Food poisoning

Causes

Food poisoning can affect one person or a group of people who all ate the same contaminated food. It more commonly occurs after eating at picnics, school cafeterias, large social functions, or restaurants.

The germs may get into the food you eat (called contamination) in different ways:

• Meat or poultry can come into contact with bacteria from the intestines of an animal that is being processed
• Water that is used during growing or shipping can contain animal or human waste
• Food handling or preparation in grocery stores, restaurants, or homes

Food poisoning often occurs from eating or drinking:

• Any food prepared by someone who does not wash their hands properly
• Any food prepared using cooking utensils, cutting boards, and other tools that are not fully cleaned
• Dairy products or food containing mayonnaise (such as coleslaw or potato salad) that have been out of the refrigerator too long
• Frozen or refrigerated foods that are not stored at the proper temperature or are not reheated properly
• Raw fish or oysters
• Raw fruits or vegetables that have not been washed well
• Raw vegetables or fruit juices and dairy products (look for the word "pasteurized," which means the food has been treated to prevent contamination)
• Undercooked meats or eggs
• Water from a well or stream, or city or town water that has not been treated

Many types of germs may cause food poisoning, including:

• Campylobacter enteritis
• Cholera
• E. coli enteritis
• Fish poisoning
• Staphylococcus aureus
• Salmonella
• Shigella

Infants and elderly people are at the greatest risk for food poisoning. You are also at higher risk if:

• You have a serious medical condition, such as kidney disease or diabetes
• You have a weakened immune system
• You travel outside of the United States to areas where you are exposed to germs that cause food poisoning

Pregnant and breastfeeding women have to be especially careful to avoid food poisoning.

Symptoms

Symptoms from the most common types of food poisoning usually start within 2 - 6 hours of eating the food. That time may be longer or shorter, depending on the cause of the food poisoning.

Possible symptoms include:

• Abdominal cramps
• Diarrhea (may be bloody)
• Fever and chills
• Headache
• Nausea and vomiting
• Weakness (may be serious)

Exams and Tests

Your health care provider will examine you for signs of food poisoning, such as pain in the stomach and signs your body does not have as much water and fluids as it should. This is called dehydration.

Tests may be done on your stools or the food you have eaten to find out what type of germ is causing your symptoms. However, tests may not always find the cause of the diarrhea.

In more serious cases, your health care provider may order a sigmoidoscopy. A thin, hollow tube with a light on the end is placed in the anus to look for the source of bleeding or infection.

Treatment

Outlook (Prognosis)

Most people fully recover from the most common types of food poisoning within 12 - 48 hours. Serious complications can occur, however, from certain types of food poisoning.

Death from food poisoning in people who are otherwise healthy is rare in the United States.

Possible Complications

Dehydration is the most common complication. This can occur from any causes of food poisoning.

Less common, but much more serious complications depend on the bacteria that are causing the food poisoning. These may include:

• Arthritis
• Bleeding problems
• Damage to the nervous system
• Kidney problems
• Swelling or irritation in the tissue around the heart

When to Contact a Medical Professional

Call for an appointment with your health care provider if you have:

• Blood or pus in your stools
• Diarrhea and are unable to drink fluids due to nausea or vomiting
• A fever above 101°F, or your child has a fever above 100.4°F along with diarrhea
• Signs of dehydration (thirst, dizziness, light-headedness)
• Recently traveled to a foreign country and developed diarrhea
• Diarrhea that has not gotten better in 5 days (2 days for an infant or child), or has gotten worse
• A child who has been vomiting for more than 12 hours (in a newborn under 3 months you should call as soon as vomiting or diarrhea begins)
• Food posoning from mushrooms, fish, or botulism

Prevention

See: Preventing food poisoning

References

Schiller LR, Sellin JH. Diarrhea. In: Feldman M, Friedman LS, Brandt LJ, eds. Sleisenger & Fordtran's Gastrointestinal and Liver Disease. 9th ed. Philadelphia, Pa: Saunders Elsevier; 2010:chap 15.

Sodha SV, Griffin PM, Hughes JM. Foodborne disease. In: Mandell GL, Bennett JE, Dolin R, eds. Principles and Practice of Infectious Diseases. 7th ed. Philadelphia, Pa: Elsevier Churchill Livingstone; 2009:chap 99.

Craig SA, Zich DK. Gastroenteritis. In: Marx JA, ed. Rosen's Emergency Medicine: Concepts and Clinical Practice. 7th ed. Philadelphia, Pa: Mosby Elsevier;2009:chap 92.

Update Date: 1/10/2011

Updated by: Linda J. Vorvick, MD, Medical Director, MEDEX Northwest Division of Physician Assistant Studies, University of Washington, School of Medicine; George F. Longstreth, MD, Department of Gastroenterology, Kaiser Permanente Medical Care Program, San Diego, California. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M. Health Solutions, Ebix, Inc.