Food poisoning

Question 1

Reducing risk of outbreaks in hospitals

Answer 1

Decrease source of infectious agents –> hygiene, prompt discharges
Prevent modes of transmission –> direct and indirect contact, ppe,hygeine
Sterile/disposable equipment, isolation, barrier nursing
identify susceptible hosts and protect them
Restricted ward access/ visiting hours/ ward closures

Question 2

What do you need to do as a doctor if you suspect a case of food poisoning?

Answer 2

• Section 11 of Public Health (Control of Disease) Act 1984
• It’s a notifiable disease - report to consultant responsible for communicable disease control
• Notify a ‘proper officer’ in the local authority

Question 3

Staphylococcus aureus

Answer 3

found in meat
severe vomit and diarrhoea in 1-2 hours
abdominal pain
hypotension
quick acting exotoxin

Question 4

Bacillus cereus

Answer 4

Causes vomiting within 1-6 hours of eating contaminated food e.g. rice
Diarrhoea and vomiting with a rapid resolution

Question 5

Salmonella

Answer 5

Often found in meat, eggs and dairy products
Vomiting not a prominent symptom
Symptoms usually last between 4-7 days
bloody diarrhoea
stomach cramps
12-48hrs inc; D+V, fever, septicaemia

Question 6

Cl. perfringens

Answer 6

8-24hrs
inc; D, afebrile
meat, not cooked properly or reheated

Question 7

Cl. botulinum

Answer 7

12-36hrs
inc; V, paralysis
processed food

Question 8

Cl. difficile

Answer 8

1-7d
bloody diarrhoea
Caused by imbalance of regional gut flora caused by antibiotic therapy
Especially after use of four Cs:
- Cindamycin
- Cephalosporins
- Ciprofloxacin
- Co-amoxiclav
Usually affects elderly/infirm patients
Can lead to perforation/toxic megacolon + malnutrition

Question 9

Vibrio parahaemolyticus

Answer 9

12-24hrs
inc; profuse D, V
seafood

Question 10

Vibrio cholerae

Answer 10

2h-5d
inc; watery stools, fever, V, rapid dehydration; water

Question 11

Campylobacter

Answer 11

most common cause of food poisoning in uk;
2-5d
inc; bloody D, fever, meningoencephalitis, intense abdominal colic
milk, poultry, water
Symptoms usually last less than a week

Question 12

Listeria

Answer 12

see campylobacter; also found in cheese, pâtés

Question 13

E.coli type 0157 VTEC

Answer 13

12-72hrs
After eating undercooked beef or drinking unpasteurised milk
Symptoms usually last for a few days or week
Associated with haemolytic uraemic syndrome, AKI and bloody diarrhoea
E Coli do not have vomiting as a prominent symptom

Question 14

Enterotoxigenic E.coli ETEC

Answer 14

Enterotoxigenic E.coli infection typically occurs in travellers with diarrhoea associated with stomach cramps and nausea
leading bacterial cause of diarrhea in the developing world
non-inflammatory, non-bloody.

Question 15

Giardia lamblia

Answer 15

1- 4wks
asymptomatic, lassitude, bloating, flatulence, abdominal discomfort, loose stools, explosive diarrhoea; water

Question 16

Rotavirus

Answer 16

1-7d
D+V, fever malaise
most common in children

Question 17

Norovirus

Answer 17

most common cause of viral gastroenteritis overall
cause abrupt onset, usually short lived GI upset 24-48 hours after innoculation.
typically self limiting in healthy people but can cause pre-renal acute kidney injury in the frail.

Question 18

Shigella

Answer 18

2-3d
Main signs are bloody diarrhoea, fever and abdominal cramps
Caused by seafood, raw vegetables, dairy and poultry