Food poisoning

Classification according to ICD-10
T62.9	Unspecified harmful substance ingested with food
A05.-	Other bacterial food poisoning, not elsewhere classified
ICD-10 online (WHO version 2019)

Food poisoning is food intolerance caused by the consumption of foods with toxic ( toxic ) ingredients. This is differentiated from non-toxic food intolerances ( food intolerances , food allergies and celiac disease ).

Food can be contaminated with a wide variety of poisons, for example metabolic toxins from bacteria , fungi or parasites , toxic chemicals or heavy metals . Causes of contamination include production errors, poor kitchen hygiene and improper storage. Sometimes food is intentionally poisoned, for example to blackmail the product .

Pathophysiology

A distinction is made between food intoxications and food infections.

Food intoxication

The disease most commonly occurs through ingestion of poisons such as bacterial toxins.

In contrast to food infections, the germs do not multiply in the body; the damage is only caused by its metabolic products. The most common food poisoning in Germany occurs when food is contaminated with Staphylococcus aureus via the hands of the cooker (e.g. after cutting a ham), whereby this skin germ, which in itself does not necessarily cause disease, increases when standing around in the food for a long time. Subsequent boiling kills the pathogen as well as stomach acid, but the (entero-) toxins it forms survive these barriers and lead to the characteristically short, but sometimes quite severe symptoms. Bacillus and clostridial species can also form enterotoxins and cause similar complaints.

Food poisoning can also be caused by:

• Hormones from the thyroid glands of slaughtered animals ( triiodothyronine , thyroxine ),
• toxic metals and metal compounds ( arsenic , antimony , zinc ),
• Mushroom toxins ( orellanins ),
• vegetable toxins ( solanine ) and
• Toxins from marine animals ( saxitoxins , ciguatoxin , tetrodotoxin )

Food infections

Pathogenic microorganisms are absorbed through food. This leads to food poisoning through infection of the gastrointestinal tract . The germs or bacteria multiply in humans (infection) and cause the symptoms (e.g. campylobacteriosis , salmonellosis , yersiniosis ) after a short incubation period (hours ). These germs often also produce toxins (e.g. typhoid , cholera ); in these cases a strict differentiation between food infection and food intoxication is not possible. Vibrio parahaemolyticus and Vibrio vulnificus can be pathogens in mussels and raw fish .

In a recent report, the World Health Organization (WHO) has again drawn attention to how dangerous diseases are caused by spoiled food. Every year one in ten people worldwide gets a food infection.

Symptoms

The symptoms of food poisoning can vary greatly depending on the toxin that triggers it . Poisoning with plants or mushrooms can lead to fever , nausea, cramps, hallucinations and in some cases even death. Fish poisoning can cause nausea, vomiting and diarrhea. In the case of the puffer fish , the poison tetrodotoxin causes paralysis, which also affects the skeletal muscles and can thus lead to death through respiratory paralysis.

The symptoms of food infections are usually nausea, vomiting, diarrhea and abdominal cramps without a fever. However, they can be fatal as infectious enteritis (with an incubation period of one to four days), with leukocytes in the stool and often with fever like food intoxication.

therapy

Basics

The loss of fluid and salt through vomiting and excreted stool is compensated for by the intake of large amounts of isotonic fluid . In the case of pure food poisoning, antibiotic therapy makes no sense, as there is no infection with a pathogen capable of multiplying. In severe cases, some bacterial infections may give antibiotics to target the active bacteria or parasites .

Vomiting and bowel movements should not be withheld in most cases, as they remove bacteria toxins from the body more quickly.

Reporting requirement

In Germany, according to Section 6 (1) sentence 1 number 2 of the Infection Protection Act (IfSG), microbial food poisoning or illness from acute infectious gastroenteritis must be reported to the public health department if

• a person who works in a food business is affected or
• two or more diseases of the same type with a probable or suspected epidemiological connection occur.

As far as a food company is affected by the event, the food control at the veterinary office must also take action.

In Austria, bacterial and viral food poisoning are notifiable diseases in accordance with Section 1 (1) of the 1950 Epidemic Act . Cases of suspicion, illness and death must be reported.

Preventive measures

In order to prevent food from spoiling by bacteria, fungi, decay, etc., it is primarily advisable to use raw materials that are low in germs and to store and process them properly. In particular, depending on the product, critical upper temperature limits must be observed. In the household, one should limit the supplies of perishable food to short-term consumption and ensure adequate cooling of perishable food. In addition to other generally applicable measures (clean work surfaces and tools, personal hygiene, etc.), other specific measures can also be taken into account, depending on the raw material, method of manufacture, consumption period, etc. The consumer can also use the best before date as a guide. However, an expired date does not immediately mean that the consumption of a product has health consequences, but that special attention should be paid here.

The Federal Food Safety and Veterinary Office suggests the following four hygiene rules in connection with the preparation of meat :

• Wash properly: Wash hands, kitchen utensils, work surfaces, etc. with soap
• Heat correctly: min. 70 ° C; even when warming up again
• Cooling properly: Max. 5 ° C
• Separate correctly: Use separate plates for raw and cooked / grilled meat

See also

• botulism
• Food scandal
• Shiga toxin
• Thyrotoxicosis
• Vero toxin

literature

• Marianne Abele-Horn: Antimicrobial Therapy. Decision support for the treatment and prophylaxis of infectious diseases. With the collaboration of Werner Heinz, Hartwig Klinker, Johann Schurz and August Stich, 2nd, revised and expanded edition. Peter Wiehl, Marburg 2009, ISBN 978-3-927219-14-4 , pp. 179-182 ( infections of the gastrointestinal tract ).

Web links

• Food-borne diseases - information from the Robert Koch Institute

Wiktionary: Food poisoning  - explanations of meanings, word origins, synonyms, translations

• Foodborne diseases, emerging ( Memento of February 27, 2004 in the Internet Archive ) (English), WHO , Fact sheet N ° 124, January 2002
• Food safety and foodborne illness ( Memento from February 27, 2004 in the Internet Archive ) (English), WHO , Fact sheet N ° 237, January 2002
• WHO statistics (English)

Individual evidence

1. ↑ Alphabetical index for the ICD-10-WHO version 2019, volume 3. German Institute for Medical Documentation and Information (DIMDI), Cologne, 2019, p. 497
2. ↑ Lucie Wartique, Lucie Pothen, Nathalie Pirson, Michel P. Hermans, Michel Lambert, Halil Yildiz: An unusual cause of epidemic thyrotoxicosis . In: Acta Clinica Belgica , 2017, 72, p. 6, 451-453, doi: 10.1080 / 17843286.2017.1309336
3. ↑ CW Hedberg et al .: An outbreak of thyrotoxicosis caused by the consumption of bovine thyroid in ground beef . In: N Engl J Med , 1987, 316, pp. 993-998, PMID 3561455 .
4. ↑ Malvinder S. Parmar, Cecil Sturge: Recurrent hamburger thyrotoxicosis . In: CMAJ , 2003 Sep 2; 169 (5), pp. 415-417, PMC 183292 (free full text).
5. ↑ Janet S. Kinney et al .: Community outbreak of thyrotoxicosis: Epidemiology, immunogenetic characteristics, and long-term outcome . In: The American Journal of Medicine , Volume 84, January 1988, Issue 1, pp. 10-18, PMID 3257352 .
6. ↑ LE Hendriks, BJ Looij: Hyperthyroidism Caused by excessive consumption of sausages. In: Neth J Med. 68 (3), Mar 2010, pp. 135-137, PMID 20308711 .
7. ↑ M. Cano Megias, J. Diez, G. Perez López, M. García Villanueva, P. Iglesias, A. Matei: Exogenous thyrotoxicosis by consumption of pork sausage. In: Endocrine Abstracts. 29, 2012, p. 468.
8. ↑ Outbreak . In: Deadly Danger , episode 89, part 2 of the German edition of the US television series Medical Detectives .
9. ^ Marianne Abele-Horn: Antimicrobial Therapy. Decision support for the treatment and prophylaxis of infectious diseases. P. 179.
10. ↑ Food poisoning . In: Pschyrembel , Clinical Dictionary . 258th edition.
11. ↑ Marianne Abele-Horn (2009), p. 179.
12. ↑ WHO publishes new report on food infections . sueddeutsche.de; Retrieved December 3, 2015.
13. ^ Marianne Abele-Horn (2009).
14. ↑ Preventive measures: Best before. Retrieved August 13, 2019 . 
15. ↑ “Enjoy safely” campaign: Those who grill properly can only win. In: blv.admin.ch. May 7, 2019, accessed May 22, 2019 . 
16. ↑ Prepare properly - enjoy safely. In: blv.admin.ch. Accessed December 1, 2019 . 

This article is about a health issue. It is not used for self-diagnosis and does not replace a diagnosis by a doctor. Please note the information on health issues !