Gastrointestinal Illnesses: Foodborne Illnesses

Foodborne Illnesses

• Caused by eating contaminated food or beverages.
• Various microbes or pathogens present in the food cause illness.
• $48$ million cases reported annually in the U.S.
• Poultry, especially chicken, is the biggest cause of food poisoning.
• $250$ different foodborne diseases are known.
• Salmonella causes the most hospital admissions.

Salmonella

• Causes one million illnesses each year.
• Leads to more than $19,000$ hospitalizations and approximately $380$ deaths annually.
• Poultry is a typical cause.
• More common in the summer months due to temperatures affecting food preservation.
• More common in:
  • Children under five.
  • Infants who are not breastfed.
  • Adults over 65.
  • Immunocompromised individuals.
  • Those taking acid reducers (stomach acid not strong enough to fight infection).
• Symptoms:
  • Fever.
  • Abdominal cramping.
  • Diarrhea.
  • Vomiting.
  • Chills.
  • Nausea.
• Symptoms develop $12$ to $72$ hours after ingestion.
• Symptoms last four to seven days.
• Most people recover without treatment, but severe cases may require hospitalization.
• Treatment and Prevention:
  • No vaccine available.
  • Cephalosporins sometimes used for treatment.
  • Increase fluid intake to combat dehydration.
  • Education on keeping food at correct temperatures.
  • Cook food to proper temperatures; avoid undercooked meat, especially poultry.
  • FDA provides listings of proper temperatures for different types of meat.
  • Separate raw foods from cooked foods to avoid cross-contamination.
  • Use separate cutting boards for raw and cooked foods.
  • Wash hands and surfaces often, including cutting boards and countertops.
  • Refrigerate properly; avoid leaving food out for extended periods.

E. coli (Escherichia coli)

• Normal bacterium in the intestines, usually harmless.
• Overgrowth or contact with contaminated food or water can cause outbreaks.
• Six different types of pathogens associated, all causing diarrhea.
• Transmission:
  • Food or water contamination, especially contact with human or animal feces.
  • Poor hand washing or inadequate food preparation.
• Incubation period: three to four days.
• Symptoms:
  • Watery or bloody diarrhea.
  • Severe abdominal cramps.
  • Possible fever.
• Diagnosis: stool sample and culture.
• Supportive therapy: hydration, possibly IV fluids.
• Treatment Considerations:
  • Avoid antibiotics as they can worsen the condition and lead to superinfections by killing both good and bad bacteria.
  • No anti-diarrheal agents should be given.

Botulism

• Rare but serious condition caused by a toxin that attacks the nervous system.
• Can lead to difficulty breathing, paralysis, and death.
• Spread through food; makes spores that grow and produce toxins.
• One of the most lethal toxins.
• Favorable conditions for spore growth: low or no oxygen, low acid, low sugar, low salt, and appropriate temperature.
• Common sources: improperly home-canned, preserved, or fermented foods.
• Spores can invade wounds and produce toxins.
• Infant botulism: spores invade an infant's intestinal tract; avoid giving honey to infants.
• Iatrogenic botulism: side effects caused by medical procedures or drugs, such as cosmetic Botox injections.
• Symptoms:
  • Abdominal cramping.
  • Difficulty breathing.
  • Difficulty swallowing and speaking.
  • Double vision.
  • Nausea and vomiting.
  • Weakness and paralysis.
• Infant botulism:
  • Starts with constipation.
  • Progresses to nervous system symptoms, such as muscle weakness and irritability.
  • Can lead to paralysis and death.
• Diagnosis:
  • Assessment of food and exposure history.
  • Brain scans, spinal taps, nerve and muscle function tests, and blood tests.
  • Wound culture if suspected in a wound.
• Treatment:
  • Anti-toxin to prevent further damage (does not reverse existing damage).
  • Hospitalization for weeks or months with supportive therapy.
• Complications: respiratory failure.
• Mortality rate reduced from 50% to about 5% due to anti-toxin.
• Long-term recovery can take months, with lasting effects.

Clostridium difficile (C. diff)

• Transmitted through direct or indirect contact with infected stool.
• Bacteria can live on fomites for weeks to months.
• C. diff toxins attack the intestinal lining.
• Symptoms:
  • Watery diarrhea for three or more days.
  • Severe abdominal cramping.
  • Fever.
  • Blood in the stool.
  • Dehydration and weight loss.
• Treatment:
  • Stool transplant from a healthy donor to restore gut bacteria balance.
  • Antibiotics like Flagyl and vancomycin.
  • IV fluids for dehydration.
  • Surgery if C. diff damages the intestinal lining.