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,
Common germs causing food
E. coli enteritis
Clostridium consists of gram positive anaerobic, spore
forming bacilli which are responsible for 3 major diseases.
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
Source : results from consumption of contaminated preserved
food,canned meat and meat products , vegetables and fish.
Wound botulism results from wound infection with
Infant botulism most probably is caused by contaminated
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.
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
Visual disturbance, dysarthria, dysphagia &
dry mouth are 4 most specific neurologic
Additional non specific neurologic symptoms:
Head ache, dizziness & paresthesia.
Oculo bulbar symptoms: blurring of vision , lateral rectus
palsy , ptosis , dilated pupils.
Botulinum toxin(heavy & light chain)
binds to pre synaptic nerve terminal
pre synaptic blockade
General principles of
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
Later hydration status should be assessed if
found normal ,maintenance therapy can began.
2. Maintenance therapy
1ml for diarrheal stool
10ml/kg for every watery stool passed
2ml/kg for each episode of vomiting
It is necessary when dehydration is severe(>10%
20ml/kg boluses of ringer’s lactate,NS
Solution is administered until pulse , perfusion
and mental status returns to normal.
Non –specific anti diarrheal agents
Agents such as kaolin –pectin
Anti motility drugs
Treatment of botulism
Monitoring of respiratory status
peak expiratory flow
Attempt to evaluate GI tract of spores and toxin with
Trivalent botulinum anti toxin types A,B and E is an equene
It shows low efficacy and high incidence of ADR
Dose-15-40mg/kg/day until improvement occurs
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