A few years ago, my child was at an overnight camp. One day, I receive a call from the camp’s infirmary that my daughter is there because they feel she had a heat stroke. Camp is six hours away. I ask if I should pick her up. The nurse tells me that they can take care of her, hydrate her and see if she gets better. I ask of her symptoms and am told, she is having body aches and some vomiting. I asked about food and told that not likely food poisoning. Just to find out later, that my daughter and her friends all got ill that evening after eating chicken.
Many things can cause food poisoning, including: bacteria, viruses, toxins, parasites, etc. As an emergency physician, we usually have an idea what is the more likely causes after reviewing our patient’s eating history and time frame of symptoms.
Everyone should be aware that vegetables, fruits, eggs, meats and dairy are the most often offenders, and can result in death.
Who is most at risk?
- Young children
- Those with chronic illnesses.
Symptoms of food poisoning are typically gastrointestinal and include nausea and vomiting as well as diarrhea. These could lead to patient’s dehydration and loss of electrolytes and water. Other symptoms can also appear, i.e. fevers, body aches, blood in the stool, abdominal pain and others.
Most common cause of food poisoning in the United States is viral, and norovirus is the lead, causing over 5 million cases a year. Noroviruses are found in drinking water, raw foods, contaminated by food handlers (most obvious examples are on Cruise ships). Symptoms begin in 12-48 hours and typically self-limiting within 48-72 hours. Patients most often have nausea, vomiting, diarrhea and headaches.
Salmonella is the next one. It causes most hospitalization out of almost one million patients go to the hospital. Salmonella is found in numerous food products, including poultry, peanut butter, juices, unpasteurized milk, eggs, and others. Symptoms are abdominal pain, vomiting, diarrhea and fever. Symptoms usually begin within six to 48 hours after ingestion and may last up to seven days. Treating with antibiotics is controversial, since it may cause prolonged shedding of the bacteria.
There are numerous other causes of infection and could be divided into those that cause hemorrhagic enteritis and non-hemorrhagic. Typically, the rule of thumb is to treat with antibiotics those that have hemorrhagic diarrheas and parasitic ones.
Of course, we should not forger toxins: botulism. It is caused by a toxin produced by bacteria: Clostridium Botulism, and cause patient to have paralysis of muscles that starts in the face and progresses down the body. It is found in unpasteurized honey and canned foods. Treatment would be supportive, mainly to help patients breath; may last a long time; does have an antitoxin to treat this type of poisoning.
Ways to help prevent food poisonings:
- Clean: wash your hands when cooking, wash your produce well.
- Cook: cook your meats well!
- Refrigerate left overs within 1-2 hours, keep foods below 40 degrees.
- Separate: separate your cooked foods from not.
- Eat and drink pasteurized food products.
In the end, I do believe by daughter had food poisoning from eating undercooked chicken! Thankfully she resolved quickly and was able to stay in camp for the duration!
Yanina Purim-Shem-Tov, MD, MS, FACEP is Associate Professor and Senior Medical Director for the Department of Emergency Medicine and Medical Director of the Chest Pain Center at Rush University Medical Center in Chicago.