NTA Level 4 • Semester 1 • PST04102

Identification of Patients with Food Poisoning

Disease Control and Prevention • Source Session/Topic 22

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Session 22: Identification of Patients with Food Poisoning

Total Session Time: 120 minutes + 2 hours Assignment

Prerequisites

• None

Learning Tasks

By the end of this session students are expected to be able to:

• Describe Cause of Food Poisoning

• Describe Mode of Transmission of Food Poisoning

• Describe Major Signs and Symptoms of Food Poisoning

• Explain Treatment of Food Poisoning

• Explain Prevention and Control of Food Poisoning

Resources Needed

• Flip charts, marker pens, and masking tape

• Black/white board, chalk and whiteboard markers

• Computer and LCD Projector

SESSION OVERVIEW

SESSION CONTENTS

STEP1: Presentation of Session Title and Learning Tasks (5 minutes)

READ or ASK students to read the learning tasks and clarify

ASK students if they have any questions before continuing

STEP 2: Causes of Food Poisoning (15 minutes)

|Activity: Buzzing (10 minutes) |

| |

|ASK students to pair up and buzz on the following question for 2 |

|minutes |

| |

|What causes food poisoning? |

| |

|ALLOW few pairs to respond and let other pairs to add on points not |

|mentioned |

| |

|WRITE their response on the flip chart/board |

| |

|CLARIFY and SUMMARIZE by using the content below |

Definition

Food poisoning is an acute intestinal disease acquired by consumption of

contaminated food or water

Causes

Food poisoning can be divided into two categories:

• Chemical (heavy metals, fluoride and others)

• Infectious: Toxins produced by microorganism present in natural food or

bacteria contaminating food or water

o Infectious agents include viruses, bacteria, and parasites

o Toxic agents include poisonous mushrooms, improperly prepared exotic

foods

Bacteria

• Bacteria can cause food poisoning in two different ways

o Some bacteria infect the intestines, causing inflammation and

difficulty absorbing nutrients and water, leading to diarrhoea

o Other bacteria produce chemicals in foods (known as toxins) that are

poisonous to the human digestive system

▪ When eaten, these bacterial toxins can lead to nausea, vomiting,

kidney failure, and even death

• The common bacteria causing food poisoning are:

▪ Salmonellae,

▪ Campylobacter,

▪ Staphylococcus aureus

▪ Escherichia coli

▪ Clostridium botulinum

▪ Vibrio cholerae

Pesticides

• In food and naturally toxic substances like poisonous mushrooms or reef

fish

Viruses

• These viruses include:

o Noroviruses

o Rotavirus

o Enteroviruses

o Hepatitis A

Parasites

• They are usually in contaminated or untreated water and cause long-

lasting but mild symptoms

o Examples of parasites which can cause illness are Giardia and

Cryptosporidium

Note: Toxic agents are the least common cause of food poisoning

STEP 3: Mode of Transmission of Food Poisoning (15 minutes)

|Activity: Brainstorming (15 minutes) |

| |

|ASK students to brainstorm on the following question: |

| |

|How is food poisoning transmitted? |

| |

|ALLOW few students to respond |

| |

|WRITE their responses on the flip chart/ board |

| |

|CLARIFY and SUMMARISE by using the content below |

• Illness is often isolated episode caused by poor food preparation or

selection

o Eating wild toxic mushrooms,

o Eating fish and other seafood that contains toxins

o Eating food which has been contaminated with pesticides

• Food poisoning illness usually arises from improper handling,

preparation, or food storage

• The illness is transmitted by undercooked foods such as eggs, potato,

salads poultry, raw milk, dairy products, fish and other sea foods

STEP 4: Signs and Symptoms of Food Poisoning (15 minutes)

• Symptoms of food poisoning 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 signs and symptoms are:

o Nausea,

o Vomiting

o Diarrhoea

o Abdominal cramping

• The incubation period is short depending on the cause of food

poisoning:

o Staphylococcal food poisoning takes 1 – 6 hours

o Salmonella food poisoning takes 12 – 14 hours

o Anthrax gastrointestinal poisoning take 2 – 5 days

• There is acute onset of vomiting and diarrhoea after ingestion of

contaminated food

• Gastrointestinal anthrax presents with vomiting, abdominal pain,

haematemesis, bloody diarrhoea and toxaemia

• Staphylococcus aureus: Causes moderate to severe illness with rapid onset

of nausea, severe vomiting, dizziness, and abdominal cramping

• Clostridium botulinum (botulism): Causes severe illness affecting the

nervous system

o Symptoms start as blurred vision

o The person then develops problems of talking and overall weakness

o Symptoms then progress to difficulty breathing and inability to move

arms or legs

o Botulism has the 4 D’s: diplopia (double vision), dysphagia

(difficulty swallowing), dysarthria/dysphonia (difficulty speaking)

and diarrhoea

• Neurological symptoms suggest insecticides e.g. organophosphorous or

mushroom poisoning and seafood poisoning

STEP 5: Treatment of Food Poisoning (15 minutes)

• Symptomatic treatment to correct dehydration by ORS or intravenous fluid.

o Helps to correct electrolyte imbalance that might arise from diarrhoea

and vomiting

o The patient may need to be admitted to the hospital

▪ This depends on the severity of the dehydration, response to

therapy, and ability to drink fluids without vomiting

• Antibiotics are usually not indicated except for anthrax food poisoning

where large dose of benzyl penicillin together with streptomycin may be

needed

• Atropine is useful in case of organophosphate poisoning

• Antidote in case of eating food contaminated with pesticides

• Aggressive treatment may include pumping the stomach (lavage)

STEP 6: Prevention and Control of Food Poisoning (40 minutes)

|Activity: Group discussion (30 minutes) |

| |

|DIVIDE students into small manageable groups |

| |

|ASK students to discuss on the following question |

| |

|What are the prevention and control measures of food poisoning? |

| |

|ALLOW students to discuss for 15 minutes |

| |

|ALLOW few groups to present and the rest to add points not mentioned |

| |

|WRITE their response on the flip chart/board |

| |

|CLARIFY and SUMMARIZE by using the content below |

• Serve meals immediately after preparation to avoid growth of

staphylococci

• Thorough cooking of food will prevent most cases of food borne

poisoning

• Exclude people with pyogenic skin infection from food handling

• Preserve and protect food from being contaminated

• Health education to food handlers about necessity of proper food

preservation, washing hands and maintaining a clean kitchen

• Educating communities to avoid eating animals that have died after

illness

• If food poisoning is suspected, trace all the persons who ate the

infected meal and treat them if possible

• Safe steps in food handling, cooking, and storage are essential to avoid

food-borne illness

• Use cooked leftovers within four days if stored in the refrigerator and

make sure to heat them thoroughly before eating

STEP 6: Key Points (5 minutes)

• Food poisoning is common and is due to contaminated food product

• Causes are intoxication or infection by bacteria

• Treatment of food poisoning is mainly symptomatic and antibiotics are

rarely needed

• Food should be served as soon as it is prepared and the remaining should

be kept properly

• Food preservation should follow aseptic procedures

• Hand washing is important to reduce the risk of contaminating food

STEP 7: Evaluation (5 minutes)

• What is food poisoning?

• How is food poisoning transmitted?

• What are the clinical features of food poisoning?

• What is the treatment of food poisoning?

• What are the prevention and control measures of food poisoning?

STEP 8: Assignment (5 minutes)

|Activity: Take Home Assignment (10 minutes) |

| |

|DIVIDE students in groups or individuals |

| |

|ASK the students to work on the following Assignment |

|Prepare a presentation on common causes of food poisoning in their |

|area. |

| |

|ALLOCATE time for students to do the assignments and submit |

| |

|REFER students to recommended references |

References

Burton, B. T. & Foster W. R. (1988) Human Nutrition; A textbook of

nutrition in health and disease (4thed). New York: McGraw-Hill Book Company

Cook, G. & Zumla, A. (2003). Manson’s Tropical Diseases. (21sted.). London:

Saunders Ltd.

Denyer, S. P. Hodges, N. A. & Gorman, S. P (2011) Ed. Hugo & Russell’s

Pharmaceutical Microbiology (8thed). Oxford: Willey-Blackwell publishing

Eshuis, J. & Manschot, P (1992). Communicable diseases, (1st ed). Nairobi:

AMREF

GoT (2004): National Infection Prevention and Control (IPC) Guidelines for

Healthcare Workers. Dar es Salaam: MOHSW

GoT (2013) Standard Treatment Guidelines & National Essential Medicines

List (4thed). Dar es Salaam: MOHSW

GoT (2013) National Tuberculosis and Leprosy Programme: Manual for the

management of tuberculosis and leprosy (6thed). Dar es Salaam: MOHSW

GoT (2012) National Guidelines for Management of HIV and AIDS. (4thed) Dar

es Salaam: MOHSW/NACP

GoT (2013) National Guidelines for Diagnosis and Treatment of Malaria. Dar

es Salaam: MOHSW

GoT (2007) National Guidelines for Management of Sexually Transmitted and

Reproductive Tract Infections (1sted). Dar es Salaam: MOHSW

Nordberg, E. (1999): Communicable Diseases, A Manual for Health Workers in

Sub-Saharan Africa, Nairobi: AMREF

Nordberg, E., Kingondu, T., & Mugambi, E., et al. (2008) Communicable

Diseases. (4thed.). Nairobi: AMREF.

Nyamwaya, D. (1994): A Guide to Health Promotion through Water and

Sanitation, Nairobi: AMREF

Tanzania Food and Drugs Authority (2009), Guidelines for safe disposal of

unfit medicines and cosmetic products. Dar es Salaam: MOH

World Health Organization (1999), Guidelines for safe disposal of unwanted

pharmaceuticals in and after emergencies. Geneva: WHO

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