FOOD TOXIC INFECTIONS

A B C D E F G H I J K L M N O P Q R S T U V W X Y Z

FOOD TOXIC INFECTIONS - acute intestinal infectious diseases that result from eating foods that multiply microorganisms and accumulate their toxins; Characterized by a sudden onset, intoxication, gastroenteritis. The group nature of the disease is often noted.

Foodborne toxic infections can be caused by conditionally pathogenic bacteria of the genera Proteus, Klebsiella, Enterobacter, Vibrio, Pseudomonas, Clostridium, and St. Aureus et al.

Sources of infectious agents are people and animals, sick or bacterial carriers that excrete the pathogen with feces polluting the soil, environmental objects, food, water from open water bodies. Pathogens are transmitted only through food, more often through meat, milk, jelly, minced meat, pate, cutlets, fish, salad, salad, contaminated during preparation, transportation, storage and sale. Possible contamination of meat during slaughter and processing of carcasses of sick animals. The disease is always associated with eating contaminated products that have not been heat treated, or finished food contaminated after its preparation, stored outside the refrigerator and not subjected to repeated heat treatment.

Clinical picture . The duration of the incubation period is from 2 to 4 to 24 to 48 hours. The onset is usually acute: repeated vomiting on the background of a painful feeling of nausea, cramping pains in the abdomen. Feces initially liquid stool, then watery, abundant, fetid (stool up to 10 - 15 times a day), more often without pathological impurities, less often with an admixture of mucus and blood. Simultaneously with dyspeptic disorders, a part of patients have chills, fever, tachycardia, arterial hypotension, skin pallor, syncope, cramps . Usually after 1-3 days these phenomena subsided. However, after cessation of vomiting and diarrhea, gastrointestinal function disorders may persist: enzyme deficiency, increased peristalsis, impaired digestive and absorption capacity of the intestine, dysbiosis , accompanied by unstable stools, flatulence, short-term abdominal pain.

The diagnosis is established on the basis of the clinical picture, the data of the epidemiological anamnesis (the group nature of the diseases, the violation of the rules of heat treatment and the timing of food storage used by the sick, etc.), the results of laboratory studies.

The main method of laboratory diagnosis is the bacteriological study of vomit, feces, food residues, etc. Recognition of an isolated microbe as a causative agent of food-borne disease should be strictly argued. To do this, it is necessary to exclude (in view of clinico-laboratory and epidemiological data) other intestinal infections, to confirm the etiological role of the suspected pathogen by isolating identical microbes from the material obtained from patients from suspicious foods, based on the massive growth of the pathogen on nutrient media, and The growth of antibody titer in the dynamics of the disease and the positive agglutination reaction with the autoscitens of the pathogens.

Lechenie. Hospitalization of patients is carried out according to clinical and epidemiological indications. Obligatory hospitalization is subject to patients with severe intoxication and dehydration, children under 2 years old, elderly people, persons with concomitant diseases, as well as workers in food enterprises, pharmacies, preschool institutions living in hostels, etc.

In the first hours of the disease, the most effective and urgent measure is gastric lavage through the probe; With continued nausea and vomiting, this procedure is carried out at a later date. Stomach is washed with 2% sodium hydrogen carbonate solution or water. The procedure is continued until the waste water is clean. Further treatment depends on the degree of dehydration of the body. Recommended oral intake of 2 - 3 liters of liquid with the following composition: sodium chloride - 3.5 g, potassium chloride -1.5 g, sodium hydrogen carbonate - 2.5 g, glucose - 20 g per 1 liter of drinking water. The solution should be given to the patient in small portions for 2 -3 hours. In those cases when there is no possibility to prepare such a solution, patients can be given mineral water, hot tea or mors. With ineffectiveness of such therapy, as well as patients who are in serious condition, with marked signs of dehydration, intravenous saline solutions (quartrel, trisol, etc.) are shown. Antibacterial drugs are indicated only in the severe course of clostridial gastroenteritis. Of great importance is therapeutic nutrition. From the diet should be excluded dishes that have an irritant effect on the gastrointestinal tract and enhance the fermentation processes. Showing slimy soups, unconcentrated broths, dishes from ground or mashed meat, boiled lean fish, steam cutlets, scrambled eggs, mashed potatoes, cottage cheese, jelly, butter, dried bread, dried biscuits, tea.

After the acute phenomena subsided, digestive deficiency is compensated with enzymes and enzyme preparations (pancreatin, festal , panzinorm, trienzyme, etc.) for 7-14 days. To normalize the intestinal microflora, bacterial preparations (bifidumbacterin, bifikol) or dietary products containing bifidobacteria (kefir bio, bifid) are prescribed.

In the treatment of food poisoning in infants, diet is particularly important. A water-salt pause is necessary for 6-14 hours. During this period, children receive tea, decoctions of rose hips or raisins. After a pause, it is best to feed the child with expressed breast milk or acidic mixtures of 10-50 ml after 2 hours, followed by a dose increase. With exsicosis and toxicosis, infusion therapy is performed (5% glucose solution, saline solutions, haemodez, rheopolyglucin, etc.). If necessary, appoint lytic mixtures, anticonvulsant and antipyretics, glucocorticoids. Children up to 1 year are shown antibacterial drugs.

The prognosis is usually favorable, fatal outcomes are possible with the development of an infectious-toxic shock.

Prevention is reduced to strict adherence to sanitary norms and rules in the procurement, transportation and storage of food products, sanitary and technological rules for the preparation and use of ready-made food, as well as personal hygiene rules for the personnel of food enterprises. The hygienic education of the population is of great importance.

Perishable products should be stored in the cold. Meat, fish, raw vegetables and semi-finished products must be cut on different boards and different knives. Store and transport the ready-made food in a clean container, pre-scalded with boiling water. The food is dispensed immediately after the heat treatment. If the food is not realized immediately after its preparation, then it must be stored in the cold, and immediately subjected to heat treatment before distribution.