original ppt creditis to dr rajalaxmi.

1. 1

2. FOOD POISONING
• Acute gastro-enteritis
caused by the ingestion
of the food or drink
contaminated with either
living bacteria or their
toxins or inorganic
chemical substances and
poison delivered from
plants and animals.
2

3. CHARACTERISTICS
• There is history of the ingestion
of a common food
• Attack of the many persons at
the same time
• Similarity of the sign and
symptoms in majority of the
cases
3

4. 4

5. 5

7. 7

8. TYPES
BACTERIAL NON-BACTERIAL
8

9. BACTERIAL FOOD
POISONING
9
• It is caused by the ingestion of the food
contaminated by the living bacteria or their toxins.
Food infection
the presence of bacteria
or other microbes which
infect the body after
consumption.
Food intoxication
ingestion of toxins contained
within the food, including
bacterially produced
exotoxins .

11. SALMONELLA
FOOD POISONING
11

12. SALMONELLA
12
• Common form of the food poisoning
 An increase in communal feeding
 An increase in international trade in human food
 A higher incidences of the salmonellosis in farm
animals
 Wide spread use of the household detergents
interfering with the sewage treatment
 Wide distribution of the prepared food

13. AGENT
Rod-shaped,
flagellated,
aerobic, Gram-
negative
bacteriumnegativ
13
Rod-shaped,
Rflaogde-lslahtaepde,d,
falaegroeblliact,eGd,ram
anergoabtiivce,Gram-
nbeagcatetirvieum
bacteriumnegativ

14. SOURCE
•
•
Disease of the animals
Man get infection from the farm animal & poultry-
•
 Contaminated Meat
 Milk & Milk Products
 Sausages
 Custards
 Eggs & Eggs Products
Rat & mice are another source, they are often
heavily infected and contaminate the foodstuffs by
their urine & faeces.
14

15. INCUBATION PERIOD
15
• 12 – 24 hours

16. MECHANISM OF ACTION
16
• After ingestion the organisms multiply in the
Intestine & give rise into acute enteritis &
colitis.

17. SIGNS & SYMPTOMS
17
•
•
•
The onset is generally sudden with
Chills
Fever
Nausea
Vomiting
Profuse Watery Diarrhea (Lasts 2 – 3 days)
Convalescent carrier state may last for several
weeks.
The mortality rate is 1%.

18. STAPHYLOCOCCAL
FOOD POISONING
18

19. AGENT
19
•
•
•
•
•
•
Staphylococcus aureus
Gram positive anaerobic coccal bacteria that
appears in clusters.
Enterotoxins of the certain strain of the coagulase
positive staphylococcus aureus.
At least five different enterotoxins have been
identified,
Toxins can be formed at optimum temperature of
35oC to 37oC.
These toxins are relatively heat stable and resist a
boiling of 30 minutes or more.

20. SOURCE
•
•
•
•
Staphylococci are ubiquitous in nature
Found on the
Skin
Nose
Throat
They are common agents of the boil and pyogenic
infection in man and animals.
Cow suffering from the mastitis have been
responsible for the outbreaks of the food poisoning
involving the milk and milk products.
20

21. INCUBATION PERIOD
21
• 1-6 hrs, short because of preformed toxin.

22. MECHANISM OF ACTION
22
•
•
•
• Food poisoning resulting from the ingestion of the
preformed toxins in the food.
In food bacteria have grown (Intradietetic toxins).
Toxin remain in the food after the organism have
been died.
Action of The toxins:
The toxin act directly on the intestine and CNS.

23. SIGNS & SYMPTOMS
23
•
•
•
•
Sudden onset of-
vomiting
Diarrhoea
Abdominal Cramps
In severe cases blood & mucus may appear.
Unlike salmonella food poisoning the staphylococci
food poisoning rarely cause the fever.
Death is uncommon .

24. DIAGNOSIS
24
Stool culture
•A stool culture is used to detect the presence of disease-
causing bacteria (pathogenic) and help diagnose an
infection of the digestive tract.
•In the case of Staphylococcal enteritis it is conducted
to see if the stool is +ve for a pathogenic bacterium.

25. BOTULISM
25

26. BOTULISM
26
•
•
•
Botulism derived its name from Latin word
(Sausage = Botulus).
Most serious type but occurs rarely.
It kills about 2/3rdof the victims.

27. AGENT
•
•
•
•
Botulinum toxin is broken into
8 neurotoxins A, B, C, D, E, F,
G which are antigenically and
serologically distinct but
structurally similar.
Discovery of H toxin- Oct
2013
Exotoxin of the clostridium
botulinum generally type A, B
or E cause toxicity in man.
Cl. Botulinum C and D cause
toxicity in animals.
27

28. SOURCE
• The bacteria is widely distributed in soil, dust and
intestinal tract of the animals.
The organism enters into the food as spores.
• Food Responsible For The Botulism:
These are preserved home food such as
Home – canned vegetables
Smoked or pickled fish
Home made cheese
Other low – acid foods
28

29. INCUBATION PERIOD
29
• 12 – 36 hours

30. MECHANISM OF ACTION
30
•
•
•
•
•
Under suitable anaerobic condition the toxins will
be preformed into the foods.
It act on the parasympathetic nervous system.
Its action on the GI – Tract is very slight.
Botulinum toxin is one of the most powerful known
toxins: about one microgram is lethal to humans
when inhaled.
It acts by blocking nerve function through inhibition
of the excitatory neurotransmitter acetylcholine's
release from the presynaptic membrane
of neuromuscular junctions in the SNS.

31. SIGNS & SYMPTOMS
•
•
•
•
•
•
•
•
•
•
Dysphagia
Diplopia
Ptosis
Dysarthria
Blurring of the vision
Muscle weakness & even
quadriplegia
Fever is generally absent.
Consciousness is generally
retained.
The condition is generally
fatal.
Death occurs 4 – 8 days later
due to respiratory or cardiac 29

32. CHARACTERISICS OF
BOTULISM TOXINS
•
•
Botulism toxin is thermolabile.
Foods contaminated with the botulism toxins heated
for 100oC for a few minutes are safe for
consumption.
30

33. INFANT BOTULISM
•
•
•
•
The botulism occurring in the infants
less than 6 months of age.
It is due to the infection of the gut by
the Cl.botulinum, with subsequent in
vivo production of the toxins.
Toxins are then absorbed into the
bloodstream and taken throughout
the body causing paralysis by
blocking the release of acetylcholine
at the neuromuscular junction.
Constipation, lethargy, weakness,
difficulty feeding and an altered cry,
often progressing to a complete
descending flaccid paralysis.
31

34. WOUND BOTULISM
•
•
Wound botulism results from
the contamination of a wound
with the bacteria, which then
secrete the toxin into the
bloodstream.
This has become more
common in intravenous drug
users since the 1990s,
especially people using black
tar heroin and those injecting
heroin into the skin rather
than the veins.
34

35. BOTULISM ANTITOXINS
• When a case of the botulism have occurred, antitoxins should
be given to all individuals partaking of the food.
• The dose varies from the 50,000 – 100,000 unit IV.
• The antitoxin is of no value if the toxin is already fixed to the
nervous tissues.
• Guanidine hydrochloride given orally in doses of the 15 – 40
mg/kg of the body weight have been shown to reverse the
neuromuscular block of the botulism.
• Active immunization with botulism toxoid is available.
35

36. PREVENTION
36
•A recommended prevention measure for infant
botulism is to avoid giving honey to infants less than
12 months of age, as botulinum spores are often
present.
•In older children and adults the normal intestinal
bacteria suppress development of C. botulinum.
•Commercially canned goods are required to undergo a
"botulinum cook" in a pressure cooker at 121 °C
(250 °F) for 3 minutes.

37. Cl. PERFRINGENS
FOOD POISONING
37

38. AGENT
• Cl. perfringens (Welchii)
38

39. SOURCE
39
•
•
The organism have been found in the faeces of the
human and animals, soil, water and air.
The majority of the outbreak have been associated
with the ingestion of the meat, meal dishes and
poultry.

40. INCUBATION PERIOD
40
• 6-24 hrs with peak from 10 to 14 hrs.

41. MECHANISM OF ACTION
41
•
•
•
The spores are able to survive the cooking.
If the cooked meat and poultry are not cooled
enough, they will germinate.
The organism multiply between the 30oC – 50oC and
produce a variety of the toxins such as alpha –
toxin, theta – toxins etc.

42. SIGNS & SYMPTOMS
•
•
•
Diarrhoea
Abdominal Cramps
Little or no fever
•
•
•
Nausea & vomiting are rare.
Illness is usually of the short duration (1 day or
less).
Recovery is rapid and no death have been reported.
Occurs 8-24hrs after food
consumption
42

43. DIAGNOSIS
•
•
•
C. perfringens can be diagnosed
by Nagler's reaction where the
suspect organism is cultured on
an egg yolk media plate.
One side of the plate contains
anti-alpha-toxin, while the other
side does not. A streak of
suspect organism is placed
through both sides.
An area of turbidity will form
around the side that does not
have the anti-alpha-toxin,
indicating
uninhibited lecithinase activity. 41

44. PREVENTION
44
• Cooking food just prior to its consumption or if it
has to be stored, by rapid and adequate cooling.

45. B. CEREUS
FOOD POISONING
45

46. AGENT
46
•
•
•
•
Bacillus – cereus is an aerobic, spore – bearing,
motile gram positive rod.
It is ubiquitous in soil and in raw, dried and
processed foods.
The spore can survive cooking and germinate and
multiply rapidly when the food is held at favorable
temperature.
B – cereus has been recognized as a cause of the
food poisoning with increasing in frequency in
recent years .

47. ENTEROTOXINS
47
•
•
•
B – cereus produce at least two distinct enterotoxins
causing two distinct form of the food poisoning
1) Emetic form of food poisoning
2) Diarrheal form Of food Poisoning

48. EMETIC FORM
48
•
•
•
•
•
Short incubation period in between 1 – 6 hours
It is characterized pre-dominantly by the upper
gastro – intestinal tract symptoms.
The 'emetic' form is commonly caused by rice
cooked for a time and temperature insufficient to
kill any spores present, then improperly
refrigerated. It can produce a toxin cereulide, which
is not inactivated by later reheating.
This form leads to nausea and vomiting one to five
hours after consumption.
Emetic toxin can withstand 121 °C (250 °F) for 90
minutes.

49. DIARRHOEAL FORM
49
•
•
•
•
•
longer incubation period of about 12 – 24 hours
It is characterized predominantly by the
Diarrhoea
Abdominal pain
Nausea with little or no vomiting and no fever
The recovery within the 24 – hours is usual
The toxins are preformed and stable.
Enterotoxin can be inactivated after heating at
56 °C (133 °F) for 5 minutes.

50. DIAGNOSIS
50
• Diagnosis can be confirmed by the isolation of the
organism of 105or more B – cereus organism per
gram of the epidemiologically incriminated food.

51. PROGNOSIS
51
•
•
Most emetic patients recover within six to 24 hours,
but in some cases, the toxin can be fatal.
In 2014, 23 neonates receiving total parenteral
nutrition contaminated with B. cereus developed
septicaemia, with three of the infants later dying as
a result of infection.

52. DIFFERENTIAL DIAGNOSIS
52
•
•
•
Cholera
Acute bacillary dysentery
Arsenic poisoning

53. CHOLERA &
FOOD POISONING
53
Cholera Food poisoning
Epidemology Occur often in
epidemic form
associated with other
cases in the
neighbourhood
Often a single group of
persons who shared a
common meal
Incubation From a few hours upto
5 days
1 to 24 hrs
Onset With purging With vomiting
Nausea & retching None Present
Vomiting Projectile, effortless,
watery and continuous
Often single, severe
vomit, mucuous and
blood streaked

54. Cholera Food poisoning
Stools Copious, rice watery, frequent, may contain
inoffensive mucus and blood,
offensive
Tenesmus None Yes
Abdominal tenderness None Yes
Dehydration Very marked Distinct
Muscular cramps Constant and severe Less constant
Surface temp Subnormal Often upto 100-102
deg F
Headache None Often
Urine Suppressed Seldom suppressed
Blood Leucocytosis Normal
54

59. INVESTIGATION OF
FOOD POISONING
59
1)Secure complete list of the people involved and
their history
2) Laboratory Investigation
3) Animal Experiments
4) Blood for the antibodies
5) Environmental Study
6)Analysis of the data according to descriptive
method of time, place and person
7)A case control study may be undertaken to establish
the epidemiologic association between illness and the
intake of the particular foods.

60. PREVENTION & CONTROL
Food sanitation Refrigeration
•Meat inspection
•Personal hygiene
• Excluding
diseased
foodhandlers
•Food handling techiques
•Sanitary improvements
•Health education
• ‘Cook and eat the food same
day immediately’
•Food held between 10oC
and 49oC are in danger
zone for
bacterial growth.
Surveillance
To avoid outbreaks of foodborne illness
60

61. 61