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Toxicoinfections. Clinical forms of the toxicoinfection. preventivon of toxicoinfection. Bacterial toxicoses. 1) Staphylococcal toxicosis.
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TOXICOINFECTIONS.
Product sources: meat products, especially minced (pies with minced meat), eggs (are frequently infected by salmonels), a fish (stuffed, cooked and hot smoked), lactic products.
Conditions when products become dangerous for toxicoinfection:
1) The reasons of hit of activators in products:
а) using ill and tired animals, wrong cutting animal carcass,
b) Wrong storage and transportation products, processing uncooked and ready products on one board, one knife etc.,
c) Non-observance by the personnel of food objects rules personal hygiene, absence regular physical examinations personnel, attraction to work at kitchen unknown or ill people.
2) The reasons of duplication and preservation activators in products:
а) Wrong storage - non-observance temperature and terms of realization,
b) Insufficient thermal processing
Clinical forms of the toxicoinfection.
There are 5 clinical forms:
1) Gastroenterythic form: nausea, vomiting, dyarrea, pains in stomach
а) easy degree - 80 %,
b) average degree - 20 % (rise temperature up to 38),
c) the heavy form - 2 % - body temperature 38-40 С, decrease of arterial pressure, very heavy intoxication.
2) Typhoid form – heavy intoxication with intermitted temperature
3) Choleric form – heavy intoxication with strong dyarrea
4) Dysentery form – dyarrea with blood in faecal masses
5) Grippe form – like grippe with gastroenterytis.
Preventivon of toxicoinfection.
Elimination the reasons of hit and duplication activators toxicoinfections in products (see higher).
BACTERIAL TOXICOSES
Group of food poisonings microbe aethyology, caused by the microbe toxins, which have collected in products.
1) Staphylococcal toxicosis.
The reason - golden staphylococc, capable to produce in products eksotoxin. Products - sources: dairy products, creams, pies, cakes, fish and meat products.
Conditions of hit staphylococcus and collect it toxine in products:
а) Staphylococcal diseases of the personnel of eating establishments - quinsy, pustular diseases of a skin of hands,
b) Wrong storage - at room temperature, non-observance terms of realization.
Clinic: gastroenterytis at rised temperature, diarrhea seldom, in heavy cases – infringement cardiac system, dehydrotation organism.
Prevention: physical examinations and discharge of personnel, correct storage products, it is especial for cakes and pies in a hot season.
2) BOTULISM
The reason it is formation in food product eksotoxine by botulin stick - Clostridium botulini. Features of the activator:
а) spore-making - spores maintain boiling 4-5 hours, (a stick in the vegetative form – only 15 minutes), are kept at temperature -16 0С during 14 months, maintain action of preservatives - salts, vinegar, sugar long time,
b) obligate anaerob microbe - develops without access oxygen (canned food),
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в) Under certain conditions (+ 10 - +30 0С without oxygen) is formed the strongest neurotropic eksotoxine - a fatal doze for person 35 microgramme.
Products - sources: earlier in Germany in 19 century - cooked and blood sausages (botul - " sausage poison" ), dry-cured and cold smoked fish, now it is especial frequently - canned food (mushroom, vegetable conserves at domestic preparation - it is difficult to destroy spores in domestic conditions), sometimes – dry-cured and smoked meat, a canned meat.
Clinical picture of botulism.
Toxin amazes central nervous system - an oblong brain - nucleus skull-brain nerves. Are amazed more often:
- Nucleus of nerve oculomotorius – pthosis (falling of upper eyelid at one eye), anisocaria (different diameter of pupils of the eyes), frustration accommodation of eyes,
- Nucleus of optic nerve - a fog, " net" before eyes, decrease of sight
- Nucleus of glossopharyngeus and hypoglossal nerve - violations of speech up to aphonia (person can not speak), violations of swallowing (person can not drink water),
- Nucleus of facialis nerve - disappearance tonus of mimic and chewing muscles at the one half of face,
- Nucleus of vagus nerve - increase pulse at the normal or lowered temperature, defecation is normal or propensity to locks (as against other microbe food poisonings – very important differential symptome! ).
Then in patient may be spasms, pains in muscles, defeat of vessel, respiratory centers in central nervous system - death. The mortality at not treatment botulism - up to 70 %, at treatment - up to 30 %.
Treatment botulism.
Introduction antybotulinic serum or anatoxine (15000 IU, repetition in a doze 5000 IU after 5 hours). At the use suspicious product - introduction serum in a doze 2000 IU.
Prevention botulism.
Strict observance temperature technology preparation canned food, dry-cured fishes, meat. At the domestic conservation – make it in small banks at long time of boiling, storage canned food at temperature less than 10 degrees.
Clinical symptoms of food poisonings microbe nature
Symptoms Toxicoinfection Staphylococcus toxication Botulism
Temperature of a body raised or high normal or raised normal or subnormal
Headache + + +
General weakness + ++ +++
Loss of consciousness - - -
Spasmes - + +
Easing pul + ++ ++
Cianosis - + -
Cold sweat + + -
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Infringement of sight + + +++
Dryness in mouth Cavity - - +++
Nausea, vomiting +++ ++ +++
Pain in epigastrium + +++ +
Constipation - - +++
Dyarrea ++ + -
Blood in faecal masses - + -
Slime in faecal masses - + -
Duration of disease
at adequate treatment 1-3 days 1-3 days 5-20 days
Notes: +++ The symptoms sharply expressed + symptoms are observed seldom ++ symptoms strongly expressed - symptoms, which are not observed + symptoms moderately expressed
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