Gastrointestinal food poisoning
Introduction
Introduction to Gastrointestinal Food Poisoning The disease is more common in May-October, especially in July-September. This is closely related to the high temperature in summer and the easy breeding of bacteria. It is often caused by negligence in food purchase (food is not fresh, or dead animal meat). (All kinds of foods are mixed and stored, or the storage conditions are poor), improper cooking, raw and cooked knives are not divided or the remainder is improperly handled, and the food hygiene supervision is not strict during the festive dinner, especially food poisoning. basic knowledge Sickness ratio: 12% Susceptible people: no specific population Mode of infection: non-infectious Complications: diarrhea, abdominal pain, acute hemorrhagic necrotic enteritis, headache, urticaria, dehydration, shock
Cause
Gastrointestinal food poisoning etiology
(1) Sources of infection: Animals with bacteria such as livestock, poultry and their eggs, fish and wild animals are the main source of infection for this disease, and patients have a short time for bacteria. It is of little significance as a source of infection.
(2) Route of transmission: Food contaminated by bacteria and its toxins enters the digestive tract and gets sick. The food itself is contaminated or contaminated during processing and storage.
(3) Susceptibility of the population: general susceptibility, no obvious immunity after the disease.
Prevention
Gastrointestinal food poisoning prevention
Do a good job in food hygiene supervision, conduct regular health checkups and health publicity and education on the perpetrators, and conscientiously implement the Food Sanitation Law. Special emphasis should be placed on food hygiene supervision for festive meals.
(1) It is forbidden to eat sick and dead poultry, death due to injury, and those who have been tested for good meat quality should pay attention when eating; discard the internal organs, wash thoroughly, the meat pieces should be small, cooked and cooked; the knife plate is washed and disinfected after use. The degraded meat is not eaten, and meat and milk should be kept cold (below 6 °C) before consumption.
(2) The meat should be cooked thoroughly. All the mouths that come into contact with the cooked food should be washed with water beforehand. The knife plate for cutting the raw meat of the raw fish should be cleaned and disinfected to cut the cooked food. The cooked crab should be thoroughly cooked in boiling water, and the leftover crab is stored. More than 6h should be cooked again to eat, drunk, salted crabs can not be sterilized, it is best not to eat; if necessary, add vinegar and dip, can be sterilized.
(3) raw fish and loose vegetables should be stored separately. The remaining rice, vegetables, porridge, etc. should be spread out to store the ventilated and cool places to prevent cockroaches, and must be thoroughly heated before meals.
(4) When selling food, it is necessary to separate the goods to avoid food contamination.
(5) The meal is planned according to the number of people eating, and it is now eaten to avoid leftovers.
(6) Eliminate flies, rodents, cockroaches and mosquitoes, and do not raise livestock and poultry near the canteen.
(7) Salmonella, staphylococcal infected persons and carriers shall be temporarily removed from the diet work unit and treated appropriately.
Complication
Gastrointestinal food poisoning complications Complications diarrhea abdominal pain acute hemorrhagic necrotic enteritis headache urticaria dehydration shock
Staphylococcal food poisoning vomiting is more obvious, vomit contains bile, sometimes with blood and mucus. Abdominal pain is more common in the abdomen and umbilical cord. Frequent diarrhea, mostly yellow loose stools and watery stools.
Food poisoning caused by invasive bacteria may have fever, paroxysmal cramps and mucus pus and blood.
Some cases of Vibrio parahaemolyticus food poisoning showed bloody stools.
Clostridium perfringens type A disease is mild, and a few types of C and F can cause hemorrhagic necrotic enteritis. Proteus mutans can also develop allergic symptoms such as facial flushing, headache, and urticaria. Severe diarrhea can lead to dehydration, acidosis, and even shock.
Symptom
Gastrointestinal food poisoning symptoms Common symptoms Watery stool diarrhea abdominal pain shoulder scapula with "simulation sputum" nausea loose dehydration shock pharyngeal pharyngeal respiratory muscles appear... facial flushing
The incubation period is short. The case of more than 72 hours can basically exclude food poisoning. Staphylococcus aureus food poisoning is caused by enterotoxin accumulated in food. The incubation period is 1 to 6 hours. The production of heat-labile enterotoxin is produced after the production of Clostridium perfringens enters the human body. , incubation period of 8 to 16 hours, invasive bacteria such as Salmonella, Vibrio parahaemolyticus, Proteus and other food poisoning, the incubation period is generally 16 to 48 hours.
The clinical manifestations are mainly acute gastroenteritis, such as nausea, vomiting, abdominal pain, diarrhea, etc., staphylococcal food poisoning and vomiting are obvious, vomit contains bile, sometimes with blood and mucus, abdominal pain is more common in the abdomen and umbilical cord, diarrhea is frequent Mostly yellow stools and watery stools, food poisoning caused by invasive bacteria, fever, abdominal paroxysmal cramps and mucus pus and bloody stools. Some cases of Vibrio parahaemolyticus food poisoning have bloody stools. Clostridium bacillus type A disease is mild, a small number of C and F can cause hemorrhagic necrotic enteritis, Proteus morganans can also have facial flushing, headache, urticaria and other allergic symptoms, severe diarrhea can lead to dehydration, Acidosis, even shock.
Examine
Gastrointestinal food poisoning examination
Take the patient's vomiting and suspected residual food for bacterial culture, blood culture in critically ill patients, and take the serum from the double serum and the suspected bacteria isolated from the early two weeks after the disease for serum agglutination test. The double serum agglutination titer is increased. Diagnostic value, when suspicious, especially those suspected of bacterial toxin poisoning, can be tested in animals to detect the presence of bacterial toxins.
Diagnosis
Diagnostic diagnosis of gastrointestinal food poisoning
diagnosis
According to the history, clinical symptoms, laboratory tests can be diagnosed.
Differential diagnosis
(1) Non-bacterial food poisoning Eating poisoned potatoes, Xanthium, bitter almond, puffer fish or poisonous cockroaches, etc., the incubation period is only a few minutes to several hours, generally no fever, mainly vomiting, abdominal pain, diarrhea Less, but the neurological symptoms are more obvious, the mortality rate is higher, mercury arsenic poisoning has sore throat, congestion, blood in vomiting and diarrhea, chemical analysis can determine the cause.
(2) Cholera and deputy heap disorder: for painless vomiting, first vomiting and vomiting, and no fever, stool is rice bran water sample, because the incubation period can be as long as 6 days, so it is rare for a large number of patients in the short term, stool painting A fluorescent antibody staining microscopy and culture can be found in Vibrio cholerae or Vibrio cholera.
(3) Occasionally, acute bactericidal dysentery, especially vomiting, often have fever, urgency and heavy, feces mixed with pus and blood, lower abdominal and left lower abdomen obviously tender, stool microscopic examination with red blood cells, pus cells and macrophages About half of the cells, stool culture, have dysentery bacilli growth.
(4) Viral gastroenteritis is caused by a variety of viruses, characterized by acute enteritis, with an incubation period of 24 to 72 hours, mainly characterized by fever, nausea, vomiting, abdominal distension, abdominal pain and diarrhea, drainage can be loose, vomiting and diarrhea In severe cases, water, electrolytes and acid-base balance disorders can occur.
