Food poisoning can be divided into five categories: bacterial food poisoning, food poisoning caused by fungi and their toxins, animal food poisoning, toxic plant poisoning and chemical food poisoning, among which bacterial food poisoning is the most common.

(1) Salmonella food poisoning

Poisoned food: mainly animal food, especially meat and its products, followed by poultry meat, eggs, milk and its products, and rarely caused by plant food.

clinical manifestations: the incubation period is usually 4-48 hours, mainly manifested as headache, nausea, anorexia, vomiting, abdominal pain, diarrhea and fever. Diarrhea can occur several times to more than ten times a day, with yellow or yellow-green watery stool, foul smell and sometimes mucus and pus. The body temperature is as high as 38 ~ 41℃, and the course of disease lasts for 3 ~ 4 days. In severe cases, it can cause spasm, dehydration and shock.

treatment and prevention: symptomatic treatment, timely correction of water and electrolyte disorders, and antibiotics can be used for severe cases. Preventive measures are mainly to prevent pollution, control bacterial reproduction and thoroughly heat before eating.

(2) Vibrio parahaemolyticus food poisoning

Poisoned food: seafood, with hairtail, cuttlefish, shrimp, crab, shellfish and jellyfish more common. Followed by other foods directly or indirectly contaminated by this bacterium, such as salted and pickled products.

clinical manifestations: the incubation period is 1.4 ~ 21 hours. Upper abdominal pain or stomach cramp at the beginning of the disease, followed by nausea, vomiting, diarrhea and fever. Abdominal pain is aggravated after 5-6 hours of onset, characterized by paroxysmal colic in the umbilical region. Diarrhea occurs several times to more than 21 times a day, mostly watery stools, or mucus or purulent blood in severe cases. The weight is not obvious after acute diarrhea. The body temperature is 37.7-39.5℃, the course of disease is 3-4 days, and the recovery is good.

treatment and prevention: give priority to symptomatic treatment and correct water and electrolyte disorders in time. To prevent food poisoning caused by Homosalmonella, especially for seafood and its products, we should strengthen measures such as preventing bacterial pollution, storing at low temperature and heating thoroughly before eating. Cold seafood should be cleaned, soaked in vinegar for 11 minutes or blanched in boiling water for several minutes.

(3) Staphylococcal enterotoxin food poisoning

Poisoned food: commonly found in milk and dairy products, eggs and various cooked meat products.

clinical manifestations: the incubation period is usually 2-4 hours, and the main symptoms are nausea, vomiting, abdominal pain and diarrhea. Among them, vomiting is violent and frequent, and it can be jet-like. Vomiting often contains bile, blood or mucus. Diarrhea is mostly watery stool or mucus stool, 3 ~ 4 times a day. Normal body temperature or low fever. The course of disease is 1 ~ 2 days, and children are more sensitive to enterotoxin than adults, so the incidence rate is higher and the symptoms are heavier.

treatment and prevention: symptomatic treatment, timely correction of dehydration, electrolyte disorder, generally do not need antibiotics. Prevent staphylococcus aureus from polluting food, conduct regular health checks for food employees, and disinfect milk and dairy products; To prevent the formation of enterotoxin, food should be frozen or refrigerated.

(4) Proteus food poisoning

Poisoned food: mainly animal food, especially cooked meat and viscera products, also found in bean products, salad, leftovers, aquatic products, etc.

clinical manifestations: the incubation period is usually 5-18 hours. The clinical features are generally colic and acute diarrhea in the upper abdomen. Diarrhea is watery stool with mucus and foul smell, several times to more than ten times a day. There are symptoms of nausea, vomiting, headache and fever, and the body temperature is generally 38 ~ 39℃. The course of disease is 1 ~ 3 days, most of them recover within 24 hours, and the prognosis is good.

treatment and prevention: symptomatic treatment, severe cases can be treated with antibiotics. Strengthen the supervision and management of food hygiene to prevent pollution. Food should be refrigerated and heated thoroughly before eating.

(5) Other bacterial food poisoning

Table 5 lists the poisoned foods, clinical manifestations and treatment principles of common bacterial food poisoning.

Table 5 Poisoned foods, clinical manifestations and treatment principles of common bacterial food poisoning

(6) Gibberella wheat poisoning

Toxic components: Gibberella is a fungus, which can cause scab after contaminated grains such as wheat and corn, and its metabolite, scab wheat toxin, is a toxic component, which is stable to heat and difficult to eliminate in general cooking.

poisoning symptoms: the incubation period is 1.5 ~ 2 hours, and the main symptoms are stomach discomfort, nausea, vomiting, abdominal pain, diarrhea, dizziness, headache and other symptoms. In severe cases, breathing, pulse, temperature and blood pressure fluctuate, limbs are weak, gait is unstable, and it looks like drunkenness, so it is called "drunken valley disease" in some places, with a course of 1-2 days and a good prognosis.

treatment and prevention: generally, there is no need for treatment or symptomatic treatment. Don't eat moldy grains, or remove or reduce diseased grains and toxins in grains to make them meet national standards.

(7) moldy sugarcane poisoning

toxic components: improper storage of sugarcane is polluted by Alternaria saccharum to produce toxins, which mainly damage the central nervous system and digestive system.

Poisoning symptoms: the incubation period is ten minutes to several hours. The initial manifestations are digestive dysfunction, nausea, vomiting, abdominal pain, diarrhea and melena, followed by neurological symptoms such as dizziness, headache and diplopia. In severe cases, paroxysmal convulsions occur. When convulsions occur, the limbs are stiff, flexion and internal rotation, and the hands are chicken-claw-shaped, which can leave a lifelong disability with nerve damage outside the pyramid as the main performance; In severe cases, pupils are dilated, coma and death.

treatment and prevention: there is no special treatment. After poisoning, gastric lavage and intestinal cleaning should be carried out as soon as possible to discharge the poison, and symptomatic treatments such as eliminating brain edema, improving blood circulation and preventing secondary infection should be actively taken. Sugarcane should be harvested after ripening. After harvesting, sugarcane should be protected from rain, moisture, frost, mold pollution and reproduction. Storage time should not be too long and sensory inspection should be carried out regularly. It is strictly forbidden to sell moldy or deteriorated sugarcane.

(8) Poisoning of puffer fish

Toxic components: The toxin contained in puffer fish is tetrodotoxin, which mainly exists in fish viscera, gonads, blood, eyes, gills, skin and other parts and is highly toxic. Its properties are stable, and it is not easy to be destroyed by boiling, salting and sun exposure.

clinical features: the incubation period is 11 minutes to 3 hours. At the early stage, I felt numbness in my mouth, tongue and fingertips, followed by gastrointestinal symptoms such as nausea, vomiting, abdominal pain, diarrhea and bloody stool, and then sensory paralysis of my lips, tongue and extremities, and nervous system symptoms such as drooping eyelids, limb weakness or muscle paralysis, and ataxia. In severe cases, the whole body was paralyzed, paralyzed, slurred speech, decreased blood pressure and body temperature, cyanosis, dyspnea, and finally died of respiratory and circulatory failure.

treatment and prevention: there is no specific antidote. Generally speaking, it is mainly to quickly expel toxins from the body (vomiting, gastric lavage, catharsis, application of adsorbent), symptomatic treatment and supportive treatment (fluid replacement, oxygen inhalation, use of adrenocortical drugs). Strengthen publicity and don't eat puffer fish; It is forbidden to discard, process and sell puffer fish at will; It is strictly forbidden for catering services to provide processing and production of fresh puffer fish.

(9) Poisoning by toadstools

Mushrooms are also called mushrooms. At present, there are more than 311 kinds of edible mushrooms and more than 111 kinds of toadstools in China, including more than 11 kinds of poisonous mushrooms. Poisoning by poisonous mushrooms usually occurs in spring and summer, in mountainous rural areas, and when mushrooms grow luxuriantly in sunny weather after rain. Because poisonous mushrooms are mixed into edible mushrooms by mistake or collection, acute poisoning is caused after eating, so the prevention is mainly not to collect unknown mushrooms.

The clinical manifestations of different toadstool poisoning are different and can be divided into the following five types:

Gastroenteritis type: caused by toadstool, Coprinus comatus and other toadstools. The incubation period is 1.5 ~ 6 hours, mainly manifested as gastrointestinal symptoms, including nausea, vomiting, paroxysmal pain in the upper abdomen, severe diarrhea and other symptoms, and no fever. After proper treatment and symptomatic treatment, the poisoned person can recover quickly.

neuropsychiatric type: caused by toadstool, leopard-spotted toadstool and other toadstools. The incubation period is 1.1 ~ 6 hours. Besides gastrointestinal symptoms, there are obvious symptoms of parasympathetic nerve excitement, such as salivation, tears, hyperhidrosis, bradycardia and miosis. Atropine drugs have a better therapeutic effect.

hemolytic type: caused by Cervus elaphus. The incubation period is 6 ~ 12 hours. At the initial stage of the disease, the symptoms were gastroenteritis, and hemolytic symptoms such as jaundice and hemoglobinuria, acute anemia, hepatosplenomegaly and headache appeared after 3 ~ 4 days. Giving adrenocortical hormone, blood transfusion and liver protection treatment can recover.

liver and kidney damage type: caused by toadstool and Pholiota fusca. Usually the condition is dangerous and the mortality rate is high. The clinical manifestations are divided into six stages, namely, incubation period, gastroenteritis period, false recovery period, visceral damage device, mental symptom period and recovery period. In addition, a few cases were fulminant and died suddenly 1 ~ 2 days after the incubation period. Poisoning caused by liver and kidney damage should first be eliminated quickly, and the stomach should be thoroughly lavage within 11 hours after eating, and then activated carbon should be given to absorb the residual toxins. Those without diarrhea should also be cathartic and detoxified. Secondly, sodium dimercaptopropane is used for detoxification treatment, and symptomatic treatment should also be given.

(11) Other toxic animal and plant poisoning

Table 6 introduces the clinical manifestations, emergency treatment and preventive measures of other toxic animal and plant poisoning.

Table 6 Clinical manifestations, emergency treatment and preventive measures of other toxic animal and plant poisoning

(11) Arsenic poisoning

Poisoning ingredients: arsenic oxides or salts have obvious toxicity, especially arsenic trioxide (arsenic) has the strongest toxicity.

clinical manifestations: the incubation period of acute arsenic poisoning is 15 minutes to 5 hours, with burning sensation in the oropharynx, metallic taste in the mouth, thirst and dysphagia. There are obvious symptoms of acute gastroenteritis, such as severe nausea and vomiting, abdominal cramps and diarrhea (watery stool or rice soup, sometimes mixed with blood), central nervous system symptoms such as headache, irritability, delirium, convulsions, confusion and coma, and finally death due to respiratory center paralysis. May be complicated with acute renal failure, polyneuritis, toxic hepatitis and myocarditis.

First aid and prevention: First, detoxification measures such as vomiting, gastric lavage and catharsis should be taken quickly, and detoxification drugs such as sodium dimercaptopropane sulfonate and dimercaprol should be applied at the same time. In addition, symptomatic treatment, maintenance of water and electrolyte balance, protection of liver function, hemodialysis and blood exchange therapy are also needed.

(12) Organophosphorus pesticide poisoning

Organophosphorus pesticides are divided into three categories according to their toxicity: ① High category. Phorate, internal phosphorus absorption, parathion, etc. ② Poisoning. Dichlorvos, methyl parathion, methamidophos, omethoate, etc. ③ Low toxicity. Trichlorfon, dimethoate, malathion, zinc thion, etc.

Poisoning symptoms: The incubation period of oral ingestion is generally 11 minutes to 2 hours, and when it is mild poisoning, the whole body is tired and weak, dizziness, headache, restlessness, blurred vision, nausea and vomiting (the vomit smells like garlic), hyperhidrosis and pupils can be narrowed; In moderate poisoning, muscle tremors, stumbling, mild dyspnea, miosis, salivation, abdominal pain and diarrhea; Severe poisoning, convulsion, coma, pulmonary edema, brain edema, respiratory failure. Some organophosphorus pesticides have delayed neurotoxicity, and sensory motor peripheral neuropathy appears 2 ~ 3 weeks after acute poisoning.

First aid and prevention: quickly eliminate poisons, induce vomiting and repeatedly gastric lavage; Use antagonists and antidotes, use anticholinergic drugs (atropine) for mild poisoning, and use anticholinergic drugs and cholinesterase resuscitators (pralidoxime chloride, pralidoxime iodide, bisphosphonate, etc.) for moderate or severe poisoning; Symptomatic treatment.

(13) Other chemical food poisoning

Table 7 lists the clinical manifestations, emergency treatment and preventive measures of other chemical food poisoning.

table 7 clinical manifestations, emergency treatment and preventive measures of other chemical food poisoning.