BN Doctors’ Lounge: Food Poisoning

The misery and plight of frequent visits to the porcelain bowl is better imagined than experienced, although more than a few of us have been at some point besieged by stomach bugs. Food poisoning increasingly begs attention, with more frequent mortalities and even more numerous hospital admissions attributed to food-borne illnesses. The sad bit is that it’s easily preventable and treatable.

Gastroenteritis, commonly known as “Food Poisoning”, occurs when food or water contaminated with harmful microbes, toxins or chemicals is eaten or drunk. This contamination can occur at any point of food processing or production; from growing (pesticide contamination eg from eating unwashed fruits) up until cooking (good ol’ germs!)

What Causes Food Poisoning?
Food usually becomes contaminated from either of the following:

• Not storing food correctly or at the correct temperature, for example, not refrigerating food properly. This is particularly a problem for meat and dairy products.
• Inadequate cooking of food (undercooking or not cooking to the correct temperature).
• Contamination from food handlers without vigilant hand washing practices
• Contamination from other foods (cross-contamination). For example, same unwashed board used to cut raw meat, then being used to cut fruits, or storing raw meat in the fridge above food that is ‘ready-to-eat’ and so allowing raw meat ‘juices’ to drip onto the food below.
• Bacteria can also be present in unpasteurised milk (northerners, think ‘fura de nunu’).
• Canned food left opened or not properly stored
Water can become contaminated with bacteria or other microbes from the water supply, or from having ice cubes in drinks (especially when the kind of water the ice was made with is doubtful).

Symptoms of Food Poisoning
Symptoms depend on the type of contaminant and the amount eaten. The symptoms can develop rapidly, within 30 minutes, or slowly, worsening over days to weeks. Most of the common contaminants cause nausea, vomiting, diarrhoea (sometimes bloody), symptoms of dehydration in severe cases, and fever. Usually, the illness runs its course in 24-48 hours.
Symptoms of dehydration include tiredness, dizziness or light-headedness, headache, muscular cramps, sunken eyes, passing little urine, a dry mouth and tongue, weakness, and irritability. In severe cases, confusion, rapid heart rate and coma may occur.
Severe dehydration is a medical emergency.

How Can My Doctor Be Certain I Have Food Poisoning?
Most people will recognise food poisoning from the typical symptoms and diagnosis is usually clinical. If symptoms are mild, you do not usually need to seek medical advice or receive specific medical treatment. In some cases, your doctor may ask you to provide a stool sample which will be examined in the laboratory to look for the cause of the infection.
Can it be treated?
Symptoms often abate within a couple of days as your immune system usually clears the infection. Occasionally, admission to hospital is needed if symptoms are severe, or if complications develop. The major health risk of food poisoning on the short term is dehydration, although there could be serious long term consequences in some cases.

Tips For Home Care
• As a rough guide, drink at least 200 mls of fluid after each bout of diarrhoea (after each watery stool). Small, frequent sips of clear liquids (those you can see through) are the best way to stay hydrated and increase elimination of the offending toxin.
• This extra fluid is in addition to what you would normally drink
• If you vomit, wait 5-10 minutes and then start drinking again, but more slowly. For example, a sip every 2-3 minutes, but making sure that your total intake is as described above.
• For most adults, fluids drunk to keep hydrated should mainly be water. Avoid sugary drinks as they can sometimes make the diarrhoea worse.
• Oral Rehydration drinks may be helpful. They are made from sachets sold over-the-counter; the contents of the sachet are dissolved in water. Rehydration drinks provide a good balance of water, salts, and sugar but they do not stop or reduce diarrhoea. Do not use home-made salt/sugar drinks, as the quantity of salt and sugar has to be exact.
• Bananas work wonders with replacing lost potassium and help regain strength!
• Do not take anti-diarrhoeal meds like imodiumTM as they slow the elimination of the toxins from your system – you’d want to poop them all out, right?
• Avoid certain foods like dairy products, caffeine, alcohol and fatty foods, until you’re feeling better.
Your doctor might prescribe antibiotics in certain cases after a stool sample has been tested.

When to Seek Medical Care
Contact your doctor if any of the following situations occur – Nausea, vomiting, or diarrhoea which lasts for more than two days, if the ill person is a child younger than three years of age, symptoms begin after recent foreign travel, other family members or friends who ate the same thing are also sick, you can’t keep any liquids down, no improvement within two days despite drinking large amounts of fluids, the ill person is pregnant.

How Do I Prevent Further Episodes?
Safe steps in food handling, cooking, and storage are essential to avoiding food-borne illness. There are 4Cs that must be kept in mind:
Cleanliness – Keep work surfaces, utensils and hands clean.
Cooking – Ensure food is properly and thoroughly cooked (especially meat), when reheating food, it needs to be cooked right through and be piping hot in the middle, and do not reheat more than once.
Chilling – Keep cold food cold. Buy cold foods last during your shopping and get home fast.
Cross-contamination – Avoid cross-contamination. Separate raw and cooked or ‘ready-to-eat’ foods, do not use the same surface or chopping board for preparing raw and ready-to-eat foods.
Discard food you’re unsure of. Bacteria cannot be seen, smelled, or tasted; so the motto is ‘when in doubt, throw it out’, or more graphically, ‘better to give it up than to throw it up’.

Also, a great deal of discernment when dining out is imperative (be it fine-dining or mama-put). Prevention is key here, with these easy practical steps.

In a Nutshell
Food poisoning may seem mundane but is increasingly one of the world’s greatest killers, and for this reason is currently on the World Health Organisation’s top 10 priority list. It results from contamination of food and water, and being a tad bit more vigilant about what goes into our mouths will go a long way in prevention.

Did You Know?
Food poisoning can result in serious complications such as joint pain and kidney failure. Reactive arthritis occurs as a complication of gastroenteritis, and acute renal failure is a fairly common sequel to food poisoning due to a certain strain of the ubiquitous E.coli.
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Annette Bazuaye is a Medical practitioner, writer, researcher and UN Millenium development ambassador. She holds a Bachelor of Medicine, Bachelor of Surgery from the University of Benin, and a Master of Science in Global health from the University of Oxford. She is committed to preventive medicine, health literacy and community development.