Food poisoning

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Food poisoning is an acute syndrome with nausea, abdominal cramping, vomiting and/or diarrhea which appear suddenly and within 48 hours after ingestion of food contaminated with pathogenic bacteria, viruses or toxins produced by bacteria. Depending on the contaminant, other symptoms such as chills and fever, bloody stools, dehydration, and nervous system damage may follow and can lead to death.


Why should I be aware of this?

  • Every year, more than 75 million people get sick from food poisoning, especially during summer when food may not be kept cold enough to prevent bacteria from growing.
  • At least one out of five Americans suffer food poisoning each year, and over 9,000 deaths are reported as a result.
  • Food poisoning stems not from food additives, chemical fertilizers, or pesticides applied to food by growers or processors, but from poor food storage or handling practices in home or restaurant kitchens that cause food to become contaminated.

All about food poisoning

  • Food poisoning occurs on eating food contaminated with bacteria or other toxins.
  • Symptoms include diarrhea, vomiting, and stomach cramps. It generally start 4 - 36 hours after eating contaminated food.
  • While food poisoning is often caused by bacteria, it can also result from eating poisonous plants (some mushrooms, for instance) and animals (pufferfish).

Signs and Symptoms

The typical signs of food poisoning are nausea, vomiting, abdominal cramping, diarrhea, head or muscle aches, and fever. Symptoms usually appear within 12 - 72 hours of eating contaminated food, but may also occur 30 minutes - 4 weeks later. Specific bacteria may cause these signs and symptoms:

Types of bacteria

  • Clostridium botulinum (C. botulinum, or botulism): weakness, blurred vision, sensitivity to light, double vision, paralyzed eye nerves, difficulty speaking and swallowing, paralysis that spreads downward, respiratory failure, death
  • Salmonella spp., Shigella spp., and Campylobacter jejuni (C. jejuni): fever, chills, bloody diarrhea.
  • Escherichia coli (E. coli): hemorrhagic colitis (diarrhea with very little stool and large amounts of blood). E. coli symptoms may appear as many as 3 days after eating contaminated food.
  • Mushroom poisoning can affect the liver, the neurological system (brain), or the gastrointestinal tract. Symptoms include stomach upset, delirium (confusion), vision difficulties, heart muscle problems, kidney failure, and death of liver tissue. It may also cause death if it is not treated right away.
  • Fish poisoning causes nausea, vomiting, diarrhea, abdominal pain, dizziness, and headache.

Types of fish poisoning

Specific types of fish poisoning can cause other signs and symptoms, such as:

  • Ciguatera: numbness or tingling around the mouth, feeling of loose teeth, impaired touch sensation of hot as cold and cold as hot, itching, muscle and joint pain, slow heart rate, low blood pressure. Caused by toxins in some fish, including grouper, snapper, mackerel, barracuda.
  • Pufferfish poisoning: numbness or tingling around the mouth, trouble coordinating movement, difficulty swallowing, excess saliva, twitching, loss of ability to talk, convulsions, paralysis that spreads upward, respiratory failure, death
  • Shellfish poisoning: numbness or tingling around the mouth or in the arms and legs, trouble swallowing, difficulty speaking. Caused by toxins in algae that are then eaten by shellfish.

What Causes It?

Usually bacteria and algae cause food poisoning, but poisonous plants and animals may also be the cause.

Common bacterial toxins

  • E. coli in undercooked hamburger, unpasteurized apple juice or cider, raw milk, contaminated water (or ice), vegetables fertilized by cow manure or spread from person to person.
  • Listeria monocytogenes (L. monocytogenes) in cole slaw, dairy products (mostly soft cheeses from outside the United States), and cold, processed meats
  • Salmonella spp. in poultry, beef, eggs, or dairy products
  • Shigella spp. from raw vegetables or cool, moist foods (such as potato and egg salads) that are handled after cooking.
  • Staphylococcus aureus(S. aureus) in salad dressing, ham, eggs, custard-filled pastries, mayonnaise, and potato salad. Usually from the hands of food handlers.
  • C. jejuni in raw milk and chicken.
  • C. botulinum in improperly home-canned foods. In children under 1 year of age, mostly from honey but also from corn syrup.
  • Clostridium perfringens(C. perfringens) in meat and poultry dishes and gravies, mostly foods that were cooked more than 24 hours before eating and were not reheated well enough.
  • V. cholerae in bivalve (two-shelled) shellfish (such as mussels, clams, oysters, and scallops), raw shellfish, and crustaceans (such as lobsters, shrimp, and crabs).

Common types of fish poisoning

  • Scombroid poisoning from bacteria in dark-meat fish (tuna, bonito, skipjack, mahi-mahi, mackerel) that are not refrigerated well
  • Ciguatera poisoning in tropical fish (grouper, surgeonfish, snapper, barracuda, moray eel, shark) that have eaten toxic plankton
  • Puffer fish poisoning from the organs and flesh of puffer fish
  • Poisoning from shellfish that feed on certain algae

Mushroom poisoning occurs from eating wild poisonous mushrooms, especially Amanita phalloides.

Who's Most At Risk?

Infants and the elderly are at greater risk for food poisoning. Other risk factors include:

  • Having a pre-existing medical condition, such as chronic kidney failure, liver disease, or diabetes
  • Taking antibiotic, antihistamine, or steroid medicines
  • Having sickle-cell anemia and other problems with red blood cells
  • Weakened immune system
  • Traveling in an area where contamination is more likely
  • Listeriosis is most common in pregnant women, fetuses, and people with immune problems. When a fetus is infected with listeria, it may be born prematurely or die.

What can I do?

These steps can help prevent food poisoning:

  • Wash your hands and clean any dishes or utensils when you are making or serving food.
  • Keep juices from meat, poultry, and seafood away from ready-to-eat foods.
  • Cook foods to proper temperatures.
  • Promptly refrigerate any food you will not be eating right away.
  • If you take care of young children, wash your hands often and dispose of diapers carefully so that bacteria can't spread to other surfaces or people.
  • If you make canned food at home, make sure to follow proper canning techniques to prevent botulism.
  • Don't feed honey to children under 1 year of age.
  • Don't eat wild mushrooms.
  • When traveling where contamination is more likely, eat only hot, freshly cooked food. Boil water before drinking. Don't eat raw vegetables or unpeeled fruit.
  • Always refrigerate fish.
  • Don't eat tropical fish caught during blooms of poison plankton.
  • Eat pufferfish only in specially licensed restaurants with chefs trained to cook it.
  • Don't eat shellfish exposed to red tides.
  • If others may have eaten a food that made you sick, let them know.
  • If you think the food was contaminated when you bought it from a store or restaurant, tell the staff and your local health department.

Treatment Plan

Treatment for most cases of food poisoning involve replacing fluids and electrolytes (such as sodium, potassium, magnesium, and chloride). While experiencing vomiting and diarrhea, the person should avoid solid food but increase clear liquids. In more severe cases, a person may need help either breathing or stopping vomiting. In most cases, health care providers do not prescribe antibiotics because they may prolong diarrhea. If you have eaten certain toxins (such as from mushrooms or shellfish), your health care provider may take steps to clean out your stomach (a process called lavage, or pumping the stomach) and administer activated charcoal, which can help absorb the remaining toxin.


The following general nutritional guidelines may be helpful in the case of food poisoning:

  • Drink plenty of fluids (to prevent dehydration).
  • Drink barley or rice water (to soothe inflamed stomach or intestine).
  • Probiotics, such as Lactobacillus acidophilus and Lactobacillus bulgaricus, can help restore the balance of good bacteria in the intestine. If you are traveling to an area where the food and water may be contaminated, in addition to taking the precautions above, taking probiotics both before and during your trip may help maintain intestinal health.
  • Apple cider vinegar is a traditional remedy that, although it has not been studied scientifically, may have some antimicrobial properties. Mix 2 tsp. in one cup warm water and drink several times a day.


  • Food Poisoning
  • Food Poisoning