DefinitionFood poisoning occurs when you swallow food or water that contains bacteria, parasites, viruses, or toxins made by these germs. Most cases of food poisoning are from common bacteria such as Staphylococcus or E. coli.
Causes, incidence, and risk factorsFood 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 processedWater that is used during growing or shipping can contain animal or human wasteFood handling or preparation in grocery stores, restaurants, or homesFood poisoning often occurs from eating or drinking:Any food prepared by someone who does not wash their hands properlyAny food prepared using cooking utensils, cutting boards, and other tools that are not fully cleanedDairy products or food containing mayonnaise (such as coleslaw or potato salad) that have been out of the refrigerator too longFrozen or refrigerated foods that are not stored at the proper temperature or are not reheated properlyRaw fish or oystersRaw fruits or vegetables that have not been washed wellRaw 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 eggsWater from a well or stream, or city or town water that has not been treatedMany types of germs may cause food poisoning, including:Campylobacter enteritisCholeraE. coli enteritisFish poisoningStaphylococcus aureusSalmonellaShigellaInfants 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 diabetesYou have a weakened immune systemYou travel outside of the United States to areas where you are exposed to germs that cause food poisoningPregnant and breastfeeding women have to be especially careful to avoid food poisoning.
SymptomsSymptoms 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 crampsDiarrhea (may be bloody)Fever and chillsHeadacheNausea and vomitingWeakness (may be serious)
Signs and testsYour 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.
TreatmentYou will usually get better in a couple of days. The goal is to make you feel better and make sure your body has the proper amount of fluids. Getting enough fluids and learning what to eat will help keep you or your child comfortable. You may need to:Manage the diarrheaControl nausea and vomitingGet plenty of rest If you have diarrhea and are unable to drink or keep down fluids, you may need fluids given through a vein (by IV). This is especially true for young children.If you take diuretics, ask your health care provider if you need to stop taking the diuretic while you have diarrhea. Never stop or change medications without first talking to your health care provider.For the most common causes of food poisoning, your doctor will NOT prescribe antibiotics.You can buy medicines at the drugstore that help slow diarrhea. Do not use these medicines without talking to your health care provider if you have bloody diarrhea, a fever, or the diarrhea is severe.Do not give these medicines to children.
Expectations (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.
ComplicationsDehydration 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: ArthritisBleeding problemsDamage to the nervous systemKidney problemsSwelling or irritation in the tissue around the heart
Calling your health care providerCall for an appointment with your health care provider if you have:Blood or pus in your stoolsDiarrhea and are unable to drink fluids due to nausea or vomitingA fever above 101°F, or your child has a fever above 100.4°F along with diarrheaSigns of dehydration (thirst, dizziness, light-headedness)Recently traveled to a foreign country and developed diarrheaDiarrhea that has not gotten better in 5 days (2 days for an infant or child), or has gotten worseA 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
PreventionSee: Preventing food poisoning
ReferencesSchiller 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.