All of the infectious organisms or their toxins are the most common ways someone can acquire food poisoning, which is sometimes referred to as a foodborne illness.
By either name, it is a miserable affliction that can start within hours of eating bad food or manifest itself days or even weeks after the fact. Whether eating in a restaurant, from a street vendor or at home, contamination can occur if the food is improperly handled, undercooked or otherwise tainted. Some cases of food poisoning are so severe that they require hospitalization. Others are merely uncomfortable interludes in an otherwise healthy life, with the illness lasting for several hours or a couple of days.
The Centers for Disease Control and Prevention estimate that the United States sees close to 50 million illnesses, more than 125,000 hospitalizations and more than 3,000 deaths each year related to foodborne illnesses. The United States Department of Agriculture’s Economic Research Service puts the cost of illnesses just from bacterial infections at close to $7 billion annually.
Food contamination is relatively simple and can occur at any point during food production, including growing, harvesting, processing, storing, shipping and preparing. The usual cause of it is cross-contamination, in which organisms are transferred from one surface to another. That’s why it’s always wise to wash vegetables and fruits thoroughly before consuming them, as raw or ready-to-eat foods are particular targets. Because the foods aren’t cooked, the harmful agents in them are not destroyed before the food is consumed.
So Many Sick Substances!
Contaminants go by such names as campylobacter, clostridium botulinum, clostridium perfringens, E.coli, giardia lamblia, hepatitis A, listeria, noroviruses, salmonella, rotavirus and more.
All of them are capable of inducing such symptoms as frequent vomiting, bloody vomit or stools, inability to keep liquids down, extreme pain, abdominal cramping, body temperature 101.5 degrees or higher, dehydration, dizziness, lightheadedness, blurry vision, muscle weakness and tingling in the arms.
There may be long-term consequences as well, and those are not confined to those who were so severely ill that they required hospitalization. The long-term effects include urinary tract problems, reactive arthritis, damage to the eyes, Guillain-Barre syndrome, ulcerative colitis, kidney failure and diabetes.
All kinds of foods are vulnerable to the agents that cause food poisoning, including meat and poultry, home-canned foods with low acidity, smoked or salted fish, potatoes baked in aluminum foil, unpasteurized milk, contaminated water, stews, gravies, shellfish, cheeses and even processed foods. All are vulnerable to the introduction of bacteria if the food is not hot enough, is chilled too slowly or is made with contaminated products. Infected food handlers can pass along their illness or fecal matter that clings to fingernails, and the counter space where the food is prepared may be contaminated with pathogens.
Those who are already in frail health or have vulnerable immune systems are at particular risk for food illnesses. These include older adults, pregnant women, infants, young children, people who have chronic conditions like liver disease, HIV/AIDS or diabetes, and those undergoing radiation therapy or chemotherapy for cancer. But even the strongest and healthiest people can be struck down if they consume the wrong product at the wrong time.
One of the most serious potential complications of a foodborne illness is dehydration from lost fluids or other essential minerals and salts because of vomiting and diarrhea. It’s crucial to replace the fluids with water, but some weaker people need to be hospitalized and given intravenous fluids. In some cases, dehydration imbalances can be fatal.
Deadly Targets
Some forms of food poisoning can be particularly dangerous to certain populations. Listeria monocytogenes can cause severe complications for a fetus, including miscarriage if it’s early in a pregnancy. If acquired later in the pregnancy, complications can include premature birth, stillbirth or a fatal infection shortly after the child is born. All of these can harm the child even if its mother was only mildly affected by the illness. There is also the potential of long-term neurological damage, which can lead to delayed development issues.
E.coli has its own set of problems. A complication called hemolytic uremic syndrome, which attacks the lining of the kidney’s blood vessels, can cause kidney failure. Older adults and children younger than age 5, along with the immune compromised, are at particular risk for this complication, which announces itself with large amounts of bloody diarrhea.
And dehydration as a result of vomiting and diarrhea is a real threat to even the healthiest person. In severe cases, patients may be hospitalized or, if left untreated, dehydration can be fatal.
Diagnosis and Treatment
The doctor will want to know where the patient has been and what foods have been ingested in the last few days. But as we've seen at fast-casual chain Chipotle, it’s really a guessing game, and a severe outbreak in a region or city will have investigators trying to pinpoint a commonality among victims who get severely ill, in hopes of finding the source of the illnesses, whether an individual or a location. A complete physical exam and blood tests, stool samples and parasite exam may be conducted, with results sent to a lab.
Treatment in all but severe cases follows a similar pattern. Drink fluids to stay hydrated and replace electrolytes, sodium, calcium and potassium.
Bland foods should be the main food source during the illness because they will put less stress on the digestive system at a delicate time. Mothers who are breastfeeding or using formula should continue as usual. The doctor may recommend Pedialyte, Enfalyte or other oral rehydration fluids for children, older adults and immune-compromised patients.
Treatment for food poisoning typically depends on the source of the illness, if known, and the severity of symptoms. For most people, the illness resolves without treatment within a few days, though some types of food poisoning may last longer.
Doctors may prescribe a round of antibiotics for those with severe symptoms who have certain types of bacteria poisoning, such as listeria or if the patient is pregnant. In adults with non-bloody diarrhea and no fever, doctors may recommend taking loperamide, (commercially, Imodium A-D) or bismuth subsalicylate (commercially, Pepto-Bismol).
Patients can help themselves experience a shorter recovery by fasting for a few hours, sucking on ice chips or taking small sips of water, drinking clear broth or non-caffeinated sports drinks like Gatorade, and generally easing back into solid foods by sticking to toast, soda crackers, bananas and rice. It’s wise to avoid alcohol, caffeine, dairy products, nicotine, fatty foods or highly seasoned foods until completely well.