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food poisoning

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  • 1. “ FOOD POISONING” (TASAMMUME GHIZAIE) DR RAHMATHULLA PG SCHOLAR DEPT OF TST NIUM, BANGALORE-91
  • 2. DEFINITION
    • THE TERM FOOD POISONING IN ITS WIDER SENSE INCLUDES ALL ILLNESSESS WHICH RESULT FROM INGESTION OF FOOD CONTAINING NON-BACTERIAL OR BACTERIAL PRODUCTS. BUT THE TERM IS USUALLY RESTRICTED TO ACUTE GASTRO-ENTERITIS DUE TO THE BACTERIAL INFECTION OF FOOD OR DRINK
  • 3. IDEAL SEASON AND CHARACTERISTICS
    • FOOD POISONING IS COMMON IN SUMMER, BECAUSE THE WARM TEMPERATURE FAVOURS MULTIPLICATION OF MICRO-ORGANISMS.
    • IT MAY OCCUR AS ISOLATED CASES OR SMALL OUTBREAKS.
    • THE CONDITION IS CHARACTERISED BY THE FOLLOWING FEATURES
  • 4.
    • 1) VOMITING,DIARRHOEA OR BOTH, USUALLY BETWEEN 1 AND 48 HOURS AFTER CONSUMPTION OF THE CONTAMINATED FOOD OR DRINK.
    • 2) HISTORY OF INGESTION OF A COMMON FOOD.
    • 3) ATTACK OF MANY PERSONS AT THE SAME TIME.
  • 5.
    • 4) SIMILARITY OF SIGNS AND SYMPTOMS IN THE MAJORITY OF CASES.
    • 5) NON-INFECTIVE CAUSES AND BACTERIAL TOXINS WHICH ARE PRE-FORMED IN THE INFECTED FOOD PRODUCE SYMPTOMS WITHIN MINUTES OR HOURS OF A MEAL
  • 6. CAUSES OF FOOD POISONING
    • INFECTIVE OR NON-INFECTIVE
    • INFECTIVE 1) TOXIN-MEDIATED AND
    • 2) NON-TOXIN-MEDIATED
    • NON-INFECTIVE 1) ALLERGIC AND
    • 2) NON-ALLERGIC
    • TOXIN-MEDIATED
    • STAPHYLOCOCCUS AUREUS
    • CLOSTRIDIUM PERFRINGENS
    • CLOSTRIDIUM BOTULINUM(BOTULISM)
    • E.COLI 0157
  • 7.
    • NON-TOXIN-MEDIATED
    • SALMONELLA SPECIES.
    • CAMPYLOBACTER JEJUNI.
    • BACILLUS CEREUS.
    • VIRUSES e.g. NORWALK VIRUSES.
    • LISTERIA MONOCYTOGENES
    • (MENINGITIS).
    • BACILLUS ANTHRACIS(ANTHRAX).
  • 8.
    • NON-ALLERGIC
    • SCROMBOTOXIN(FISH )
    • CIGUATOXIN(TROPICAL FISH)
    • FUNGI (e.g. AMANITA PHALLOIDES)
    • CHEMICALS,METALS (e.g. in cooking pots)
    • ALLERGIC
    • SHELLFISH,STRAWBERRIES
  • 9.
    • INFECTIVE TYPE
    • 1) SALMONELLA FOOD POISONING
    • EXTREMELY COMMON TYPE OF F P.
    • SALMONELLOSIS IS PRIMARILY A DISEASE OF ANIMALS.
    • MAN GETS THE INFECTION FROM FARM ANIMALS AND POULTRY THROUGH CONTAMINATED MILK AND MILK PRODUCTS, MEAT, SAUSAGES, CUSTARDS, EGG AND EGG PRODUCTS.
  • 10.
    • RATS AND MICE ARE OFTEN HEAVILY INFECTED AND CONTAMINATE FOODSTUFFS BY THEIR URINE AND FAECES.
    • TEMPORARY HUMAN CARRIERS CAN ALSO CONTRIBUTE TO THE PROBLEM.
    • COMMON SPECIES ARE S.ENTERITIDIS,
    • S.TYPHIMURIUM AND S.CHOLERA-SUIS,
    • BESIDES MANY OTHERS.
  • 11.
    • INCUBATION PERIOD IS 12-24 HOURS.
    • MECHANISM OF FOOD POISONING
    • THE CAUSATIVE ORGANISMS ON INGESTION MULTIPLY IN THE INTESTINE AND GIVE RISE TO ACUTE ENTERITIS AND COLITIS.
    • SUDDEN ONSET WITH CHILLS,FEVER,NAUSEA, VOMITING AND A PROFUSE WATERY DIARRHOEA WHICH LASTS FOR 2-3 DAYS.
    • MORTALITY IS ABOUT 1 PER CENT.
    • PATIENT REMAINS CARRIER FOR SRL WEEKS.
  • 12.
    • 2) CAMPYLOBACTER JEJUNI IS NOW THE MOST COMMON CAUSE OF BACTERIAL FOOD POISONING IN BRITAIN.
    • SOURCES OF INFECTION INCLUDE POULTRY, DOGS, WATER AND UNPASTEURISED MILK
    • 3) LISTERIA MONOCYTOGENES IS AN ENVIRONMENTAL BACTERIUM WHICH CAN CONTAMINATE FOOD INCLUDING POULTRY AND CHEESE.
  • 13.
    • IT DOES NOT USUALLY CAUSE INTESTINAL SYMPTOMS BUT IS A CAUSE OF SEPTICAEMIA AND MENINGITIS, ESPECIALLY IN PREGNANCY, THE NEONATE, THE IMMUNOSUPPRESSED, DIABETICS AND ALCOHOLICS.
    • 4) BACILLUS CEREUS FOOD POISONING
    • IT IS AN AEROBIC, SPORE-BEARING, MOTILE,GRAM POSITIVE ROD.
    • IT IS WIDESPREAD IN SOIL AND IN RAW,DRIED AND PROCESSED FOODS.
  • 14.
    • THE SPORES CAN RESIST COOKING AND GERMINATE AND MULTIPLY RAPIDLY WHEN THE FOOD IS HELD AT FAVOURABLE TEMPERATURES
    • RECENT WORK HAS SHOWN THAT B.CEREUS PRODUCES AT LEAST 2 DISTINCT ENTEROTOXINS, CAUSING 2 DISTINCT FORMS OF FOOD POISONING, 1 THE EMETIC FORM(1-6 HRS) AND THE OTHER THE DIARRHOEAL FORM ( 12-24 HRS).
  • 15.
    • THE TOXINS ARE PREFORMED AND STABLE.
    • DIAGNOSIS CAN BE PERFORMED BY ISOLATION OF 10 5 OR MORE B.CEREUS ORGANISMS PER GRAM OF EPIDEMIOLOGICALLY INCRIMINATED FOOD.
    • TREATMENT IS SYMPTOMATIC.
  • 16.
    • CERTAIN VIRUSES SUCH AS NORWALK VIRUSES, CORONAVIRUSES, AND ROTAVIRUSES ALSO CAUSE OUTBREAKS OF FOOD POISONING ESPECIALLY IN INSTITUTIONS AND CATERING ESTABLISHMENTS.
    • THESE ARE NOT YET CULTURABLE BUT CAN BE IDENTIFIED ONLY BY ELECTRON MICROSCOPY OF STOOL.
    • PROTOZOA GIARDIA AND CRYPTOSPORIDIUM ALSO CAUSE FOOD POISONING OR H2O BORNE OUTBREAKS OF DIARRHOEAL DISEASE.
  • 17.
    • TOXIN TYPE
    • 1) STAPHYLOCOCCAL FOOD POISONING
    • IT IS AS COMMON AS SALMONELLA FOOD POISONING.
    • IT IS CAUSED BY ENTEROTOXINS OF CERTAIN STRAINS OF COAGULASE POSITIVE STAPHYLOCOCCUS AUREUS.
    • AT LEAST 5 DIFFERENT ENTEROTOXINS HAVE BEEN IDENTIFIED.
    • TOXINS CAN BE FORMED AT OPTIMIM TEMPERATURES OF 35 TO 37 C.
    • THESE TOXINS ARE HEAT STABLE AND RESIST BOILING FOR 30 MINUTES OR MORE.
  • 18.
    • THESE ORGANISMS ARE WIDELY SPREAD IN
    • NATURE, ON THE SKIN AND IN THE NOSE AND THROAT OF MEN AND ANIMALS.
    • THEY ARE A COMMON AGENT OF BOILS AND PYOGENIC INFECTIONS OF MAN AND ANIMALS.
    • COWS SUFFERING FROM MASTITIS CAUSES OUTBREAKS OF FOOD POISONING INVOLVING MILK AND MILK PRODUCTS.
    • ITS INCUBATION PERIOD IS SHORT( 1-6 HOURS) BECAUSE OF PREFORMED TOXIN.
  • 19.
    • MECHANISM OF FOOD POISONING
    • RESULTS FROM INGESTION OF TOXINS PREFORMED IN THE FOOD IN WHICH BACTERIA HAVE GROWN.
    • THE TOXIN IS HEAT RESISTANT AND REMAIN IN FOOD EVEN AFTER THE DEATH OF THE ORGANISMS.
    • THE TOXINS ACT DIRECTLY ON THE INTESTINE AND CNS.
  • 20.
    • SYMPTOMS
    • SUDDEN ONSET OF VOMITING,ABDOMINAL CRAMPS AND DIARRHOEA, IN SEVERE CASES, BLOOD AND MUCUS MAY APPEAR.
    • IT RARELY CAUSES FEVER UNLIKE SALMONELLA FOOD POISONING.
    • DEATH IS UNCOMMON.
  • 21.
    • CL.PERFRINGENS FOOD POISONING
    • THE ORGANISM IS FOUND IN FAECES OF HUMANS AND ANIMALS, IN SOIL, WATER AND AIR.
    • OUTBREAKS OCCURS WITH INGESTION OF MEAT, MEAT DISHES AND POULTRY.
    • FOOD CONSUMED AFTER 24 HOURS OF PREPARATION AND HEATED IMMEDIATELY PRIOR TO SERVING IS THE STORY BEHIND THIS FOOD POISONING.
  • 22.
    • INCUBATION PERIOD IS FROM 6-24 HOURS, WITH A PEAK FROM 10-14 HRS.
    • MECHANISM OF FOOD POISONING
    • SPORES SURVIVE COOKING, AND IF THE COOKED MEAT AND POULTRY ARE NOT COOLED ENOUGH, THEY WILL GERMINATE.
    • IT MULTIPLY BETWEEN 30 AND 50 C.AND PRODUCE A VARIETY OF TOXINS.
    • RAPID AND ADEQUATE COOLING AND COOKING JUST PRIOR TO ITS CONSUMPTION IS THE PREVENTION METHOD.
  • 23.
    • SYMPTOMS
    • MOST COMMON SYMPTOMS ARE DIARRHOEA, ABDOMINAL CRAMPS AND LITTLE OR NO FEVER.
    • NAUSEA AND VOMITING ARE RARE.
    • ILLNESS LASTS FOR 1 DAY OR LESS, RECOVERY IS RAPID AND NO DEATHS HAVE BEEN REPORTED.
  • 24.
    • BOTULISM
    • MOST SERIOUS BUT RARE FORM AND KILLS TWO-THIRDS OF ITS VICTIMS.
    • CAUSED BY THE EXOTOXIN OF TYPE A,B OR E OF CLOSTRIDIUM BOTULINUM
    • IT IS WIDELY DISTRIBUTED IN SOIL,DUST AND THE INTESTINAL TRACT OF ANIMALS AND ENTERS FOOD AS SPORES.
    • BOTULISM DERIVES ITS NAME FROM THE LATIN WORD FOR SAUSAGE( BOTULUS).
  • 25.
    • FOODS RESPONSIBLE FOR BOTULISM ARE HOME PRESERVED FOODS SUCH AS HOME-CANNED VEGETABLES, SMOKED OR PICKLED FISH, HOME MADE CHEESE AND SIMILAR LOW ACID FOODS.
    • INCUBATION PERIOD IS 12-36 HOURS.
    • INFANT BOTULISM IS DUE TO INFECTION OF THE GUT BY CL.BOTULINUM WITH SUBSEQUENT IN VIVO PRODUCTION OF TOXIN.
  • 26.
    • MECHANISM OF FOOD POISONING
    • THE TOXIN IS PREFORMED IN FOOD ((INTRADIETETIC) UNDER SUITABLE ANAEROBIC CONDITIONS.
    • IT ACTS ON PARASYMPATHETIC NS.
    • HERE THE G.I. SYMPTOMS ARE SLIGHT.
    • SYMPTOMS ARE DYSPHAGIA, DIPLOPIA ,PTOSIS ,DYSARTHRIA ,BLURRING OF VISION , MUSCLE WEAKNESS OR EVEN QUADRIPLEGIA.
    • FEVER IS GENERALLY ABSENT, CONSCIOUSNESS IS RETAINED. DETH OCCURS WITHIN 4-8 DAYS DUE TO RESPIRATORY OR CARDIAC FAILURE.
  • 27.
    • THE TOXIN IS THERMOLABILE AND FOOD IS SAFE IF CONSUMED AFTER HEATING AT 100C FOR FEW MINUTES BEFORE CONSUMPTION.
    • ANTITOXIN IS OF CONSIDERABLE VALUE IN THE PROPHYLAXIS OF BOTULISM.
    • WHEN A CASE OF BOTULISM HAS OCCURRED, ANTITOXIN SHOULD BE GIVEN TO ALL INDIVIDUALS PARTAKING OF THE FOOD.
    • DOSE VARIES FROM 50,000-100,000 UNITS IV.
  • 28.
    • THE ANTITOXIN WILL BE OF NO USE IF THE TOXIN IS ALREADY FIXED TO THE NERVOUS TISSUE.
    • GUANIDINE HCL GIVEN ORALLY IN DOSES OF 15-40 MG/KG BODY WT HAS BEEN SHOWN TO REVERSE THE NEUROMUSCULAR BLOCK OF BOTULIS.
    • ACTIVE IMMUNIZATION WITH BOTULINUM TOXOID TO PREVENT BOTULISM IS ALSO AVAILABLE.
  • 29.
    • INVESTIGATION OF FOOD POISONING
    • SECURE COMPLETE LIST OF PEOPLE INVOLVED AND THEIR HISTORY.
    • LABORATORY INVESTIGATIONS.
    • ANIMAL EXPERIMENTS.
    • BLOOD FOR ANTIBODIES.
    • ENVIRONMENTAL STUDY.
    • DATA ANALYSIS.
  • 30.
    • PREVENTION AND CONTROL
    • FOOD SANITATION
    • 1) MEAT INSPECTION
    • 2) PERSONAL HYGIENE
    • 3) FOOD HANDLING TECHNIQUES
    • 4) SANITARY IMPROVEMENTS
    • 5) HEALTH EDUCATION
  • 31.
    • REFRIGERATION
    • FOOD SHOULD NOT BE LEFT IN WARM PANTRIES, A FEW GERMS CAN MULTIPLY TO MILLIONS BY THE NEXT MORNING.
    • FOODS NOT EATEN IMMEDIATELY SHOULD BE KEPT IN COLD STORAGE TO PREVENT BACTERIAL MULTIPLICATION AND TOXIN PRODUCTION.
    • COOK AND EAT THE SAME DAY IS A GOLDEN RULE.
    • WHEN FOODS ARE HELD BETWEEN 10C AND 49C THEY ARE IN THE DANGER ZONE FOR BACTERIAL GROWTH.
    • COLD IS BACTERIOSTATIC AT TEMP BELOW 4C
  • 32.
    • SURVEILLANCE
    • FOOD SAMPLES MUST BE OBTAINED FROM THE FOOD ESTABLISHMENTS PERIODICALLY AND SUBJECTED TO LABORATORY ANALYSIS IF THEY WERE UNSATISFACTORY.
    • CONTINUING SURVEILLANCE IS NECESSARY TO AVOID OUTBREAKS OF FOOD-BORNE DISEASES.
  • 33.
    • UNANI CONCEPT OF FOOD POISONING
    • ZOAFE HAZM, SUE HAZM WO TUQHMA.
    • ZOAFE HAZM SE MURAAD YE HAI KE MEDE SE GHIZA JALD NA UTRE BALKE MAMOOL SE ZIYADA ARSE TAK MEDE KE ANDAR PADI RAHE.
    • ZOAFE HAZM WO MARZ HAI JIS ME MEDA AUR AANTOAN KA AML BIGAD JAA TA HAI, MAGAR INKI SAAQT AUR TARKEEB ME KOI NUMAAYAN KHARABI MEHSOOS NAHI HOTI.
  • 34.
    • SUE HAZM YA FASAADE HAZM KE YE MAAYINE HAIN KE GHIZA ACHCHI TARHA AUR POORE TAUR HAZM NA HO BALKE BURE TAUR PAR HAZM HO KAR IS ME KOI BURI KAIFIYAT PAIDA HO JAYE.
    • TUQHMA KE MAAYINE YE HAIN KE GHIZA MEDE ME BILKUL HAZM NA HO BALKE FASID HO KAR GHAIR TABYI SHAI ME TABDEEL HO JAYE YA APNI HALAT PAR QHAYIM RAHE AUR NEECHE NA UTRE YA PAI DAR PAI DAST JARI HO JAYEN.
  • 35.
    • ASBAAB
    • SUE MIZAJE MEDA
    • IJTIMA-E- MAADA-E-FAASIDA
    • INSBAAB-E-MAADA
    • FAASID GHIZA(WHICH ACCEPTS FASAAD EASILY)
    • ILAJ
    • TO CLEAN MEDA FROM FASID GHIZA,EMESIS SHOULD BE DONE WITH JOSHANDE PUDINA OR SIKANJABEEN.
  • 36.
    • PURGATIONS SHOULD BE CARRIED OUT WITH GHULKHAND,JAW SHEHRYARAAN OR JAW TAMARHINDI.
    • AFTER CLEANING THE MEDA, IT SHOULD BE KEPT EMPYY OR LIGHT AND ZOAD HAZM FOODS SHOULD BE GIVEN.
    • HAB E HILTEET, JAW KAMOONI, HAB E PAPITA, HAB KABID NAUSHADRI, ZULAL TAMARHINDI, AAB ANAAR, HAB KIBRIYAT,JAW JALINOOS,MAJ NAANQUWA.
  • 37.
    • T H A N K
    • Y O U
    • 05-08-2009

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