Dr. Ben Wedro practices emergency medicine at Gundersen Clinic, a regional trauma center in La Crosse, Wisconsin. His background includes undergraduate and medical studies at the University of Alberta, a Family Practice internship at Queen's University in Kingston, Ontario and residency training in Emergency Medicine at the University of Oklahoma Health Sciences Center.
Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.
There many causes of food poisoning. Sometimes they classified by how quickly their symptoms begin after eating potentially
contaminated food. Think of this as the incubation time from when food enters
the body and symptoms begin. The following are several examples how this time
classification can be arranged:
Short incubation or less than 16 to 24 hours
Chemical causes
Scombroid poisoning usually is due to poorly cooked or stored fish. The
affected person will experience flushing, itching, shortness of breath, and difficulty swallowing
within 1 to 2 hour of eating.
Ciguatera poisoning is another fish toxin that occurs after eating fish
such as grouper, snapper, and barracuda. Symptoms include vomiting and diarrhea,
muscle aches, and neurologic complaints including
headache, numbness and
tingling, hallucinations, and difficulty with balance (ataxia).
Mushroom ingestions can cause initial symptoms like vomiting and diarrhea.
Eating Amanita mushrooms can cause liver and
kidney failure leading to death.
Bacterium Causes
Staphylococcus aureus poisoning is due to a toxin that is pre-formed in food
before it is eaten. It causes vomiting within 1 to 6 hours after eating the
contaminated food.
Bacillus cereus is an infection that occurs after eating poorly cooked or
raw rice.
Clostridium Perfringens is a spore that infects cooked meat that has been
stored in an environment that was too warm. Within 8 to 12 hours, it may cause profuse
diarrhea.
Intermediate incubation from about 1 to 3 days
Infections of the large intestine or colon can cause bloody, mucoid diarrhea
associated with crampy abdominal pain.
Campylobacter, according to CDC data, is the number one cause of food borne
disease in the United States.
Shigella spp contaminate food and water and cause dysentery (severe
diarrhea often containing mucus and blood).
Salmonella infections often occur because of
poorly or undercooked cooked, and poor handling of the
chicken and eggs. In individuals with weakened immune systems, including the
elderly, the infection can enter the bloodstream and cause potentially life-threatening infections.
Vibrio parahaemolyticus can contaminate saltwater shellfish and cause a
watery diarrhea.
Diarrhea due to small bowel infection tends not to be bloody, but infections
may affect both the small and large intestine at the same time.
Botulism is caused by
Clostridium botulinum toxin and may present with
fever, vomiting, mild diarrhea, numbness, and
weakness leading to
paralysis.
Long incubation 3 to 5 days
Hemorrhagic E. coli (mainly E. coli 0157:H7) can cause inflammation of the
colon leading to bloody stools. In some children, about a week after infection,
it can progress to hemolytic uremic
syndrome (HUS). Elderly individuals may contract
thrombotic thrombocytopenic purpura (TTP). Toxins from the bacteria enter the
blood stream and hemolyze or destroy red blood cells (hemo=blood +
lyse=disintegrate). In addition, the toxins cause kidney failure and uremia,
where waste products build up in the body.
Giardiasis may occur after drinking water from lakes or rivers that have
been contaminated by beavers, muskrats, or sheep that have been grazing. It also can be passed from person to person, for example in day care settings.
Amoebiasis is encountered in contaminated drinking water, usually in
tropical or semitropical climates and can be passed person to person.
Trichinosis is due to an infection from eating undercooked pork or wild
game such as bear meat. Aside from fever and gastrointestinal complaints, symptoms
include muscle pain, facial swelling, and bleeding around the eyes and under the
fingernails.
Cysticercosis is often seen in developing countries where water is
contaminated with pork tapeworms and the person drinks the ova form the
tapeworm. The infection can invade the brain (neurocysticercosis) causing
seizures.
Bacteria
Listeriosis usually occurs after foods contaminated with
Listeria bacteria
are ingested. These include unpastruized, raw milk, soft cheeses, and processed
meats and poultry. Vegetables and fruits may also become infected with
Listeria. The bacteria may lay dormant in or on the surface of the food
products for weeks.
Brucellosis occurs by ingesting raw or unpasteurized milk and cheese,
especially goat's milk contaminated with Brucella spp
Virus
Hepatitis A is spread by poor food handling,
and not due to blood exposure such as
hepatitis B and
C.
Protozoans
Toxoplasmosis is usually transmitted to humans from cat feces containing
Toxoplasma parasites; most infections are asymptomatic, but people
who are immune depressed can develop systemic disease symptoms.
Prion
Bovine Spongiform encephalopathy (mad cow disease) is acquired by eating
foods containing prions (transmissible agents that induces abnormal folding of
brain protein) contaminating brain or spinal cord from infected cows.
Abdominal pain is pain in the belly and can be acute or chronic. Causes include inflammation, distention of an organ, and loss of the blood supply to an organ. Abdominal pain can reflect a major problem with one of the organs in the abdomen such as the appendix, gallbladder, large and small intestine, pancreas, liver, colon, duodenum, and spleen.
Gastroenteritis (viral gastroenteritis, stomach flu) is an infection caused by a variety of viruses that results in vomiting and/or diarrhea. Even though it is often called the "stomach flu," it is not caused by the influenza viruses. Viruses that can cause gastroenteritis (stomach flu) include: rotaviruses, adenoviruses, caliciviruses, astroviruses, Norwalk virus, and a group of Noroviruses. Gastroenteritis is not caused by bacteria. The main symptoms of gastroenteritis include vomiting and watery diarrhea, however, headache, fever, and abdominal cramps (stomach ache) may also be present.
Staphylococcus or Staph is a group of bacteria that can cause a multitude of diseases. Staph infections can cause illness directly by infection or indirectly by the toxins they produce. Symptoms and signs of a Staph infection include redness, swelling, pain, and drainage of pus. Minor skin infections are treated with an antibiotic ointment, while more serious infections are treated with intravenous antibiotics.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
Norovirus infection causes stomach flu, or gastroenteritis. It's a very contagious illness with symptoms that include nausea and vomiting, diarrhea, stomach cramps, fever, headache, chills, and muscle aches. Norovirus infection cannot be treated with antibiotics, so treatment focuses on maintaining proper hydration.
The most common food allergies are to eggs, nuts, milk, peanuts, fish, shellfish, strawberries and tomatoes. Symptoms and signs include nausea, vomiting, diarrhea, abdominal pain, itching, hives, eczema, asthma, lightheadedness, and anaphylaxis. Allergy skin tests, RAST, and ELISA tests may be used to diagnose a food allergy. Though dietary avoidance may be sufficient treatment for mild allergies, the use of an Epipen may be necessary for severe food allergies.
Inflammation of the inner lining of the colon is referred to as colitis. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool. There are several causes of colitis including infection, ischemia of the colon, inflammatory bowel disease (Crohn's disease, Ulcerative colitis, or microscopic colitis). Treatment depends on the cause of the colitis.
Salmonella bacteria are known to cause salmonellosis, typhoid fever, and paratyphoid fever in humans. Salmonella infection is usually caused by ingesting large amounts of the bacteria in contaminated food or water.
There are many types of E. Coli (Escherichia coli ). Pathogenic E. coli can cause urinary tract and bladder infections, or lead to sepsis. E coli O157:H7 (EHEC) causes bloody diarrhea and colitis. Complications of E. coli infection include hemorrhagic diarrhea, hemolytic-uremic syndrome, and thrombotic thrombocytopenic purpura. Symptoms include severe abdominal pain and bloody diarrhea. E coli O157:H7 commonly is due to eating raw or undercooked hamburger or raw milk or dairy products.
Botulism is an illness caused by a neurotoxin produced by the bacterium Clostridium botulinum. There are three types of botulism: food-borne, wound, and infant. Symptoms include muscle paralysis, dry mouth, constipation, slurred speech, and blurred vision. If food-borne and wound botulism are detected early enough, they may be treated with an antitoxin. Infant botulism is treated intravenously with BabyBIG (Botulism Immune Globulin).
Listeria is a type of bacteria that can cause food poisoning. Listeriosis symptoms include diarrhea, nausea and fever. Pregnant women are 20 times more likely than other healthy adults to get listeriosis. Listeria infection is treated with antibiotics.
Travelers' diarrhea is generally contracted by eating contaminated food or drinking contaminated water. Food is the primary source of travelers' diarrhea. Enterotoxigenic E. coli is the cause of up to 70% of all cases of travelers' diarrhea. There are five unique classes of E. coli that causes gastroenteritis. Other bacteria responsible for travelers' diarrhea include
Campylobacter, jejuni, shigella, and salmonella. Viruses such as rotavirus and Norwalk virus (norovirus) and giardia lamblia a parasite may cause travelers' diarrhea. Prevention is careful eating and drinking of water.
Trichinosis is a food-borne disease caused by ingesting parasites (roundworms) in undercooked pork or wild-game meat. Symptoms of trichinosis include diarrhea, nausea, muscle aches, itching, fever, chills, and joint pains. Trichinosis usually resolves without treatment, but more severe cases are treated with thiabendazole, albendazole, or mebendazole.
Cholera is an infectious disease characterized by intense vomiting and profuse watery diarrhea and that rapidly lease to dehydration and often death. Cholera is caused by infection with the bacteria Vibrio cholerae, which may be transmitted via infected fecal matter, food, or water.
Brucellosis is an infectious disease caused by the Brucella bacteria. Symptoms and signs include sweating, fever, fatigue, dizziness, headache, cough, chest, joint, and abdominal pain, and enlarged liver and/or spleen. Brucellosis is treated with antibiotics.
Anthrax is a deadly infectious disease that may be transmitted to humans by infected animals or by biological warfare. There are three types of anthrax: cutaneous, inhalation, and gastrointestinal. Symptoms of cutaneous anthrax include a swollen glands, muscle ache, headache, fever, nausea, vomiting, and a red-brown raised spot that enlarges, blisters, and hardens, forming an ulcer crater with black crust. Symptoms of inhalation anthrax are flulike and may progress to respiratory distress, shock, coma, and death. Symptoms of gastrointestinal anthrax include loss of appetite, bloody diarrhea, and abdominal pain. Treatment for cutaneous anthrax involves penicillin, tetracycline, erythromycin, and ciprofloxin. Inhalation anthrax necessitates treatment with IV therapy with antibiotics.
Shigellosis is a disease caused by the Shigella bacteria. Bloody diarrhea, stomach cramps and fever are common symptoms. Mild infections usually resolve on their own. Antibiotics are used to treat more severe cases.
Hepatitis means inflammation of the liver. Hepatitis A is one type of liver disease caused by a virus. Since hepatitis A is a virus, it can pass from person to person from eating or drinking contaminated food or coming into contact with contaminated materials containing the virus. Symptoms of hepatitis A include stomach pain, diarrhea, dark yellow urine, jaundice, and more. There is a vaccine to prevent contracting hepatitis A.
Hemolytic uremic syndrome (HUS) is a diseases in which blood clots within the capillaries. Causes associated with HUS include E. Coli, birth control pills, pneumonia, medications such as chemotherapy, Ticlid, and quinine. Symptoms of HUS include gastroenteritis, abdominal cramping, vomiting, and bloody diarrhea. Diagnosis of HUS includes medical history, physical examination, and medical tests. Treatment includes rest, fluids, possible hospitalization for blood transfusion or complications due to kidney failure.
Cryptosporidiosis is an intestinal disease caused by the Cryptosporidium parasite. Symptoms include watery diarrhea, stomach cramps, nausea and vomiting, fever, weight loss, dehydration, and weight loss. Antibiotics are used in the treatment of cyptosporidiosis.
Cysticercosis is an infection caused by Taenia solium, the pork tapeworm. Symptoms include seizures, lethargy, nausea and vomiting, headache, vision changes, weakness, and confusion. Treatment depends upon the individual's symptoms and the stage of the infection. Treatment may incorporate anthelmintics, corticosteroids, anticonvulsants, and/or surgery.
Enterovirulent Escherichia coli (E. coli) are strains of related bacteria that have a strong propensity to cause gastrointestinal tract infections. Examples of strains include: EHEC (enterohemorrhagic E. coli), ETEC (enterotoxigenic E. coli), EPEC (enteropathogenic E. coli), EIEC (enteroinvasive E. coli), EAEC (enteroadherent E. coli), and EAggEC (enteroaggregative E. coli). Symptoms may vary depending on the strain the individual contracts. Infection is spread generally through contaminated food or drink.
Mad cow disease (or bovine spongiform encephalopathy [BSE]) is a fatal disease that attacks the central nervous system of adult cattle. Though the specific cause isn't known, it is speculated that infectious prions are the likely cause. Creutzfeldt-Jacob disease is found in people and is similar to BSE. A variation of this disease is thought to be caused by eating beef products from BSE-infected cattle.
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