Microbial foodborne illness, or food poisoning, occurs commonly throughout the world. resulting in approximately 3000 deaths per year. Close to one in five episodes of diarrhea is likely to be due to a foodborne disease. Fortunately, most people recover from an episode of foodborne illness without any need to consult with a healthcare provider or without any long-term complications.
This topic review discusses the causes, signs and symptoms, and treatment of foodborne illness, along with ways to avoid it.
Microorganisms that cause food poisoning — Some of the most common microorganisms that cause food poisoning include the following:
Salmonella — Salmonella is the leading cause of foodborne illness in the United States with an estimated one million cases of salmonellosis each year. There are many types of Salmonella, including those that cause typhoid fever and those that cause gastroenteritis. In the United States, the type that causes gastroenteritis is much more common.
Salmonella is very common in the intestines of animals and reptiles and often exists in the environment. When food is contaminated from the environment or from contact with animals, it can make humans sick when they subsequently consume that food. Contamination of food can occur on a farm, during food processing, or as a result of cross-contamination (transfer from raw meat to salad) in the home, at a restaurant, or at some other point in the supply chain. Thus, most cases of Salmonella food poisoning are due to either cross-contamination or undercooking of raw meat or poultry products or contamination of fresh produce. However, there have also been large outbreaks of Salmonella from unusual foods, such as peanut butter.
Escherichia coli — Escherichia coli is a common cause of food poisoning and traveler's diarrhea. Infection with E. coli can occur when food or water becomes contaminated with bacteria from infected feces. Some types of E. coli infection can be very serious, resulting in kidney failure or worse.
Hepatitis A virus — Hepatitis A virus is transmitted in foods contaminated by an infected human such as a food handler or from raw shellfish. Symptoms do not usually appear until 15 to 50 days after infection, which can make it difficult to determine the source of infection. In nonimmune individuals, post-exposure administration of passive immune globulin might prevent or mitigate clinical infection.
Detailed information about hepatitis A is available in a separate topic review.
Norovirus — Norovirus infection is the most common foodborne illness and is often acquired when infected food handlers contaminate the food they are preparing (eg, in restaurants). Norovirus is very infectious and easily passed from person to person. Symptoms usually start 24 to 48 hours after exposure with nausea, vomiting, diarrhea, and abdominal pain. Most cases resolve without medical treatment.
Listeria monocytogenes — Listeria is a bacteria that has traditionally been found in unpasteurized or contaminated milk, soft cheese, and other dairy products or in contaminated processed/delicatessen meats, hot dogs, and smoked seafood. More recently, Listeria monocytogenes has been found in a variety of other ready-to-eat foods such as hummus, sunflower seeds, and frozen vegetables. Listeria infection may cause gastrointestinal symptoms, which usually develop within 24 hours and include fever, watery diarrhea, nausea, vomiting, headache, and pains in joints and muscles. A much more serious infection, known as listeriosis, may occur one to three weeks later if the bacteria invade the bloodstream. Listeriosis can occur without any of the gastrointestinal symptoms. Listeriosis is usually seen in pregnant women or older adults and the immunocompromised.
Other microorganisms — More than 200 different microbes are known to cause food poisoning. Detailed information about some of these microbes is available separately.
FOOD POISONING SYMPTOMS
The symptoms of food poisoning depend upon which microbe you eat. Symptoms can appear hours after the food is ingested or may not appear until days or weeks later. The most common symptoms include:
●Nausea
●Vomiting
●Abdominal pain
●Diarrhea, which may be watery or bloody
●Fever
Less commonly, neurologic symptoms develop, such as blurry vision, dizziness, or tingling in the arms. In some instances, the most life-threatening problems occur several days after the start of intestinal symptoms, and these can include kidney failure, meningitis, arthritis, and paralysis, depending on which foodborne microbe you have been exposed to.
FOOD POISONING TREATMENT
In most cases of food poisoning, treatment is primarily supportive. Supportive treatment includes drinking adequate fluids, eating small, low-fat meals, and resting as needed.
Antibiotics are not usually needed or recommended but may be used for some types of food poisoning. In most cases, symptoms resolve quickly and no special treatment is necessary. In people with persistent diarrhea and/orvomiting, intravenous fluids may be needed to prevent dehydration. Antidiarrheal medications (eg, Imodium, Pepto-Bismol) are not generally recommended.
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