Food poisoning refers to an acute or subacute disease that occurs after people eat biological and chemical toxic and harmful substances by mistake or eat toxic and harmful substances as food, which belongs to the category of food-borne diseases. Food poisoning does not include acute gastroenteritis, food-borne intestinal infectious diseases (such as typhoid fever) and parasitic diseases (such as cysticercosis) caused by overeating, nor does it include diseases with chronic toxicity (such as teratogenesis, carcinogenesis and mutation) caused by large or long-term intake of certain toxic and harmful substances. Food poisoning usually occurs unconsciously.
Food poisoning caused by biological and chemical harmful substances includes the following categories: food contaminated by pathogenic bacteria or their toxins; Food contaminated by toxic chemicals with acute poisoning dose; Substances that are similar in appearance to food and contain toxins themselves, such as toadstools; Foods that contain toxic substances themselves and cannot be removed by improper processing and cooking methods, such as river fish and cassava; Foods that produce toxic substances during storage due to improper storage conditions, such as sprouted potatoes.
Edit the classification of food poisoning in this paragraph.
According to the classification of pathogenic substances can be divided into:
I. Bacterial food poisoning
Refers to food poisoning caused by people eating food containing bacteria or bacterial toxins. There are many reasons for food poisoning, among which the most important and common reason is that food is contaminated by bacteria. According to the statistics of food poisoning in China in recent five years, bacterial food poisoning accounts for about 50% of the total food poisoning. Animal food is the main food causing bacterial food poisoning, among which meat and cooked meat products rank first, followed by spoiled poultry meat, dead livestock meat, fish, milk and leftovers.
The main reasons for food contamination by bacteria are as follows:
1, livestock and poultry are sick poultry before slaughter;
2, knives, chopping boards and utensils are unclean, and raw and cooked cross infection;
3. Poor sanitary conditions breed mosquitoes and flies;
4. Food practitioners contaminate food with bacteria.
Food poisoning does not happen immediately after people eat food contaminated by bacteria. Bacteria pollute food and multiply on it. When it reaches a certain amount, it will cause diseases or produce pathogenic toxins. Food poisoning only happens when people eat this kind of food. Therefore, another major cause of food poisoning is improper storage or long-term storage at a higher temperature. The moisture and nutritional conditions in food make pathogenic bacteria multiply in large numbers. If the pathogenic bacteria are killed by thorough heating before eating, food poisoning will not occur. Then, the last important reason is that it is not fully heated and cooked before eating.
The occurrence of bacterial food poisoning is closely related to people's eating habits in different regions. The United States eats more meat, eggs and cakes, and staphylococcus food poisoning is the most; Japan likes to eat sashimi, and Vibrio parahaemolyticus has the most food poisoning. There are many kinds of poultry meat and eggs in China, and salmonella food poisoning has been in the first place for many years. The initiators of bacterial food poisoning are Salmonella, Staphylococcus, Escherichia coli, Botox, hepatitis virus and so on. These bacteria and viruses can grow directly in food, or pollute other foods through the hands or containers of food operators. When people eat these contaminated foods, toxins produced by harmful bacteria can lead to poisoning. Every summer, all kinds of microorganisms grow and multiply vigorously, and there are more bacteria in food, which accelerates their spoilage; In addition, people are greedy for cold food and often eat food that is not fully heated, so summer is the high incidence season of bacterial food poisoning.
Second, mycotoxin poisoning
Fungi grow and reproduce in cereals or other foods to produce toxic metabolites, and the poisoning caused by cannibalism is called fungal food poisoning. Poisoning mainly occurs through food contaminated by fungi, and mycotoxins in food can not be destroyed by heating treatment with common cooking methods. Fungi need certain temperature and humidity to grow, reproduce and produce toxins, so poisoning often has obvious seasonal and regional characteristics.
Third, animal food poisoning.
Food poisoning caused by eating animal food poisoning is animal food poisoning. There are two main kinds of food poisoned by animals: (1) taking animals or animal parts that naturally contain toxic ingredients as food, and eating them by mistake will cause poisoning reactions; Under certain conditions, eating animal foods that produce a lot of toxic ingredients, such as eating mackerel, can also cause poisoning. In recent years, the main animal food poisoning in China is puffer fish poisoning, followed by fish gall poisoning.
Fourth, plant food poisoning.
There are three main types. (1) food poisoning caused by natural plants containing toxic ingredients or their processed products, such as tung oil and sesame oil; (2) In the process of food processing, plants that fail to destroy or remove toxic components are eaten as food, such as cassava and bitter almond; (3) Under certain conditions, eat a lot of plant foods containing toxic ingredients improperly, and eat fresh day lilies, sprouted potatoes, unsalted pickles or uncooked lentils. Can cause poisoning. Generally, it is caused by eating poisonous plants or seeds of poisonous plants by mistake, or by improper cooking and processing methods, and failing to remove toxic substances from plants. The most common plant food poisoning is bean poisoning, poisonous mushroom poisoning and cassava poisoning; Poisonous mushrooms, potatoes, Datura stramonium, Ginkgo biloba, bitter almond and tung oil can cause death. There is no specific treatment for most plant poisoning. For some serious poisoning that can cause death, it is very important for the prognosis of the poisoned person to eliminate the poison as soon as possible.
Verb (abbreviation for verb) chemical food poisoning
It mainly includes: ① eating food contaminated by toxic chemicals by mistake; (2) food poisoning caused by adding non-food grade or forged or banned food additives and nutritional fortifiers and excessive use of food additives; (3) Foods with chemical changes in nutrients due to storage and other reasons, such as rancidity and poisoning of oil. Food poisoning caused by eating chemically poisoned food is chemical food poisoning. The characteristics of chemical food poisoning are: the onset is related to eating time and consumption. It usually occurs shortly after eating, and often appears in groups. The patients have the same clinical manifestations. Chemical poisons can be detected in food residue, vomit, blood and urine. When dealing with chemical food poisoning, we should highlight the word "fast"! Timely treatment is not only very important to save patients' lives, but also more important to control the development of the situation, especially in the case that group poisoning and chemical poisons are unknown for a while.
Food poisoning is an acute toxic disease caused by eating food contaminated by bacteria and their toxins, or eating animals and plants containing toxins such as toadstools and puffer fish. Deteriorated food and polluted water sources are the main sources of infection, and unclean hands, tableware and flies with bacteria are the main routes of transmission.
The disease has a short incubation period and can occur collectively. It is characterized by sudden onset, accompanied by abdominal pain, diarrhea, vomiting and other acute gastroenteritis symptoms, often accompanied by chills and fever. Severe vomiting and diarrhea can lead to dehydration, acidosis and shock. The treatment of this disease is mainly symptomatic and supportive treatment, and antibiotics can be used in severe cases. Correct water and electrolyte disorders and acidosis in time. Patients with botulism can be injected with botulism antivenom as soon as possible.
Edit this diagnosis: What tests should be done for food poisoning?
In order to find the pathogenic bacteria, samples should be collected from various aspects according to the actual situation, such as excrement, vomit, food and utensils left by feces.
There are many bacteria causing food poisoning in clinic, such as Salmonella, Campylobacter jejuni, Vibrio parahaemolyticus of Staphylococcus, Bacillus cereus, Proteus of pathogenic Escherichia coli, Clostridium botulinum and yersinia enterocolitica.
Salmonella is one of the main pathogens and the most common cause of food poisoning. Salmonella is usually isolated from patients' feces or vomit.
Food poisoning caused by Staphylococcus aureus: The diagnosis is mainly made by detecting the enterotoxin in food or feces, because the staphylococci have been killed after the contaminated food is heated, and negative results will appear if it is cultured, while the enterotoxin is not destroyed under the condition of heating.
Food poisoning caused by Vibrio parahaemolyticus: Food poisoning caused by Vibrio parahaemolyticus is mainly caused by eating aquatic products and pickles contaminated by Vibrio parahaemolyticus by mistake, and the diagnosis mainly depends on bacteriological detection.
Food poisoning caused by Campylobacter jejuni is caused by eating meat or milk contaminated by Campylobacter jejuni. The diagnosis of the disease is mainly based on bacteriological detection.
Food poisoning caused by yersinia enterocolitica: Collect food or feces samples for bacterial culture.
Food poisoning caused by Botox: It is mainly caused by exotoxin produced by Botox, and suspicious food should usually be collected at the scene for bacteriological detection or animal test.
The diagnosis of Clostridium botulinum poisoning in infants is mainly through the detection of fecal endotoxin, and the results of fecal culture are mostly negative.
Edit the characteristics of food poisoning in this paragraph.
Food poisoning is characterized by short incubation period, sudden collective outbreak, mostly symptoms of gastroenteritis, which is obviously related to eating certain foods. Food poisoning caused by bacteria accounts for the vast majority. Food poisoning caused by bacteria is mainly animal food (such as meat, fish, milk and eggs). ) and plant foods (such as leftovers, bean products, etc. Eating poisonous animals and plants can also cause poisoning. If properly processed puffer fish is ingested, it can paralyze the peripheral and central nerves, and finally die due to paralysis of the respiratory center and blood vessels. Some vegetables containing a certain amount of nitrate will be stored for too long or cooked for too long, and a large number of bacteria will turn nitrate into nitrite. When nitrite enters the human body, it will oxidize the low-iron hemoglobin in the blood into methemoglobin, lose the ability of oxygen transmission, and cause tissue hypoxia. In severe cases, he may die of respiratory failure. Moldy soybeans, peanuts and corn contain aflatoxin, which is a metabolite of Aspergillus flavus and is very toxic. It will damage the liver and induce liver cancer, so you can't eat it. Eating food contaminated with lead, mercury, cadmium, cyanide, pesticides and other chemicals can lead to poisoning. Adding too many nutrients to food is also harmful to human body. For example, adding proper amount of lysine to foods lacking lysine in cereals can improve the nutritional value and benefit people. However, if it is added in excess, or in foods that do not need lysine such as milk and soybean milk, it may disturb the metabolism of amino acids in the human body and even cause damage to the liver. The main ways to prevent food poisoning are to pay attention to food hygiene, preserve food at low temperature, strictly sterilize it, and eat it after thorough heating. Do not eat toxic, deteriorated animals and plants and food contaminated by chemical substances. Once food poisoning patients are found, they should be sent to the hospital for treatment in time.
(1) Because there is no infection process between individuals, the onset is explosive, with short incubation period and acute onset. Most people may get sick in a short time, and the incidence curve shows a sudden upward trend.
(2) Poisoned patients generally have similar clinical symptoms. Nausea, vomiting, abdominal pain, diarrhea and other digestive tract symptoms often occur.
(3) The onset is related to food. All patients have eaten the same food recently, and the scope of the disease is limited to people who eat this toxic food. After stopping eating this kind of food, the onset stopped soon, and the onset curve showed a sudden increase and then a sudden decline.
(4) Food poisoning patients are not contagious to healthy people.
What should I do after food poisoning?
1. replenish liquid, especially boiled water or other transparent liquid.
2. Replenish electrolytes lost due to vomiting and diarrhea, such as potassium, sodium and glucose.
Avoid acid generators
Don't stop diarrhea, let the toxins in the body be discharged before consulting a doctor.
5. No need to induce vomiting
6. The diet should be light, eat easily digestible food first, and avoid foods that are easy to stimulate the stomach.
Edit the emergency measures for food poisoning in this paragraph.
Food poisoning generally has the characteristics of short incubation period, concentrated time, sudden outbreak and fierce momentum. According to statistics, most food poisoning occurred in July, August and September. The clinical manifestations are acute gastroenteritis with vomiting, diarrhea and abdominal pain. In severe cases, it may be life-threatening due to dehydration, shock and circulatory failure. Therefore, in the event of food poisoning, don't panic, calmly analyze the causes, and take the following emergency measures in time according to the food that caused the poisoning and the length of time taken:
First, vomiting. If you take it within 1 ~ 2 hours, you can use the method of inducing vomiting. Immediately take 20g of salt and add 200ml of boiling water to dissolve it, and drink it once after cooling. If you don't vomit, you can drink more times to quickly promote vomiting. You can also mash fresh ginger 100g to get juice and take it with 200ml warm water. If you eat bad meat, you can drink ten drops of water to promote rapid vomiting. Some patients can also stimulate their throats with chopsticks, fingers or goose feathers, causing vomiting.
Second, vent. If the patient eats for a long time, usually more than 2 ~ 3 hours, and has a good spirit, he can take some laxatives to urge the poisoned food to be excreted as soon as possible. Generally, 30g rhubarb is decocted once, and 20g mirabilite can be used for elderly patients. Taking it with boiling water can relieve diarrhea. For healthy elderly people, senna 15g can also be decocted once or taken with boiling water to induce diarrhea.
Third, detoxification. If it is food poisoning caused by eating spoiled fish, shrimp, crabs, etc. , vinegar 100ml plus 200ml of water, diluted and taken once. In addition, perilla 30g and licorice 10g can be decocted once. If you eat spoiled drinks or preservatives by mistake, the best first aid is to fill your stomach with fresh milk or other drinks containing protein.
If the symptoms do not improve after the above first aid, or if the poisoning is serious, you should send it to the hospital as soon as possible. In the course of treatment, we should give patients good care, try to make them quiet, avoid mental stress, pay attention to rest, prevent catching cold, and supplement enough light salt boiled water at the same time.
The key to control food poisoning is prevention, good food hygiene and strict control of "oral diseases".
Prevention of bacterial food poisoning
(1) Prevent food from being contaminated by bacteria. First of all, we should strengthen the hygiene management of food enterprises, especially the inspection and management of slaughterhouses before and after slaughter. It is forbidden to use dead animal meat. Operators of food processing and sales departments, catering industries and collective canteens should strictly abide by the Food Hygiene Law and operating rules, so as to separate raw meat from cooked meat, especially when making cold meat and cooked meat. Employees should pass the health examination before taking up their posts. If intestinal infectious diseases and carriers are found, they should be transferred in time.
(2) Control bacterial reproduction. The main measures are refrigeration and freezing. The temperature is controlled at 2C-8C, which can inhibit the reproduction of most bacteria. Cooked food is refrigerated to avoid light, oxygen and repeated pollution, and the refrigeration effect is better.
(3) high temperature sterilization. It is a reliable method to sterilize food at high temperature before eating, and its effect is related to factors such as temperature, heating time, bacterial species, pollution and the characteristics of processed food, depending on the specific situation.
How to deal with sudden food poisoning
Generally, food poisoning is mostly caused by bacterial infection, and a few are caused by food itself containing toxic substances (organophosphorus, arsenic and mercuric chloride) and natural toxins (such as toadstools and poisonous fish). The onset time is usually several hours after eating, often accompanied by vomiting and diarrhea. If you are sick at home, you should be treated appropriately according to the degree of vomiting, diarrhea and abdominal pain.
The main first aid methods are:
1, supplement liquid, especially boiled water or other transparent liquid;
2. Replenish electrolytes lost due to vomiting and diarrhea, such as potassium, sodium and glucose;
3. Avoid acid generators;
4, do not stop diarrhea first, let the toxins in the body be discharged before consulting a doctor;
5, no need to induce vomiting;
6, the diet should be light, eat foods that are easy to digest first, and avoid foods that are easy to stimulate the stomach.
It should be emphasized that vomiting and diarrhea are a manifestation of the body's defense function, which can eliminate a certain amount of enterotoxin released by pathogenic bacteria, so antidiarrheal drugs such as Yimengting should not be used immediately. Especially for patients with high fever, toxemia and mucus purulent bloody stool, it should be avoided to avoid aggravating poisoning symptoms.
Upwelling vomiting and diarrhea cause massive loss of body fluids, which will lead to various complications and directly threaten patients' lives. At this time, drinking more clean water can promote the elimination of pathogenic bacteria and their enterotoxins, and alleviate the symptoms of poisoning.
Patients with severe abdominal pain can be given an appropriate amount of turbulence reducer, such as belladonna mixture or belladonna tablets.
If there are no signs of remission, or even obvious dehydration, chills in limbs, aggravated abdominal pain and diarrhea, extreme fatigue, pallor, sweating, confusion, nonsense or convulsions, or even shock, you should be sent to the hospital immediately, otherwise your life will be in danger.
prescription
1. Do a good job in food hygiene supervision and canteen hygiene, and prohibit eating dead animal meat or other spoiled meat. Drunken shrimp, pickled crab, etc. You'd better not eat it.
2. Frozen food should be of good quality and fresh-keeping. Animal food should be thoroughly heated and cooked before eating, and it should be fully heated before eating.
3. Separate raw and cooked food to avoid cross-contamination.
4. Marinated cans should be boiled for 6 ~ 10 minutes before eating.
5. It is forbidden to eat poisonous animals and plants such as toadstools and puffer fish.
6. Cooks and nurses with salmonella infection or carriers should be transferred from their jobs, and they can only return to their original jobs after three negative stool cultures.
1. Eggs and soybean milk should not be eaten together: people often eat soybean milk to wash eggs, thinking that both of them are rich in protein, which is good for health. From the point of view of scientific diet, the two should not be eaten together. Because raw soybean milk contains trypsin inhibitor, it can inhibit the activity of human protease and affect the digestion and absorption of protein. Egg white contains viscous protein, which can combine with trypsin in soybean milk, so that the decomposition of protein is hindered, thus reducing the absorption rate of protein.
2. Radish and orange should not be eaten together; Clinical experiments have found that cruciferous vegetables such as radish can quickly produce a substance called thiocyanate after ingesting into human body, and then metabolize it to produce another antithyroid substance-thiocyanate. The production of this substance is directly proportional to the intake of steamed vegetables. At this time, if the flavonoids in oranges containing a lot of plant pigments are ingested at the same time, they will be decomposed by bacteria in the intestine and converted into hydroxybenzoic acid and ferulic acid. These two drugs can strengthen the inhibition of thiocyanate on thyroid function, thus inducing or leading to goiter. Therefore, these two foods should not be eaten together, especially in areas where goiter is prevalent or people who are suffering from goiter.
3. Persimmon and sweet potato should not be eaten together: Persimmon is sweet in taste, cold in nature, can clear away heat and promote fluid production, moisten the lungs, and contains nutrients such as protein, sugar, fat, pectin, tannic acid, vitamins and inorganic salts. Sweet potato is sweet in taste, flat in nature, tonifying deficiency and qi, tonifying kidney and strengthening spleen, and contains a lot of nutrients such as sugar. If you eat separately, it is good for your health, and if you eat at the same time, it is harmful to your health. Because eating sweet potatoes will produce a lot of hydrochloric acid in people's stomach, if you eat some persimmons, it will produce precipitates under the action of gastric acid, and the precipitates will pile up together to form water-insoluble ones.
4. Milk and chocolate should not be eaten together: milk is rich in protein's secret calcium, while chocolate contains oxalic acid. If they are eaten together, calcium in milk will combine with oxalic acid in chocolate to form a kind of water-insoluble calcium oxalate, which will not be absorbed after eating, and will also cause symptoms such as diarrhea and dry hair, which will affect growth and development, so it is not suitable for eating together.
5. Some fruits and seafood should not be eaten together; People like to eat seafood and fruits, especially children. However, it should be noted that if you eat grapes, hawthorn, pomegranate, persimmon and other fruits while eating seafood, you will have symptoms such as vomiting, abdominal distension, abdominal pain and diarrhea. Because these fruits contain tannic acid, protein in aquatic products will precipitate and solidify, forming indigestible substances. At the same time, tannic acid also has the effect of collecting sword, which can inhibit the secretion of digestive juice, make solidified substances stay in the intestine for a long time, and then cause fermentation. So don't eat seafood with the above water, and eat this fruit at intervals of more than 4 hours after eating seafood.
6. Milk, yogurt and cheese should not be eaten together with broccoli, soybeans, spinach, amaranth and water spinach. Because the former is rich in calcium, the chemical composition contained in the latter affects the digestion and absorption of calcium.
7. Others, such as mutton and watermelon; Bananas and taro; Preserved eggs and brown sugar; Tofu and honey; Cucumber and peanuts; Mustard and rabbit meat; Dogs and mung beans; Persimmon and crab should not be eaten at the same time.
The above foods that are not suitable for eating at the same time can be eaten separately, preferably at intervals of 3-4 hours to prevent mutual interference.
Edit the diagnosis and treatment of food poisoning in this paragraph.
(1) Diagnosis of food poisoning?
1. Food poisoning diagnosis institution: It is clearly stipulated in the Diagnostic Criteria and General Rules for Technical Treatment of Food Poisoning that the diagnosis of food poisoning patients shall be determined by doctors above or including food hygiene doctors; The identification of food poisoning incidents shall be determined by the food hygiene supervision and inspection institutions according to the general principles of food poisoning diagnosis standards and technical treatment. ?
2. Diagnostic basis of food poisoning: The diagnosis of food poisoning is based on the data occupied in the food poisoning investigation, analyzed by epidemiological methods, and comprehensively judged by combining the characteristics of various food poisoning. See part 4 of GB 14938-34 for the judgment basis. To sum up, there are the following aspects:
(1) Relationship with eating: Poisoned patients have eaten some poisoned food in a similar period of time. Those who have not eaten are not sick, and those who are sick are all eating. The disease will soon stop after stopping eating this poisonous food. ?
(2) The characteristic clinical manifestations of food poisoning: acute onset, short incubation period and short course of disease. The same food poisoning patient has the same onset in a very short time, and soon the onset peak and the same incubation period are formed, and the clinical manifestations are basically similar (or the same). Generally, there is no direct infection between people, and the incidence curve has no tail peak. ?
(3) The judgment of food poisoning should have laboratory data as much as possible: the same pathogen was detected from different patients and poisoned food, but due to the delay in reporting, sampling was not timely or the remaining poisoned food could not be collected, or the patient had used drugs, or other reasons, the positive results of detection data could not be obtained. Through epidemiological analysis, it can be judged as food poisoning of unknown cause. ?
For food poisoning with unknown causes, the epidemiological analysis report is very important, and it must meet the requirements of the epidemiological characteristics of food poisoning. If necessary, it can be evaluated by more than three food hygiene experts with deputy chief physicians or above. ?
Diagnostic criteria of different types of food poisoning are slightly different. To make a definite diagnosis and identification, food hygiene doctors should have a certain professional and technical level. ?
(2) How to deal with food poisoning?
The treatment of food poisoning can be divided into technical treatment and administrative treatment. The former, such as treating poisoned patients and cleaning and disinfecting poisoned places; The latter, such as administrative control measures (compulsory measures) and administrative penalties. The treatment targets may include poisoned patients, poisoned food and persons responsible for poisoning. The technical treatment of food poisoning has been stipulated in principle in Part 5 of GB 14938, and the relevant administrative treatment can be found in Chapter 15 of this book. However, we must emphasize several issues:
1, food poisoning administrative control measures require timely and effective. This is of great significance to control the development of food poisoning, and legal forms must be used in accordance with legal procedures. Of course, poisoned food and raw materials that have been sold or exported are also sealed. Therefore, it should be ordered to recover before sealing up, and then seal up. There should also be a written notice of order for restoration. ?
2. Ordering to stop production and business in administrative punishment is a severe punishment. The Administrative Punishment Law stipulates that the parties concerned have the right to request a hearing when they are ordered to stop production or business. However, whenever food poisoning occurs, the situation is urgent. In order to control food poisoning as soon as possible, which is conducive to social stability and protect people's right to health from infringement, it is very immediate to order the food producers and operators involved in the accident to stop the production and business activities of suspected poisoned food, and it must be implemented immediately as a temporary control measure. ?
Article 39 of the Food Hygiene Law stipulates that those who cause serious food poisoning accidents and cause serious harm to human health shall be investigated for criminal responsibility according to law. What is "earnest"? Attention should be paid to the consequences of food poisoning accidents. If a large number of people are poisoned, it will cause great social impact, death and disability, and cause great losses to state property. In the investigation of major food poisoning cases, according to the Interim Provisions on Investigating and Handling Cases of Violation of Food Hygiene issued by the Supreme People's Procuratorate, the Ministry of Health and the Ministry of Public Security, contact the judicial organs in time. ?
4. In the Measures for Administrative Punishment of Food Hygiene promulgated by the Ministry of Health, the amount of fines for food poisoning is reasonably determined according to the number of patients, which is divided into 10 and below; 1 1 to 30 people; 3 1 to 100, 10 1. However, other conditions should be considered when applying, such as the severity of poisoning patients and the attitude of the accident unit to actively eliminate the impact. ?
5. Article 48 of the Food Hygiene Law stipulates that those who cause food poisoning shall also be liable for civil compensation (damages). Civil law shall apply to the investigation of civil liability for compensation. It should be initiated by the injured person, and mediation should be applied, which can be decided by the judicial organ. The introduction of civil compensation is often based on the investigation of administrative responsibility, so the health administrative department may follow a civil compensation case when making administrative punishment decisions on food poisoning cases.