complication of food poisoning in children is intestinal dysbacteriosis, which cannot be cured quickly.
Diagnosis
As a rule, doctors can easily determine a food poisoning in a patient. The diagnosis is made on the basis that a sharp deteriorationhe alth happened suddenly after eating certain foods. Especially clear are cases where the same symptoms and similar pathogenesis are observed immediately in a group of people who reported that they ate the same food.
However, doctors must perform laboratory tests to differentiate food bacteriotoxicosis from other dangerous diseases, such as dysentery, salmonellosis, cholera, the signs and methods of infection of which are largely similar.
If there is only one patient with symptoms of diarrhea, vomiting and abdominal pain, food poisoning is differentiated from appendicitis, pancreatitis, intestinal obstruction, acute gastritis.
For the diagnosis of food poisoning, vomit, feces, urine, blood are taken for analysis. In these biomaterials, bakposev, serological tests, PCR and other methods reveal the pathogen and its resistance to drugs.
If, as a result of the ingress of toxins into the blood, paresis of arterioles and venules occurred, which is manifested by pinpoint bleeding, the patient undergoes hardware studies of internal organs.
Sometimes (if possible) food that caused the disease is taken for research.
Dehydration
One of the very dangerous complications of foodborne illness, accompanied by vomiting and/or diarrhea, is dehydration. His signs:
- Dry mucous membranes in the mouth.
- Loss of skin turgor.
- Decrease in urine volume and quantityacts of urination.
- Sunken eyes.
- Crying without tears (a common sign of dehydration in children).
- Dry out ("baked") lips.
- Confusion.
- Dry skin.
- Hyperthermia.
With dehydration, the situation of a patient with food poisoning is aggravated, as the work of all organs is disrupted.
Nursing care
Because in most cases there is little time between the moment of infection and the first signs of poisoning, the food does not have time to be completely digested. Therefore, gastric lavage is a very relevant method for the treatment of food poisoning. Nursing care consists in giving the patient a sufficient amount of clean water to drink and causing him to vomit so many times until only the same water that the person has poured into himself begins to come out of the stomach. If the patient is unable to drink, gastric lavage should be carried out through a tube. You can also induce vomiting several times in a row at home, as soon as signs of poisoning appear.
After this, the victim is laid on his back in such a position that his head is slightly raised, wrapped up, a heating pad is placed on his stomach.
In case of dehydration, the patient is required to put droppers with glucose-s alt solutions or give water orally every 5-10 minutes if his consumption does not cause new bouts of vomiting.
Treatment
Usually, before toxic shock, the condition of patients withno food poisoning. After cleansing the stomach, the treatment of food poisoning consists in prescribing sorbents (Polysorb, activated carbon, Smekta) to the patient, as well as:
- For pain in the abdomen, the patient is given a pill with belladonna.
- Oral or intravenous rehydrants to prevent dehydration.
- Often, doctors give patients siphon enemas to flush out bacteria and their toxins from the lower intestines, and for some infections, they prescribe a laxative.
- If toxic substances managed to seep into the blood, which can be seen from more severe symptoms (there is a decrease in blood pressure, breathing difficulties) and is confirmed by tests, the patient is given a series of resuscitation measures, administering intravenous glycocorticosteroids, "Dopamine" to restore blood flow, "Albumin" for infusion therapy.
Doctors prescribe antibiotics depending on the patient's condition. In most cases, they are not used.
The course of treatment depends on the type of pathogen. So, infection with staphylococcus is treated for 2-3 days, and botulism - up to two weeks.
Children, if they develop dysbacteriosis as a result of food poisoning, are prescribed probiotics and prebiotics.
How to avoid infection
Prevention of food poisoning consists of the following activities:
- Personal hygiene.
- Eating only clean fruits and vegetables, herbs (dill, parsley and others), berries.
- Maintain product shelf life.
- Baby trainingto the fact that you can not put fingers, toys and other objects in your mouth, as well as the fact that you must wash your hands, even before eating one candy.
- Boil water from open sources before use.
- Keep raw meat and fish, dairy products, vegetables (especially root vegetables) separate from cooked meals.
- Eat smoked products (fish, chicken legs, sausages) with great care.
- At the slightest suspicion that the product is spoiled (mucus, unusual color, incomprehensible plaque), refuse to use it.
- Proper cooking. All bacteria are killed by thermal exposure, but each species requires a different time. For example, for staphylococcus - boiling for 2 hours, for clostridium - heating for 15 minutes at 80 ° C, half an hour at 65 ° C is enough to destroy proteas.
After suffering from food poisoning, you should follow a diet for a while. It is allowed to eat low-fat fish, meat, kefir, cereals on the water (you can add olive oil), baked and boiled vegetables, low-fat soups.
