There are many reasons for food poisoning. Mainly can be divided into the following categories:
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 food, reaching a certain amount, which can lead to 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. (a) food poisoning caused by plants or their processed products that contain toxic ingredients naturally, 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.
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.
(Professor Cai from Shanghai Medical University)
Food poisoning refers to an infection or poisoning disease caused by eating a normal amount of edible food in a normal eating state, which belongs to the category of food-borne diseases. Therefore, food poisoning does not include acute gastroenteritis and food-borne intestinal infectious diseases caused by overeating.
In addition to bacterial food poisoning, there are toxic foods such as river fish, poisonous plants such as poisonous mushrooms and green beans, pesticide pollution, moldy sugarcane poisoning and so on. Compared with bacterial food poisoning, although the incidence of this kind of disease is less and the symptoms of gastroenteritis are lighter, the symptoms of nervous system are obvious. Some poisonings, such as river fish poisoning, have a mortality rate as high as 50%, and even if they don't die, they will leave a lifelong disability. So we need to pay enough attention to it.
Food poisoning is preventable. First of all, we must prevent bacterial pollution. When buying raw meat, you should pay attention to identifying the quarantine seal of the health and quarantine department. Do a good job in cleaning and disinfecting utensils and cookers, use raw and cooked cookers separately, and improve sanitary conditions. The food supervision department shall strengthen the regular physical examination of food practitioners. Patients with upper respiratory tract infection and suppurative diseases should not participate in food operation before they are cured. Second, food should be kept at low temperature, which can control the reproduction of general bacteria. Meat and cooked meat should be stored at a low temperature below 65438 00℃, but it is ineffective for Vibrio parahaemolyticus in seafood. It can survive in a low-temperature refrigerator for several months. So when eating cold jellyfish, soak in vinegar or blanch in boiling water at 100℃ for a few minutes. The last measure is thorough heating to kill pathogens and destroy toxins. Meat food must be cooked, thoroughly cooked, the meat pieces should not be too big, and the heating time should be guaranteed. Cooked food should be eaten in time, and leftovers should be heated before storage, and then heated before eating. Kidney bean poisoning and pesticide poisoning closely related to life should pay attention to the following points: kidney beans should be thoroughly cooked and heated, and there are pesticide residues on vegetables and fruits. Wash them or soak them in water for a period of time before eating.
Classification of food poisoning Yao Yongqing Mu Liyuan
Food poisoning refers to non-infectious acute and subacute diseases that occur after ingesting biological and chemical toxic and harmful foods or taking harmful substances as food. Harmful microorganisms are generally "cunning" and like to gather in foods with high nutritional value to breed. For example, there are often salmonella in cooked meat, fish and dairy products that are not fully heated for a long time; Food prepared with mayonnaise is a favorite hotbed of bacteria. Botulinum Botulinum Botulinum Botulinum may exist in canned food that is improperly stored and is harmful. Therefore, never eat canned food that has been deformed. Once you find botulism, you should be hospitalized immediately. Aquatic products, especially contaminated shellfish, are most likely to cause viral food poisoning. In 1980s, the chief culprit of hepatitis A epidemic in Shanghai was Scapharca subcrenata.
Clinical manifestations of food poisoning
Usually, food poisoning can cause nausea, vomiting and diarrhea at the same time, or be accompanied by other symptoms. Generally, it takes as little as half an hour and as much as 48 hours after meals. Its symptoms vary according to the kind of food you eat. Generally speaking, there are abdominal pain, nausea, vomiting and diarrhea, ranging from several times to dozens of times a day, and some stools have pus and mucus. In addition to the above symptoms of acute gastroenteritis, patients also have symptoms of nervous system, such as headache, fear of cold, fever, fatigue, dilated pupils, blurred vision, dysphagia and dyspnea. Severe poisoning may lead to dehydration shock or failure and death due to diarrhea.
Some patients with food poisoning are very common in clinic. When they started to see a doctor, the gastrointestinal symptoms were not obvious. The main complaints are: cold, fever, headache, fatigue, etc. It is easy to be confused with the common cold, so be sure to pay attention to identification. If the symptoms persist for more than 2 days, you may want to test your stool, blood or vomit to determine the cause. People who have had the same symptoms and eaten the same food should be highly suspicious of food poisoning, especially in the high-risk season of summer. For example, Salmonella poisoning often occurs 8-48 hours after meals, showing watery diarrhea, abdominal distension, abdominal pain, nausea and vomiting, and the course of disease is generally 2-5 days.
How to diagnose food poisoning
China has formulated detailed diagnostic criteria for food poisoning, mainly based on the incubation period of patients and the unique manifestations of poisoning. The most obvious characteristics are: all poisoned patients have eaten some poisoned food in a similar time, and those who have not eaten are not poisoned; After stopping eating toxic food, the disease soon stopped; Short incubation period, acute onset and short course of disease; The clinical manifestations of all poisoned patients are basically similar; There is no direct infection between people. Food poisoning cannot be ignored. It not only harms individuals, but also often harms people who eat in collective canteens (factories, mines, institutions, kindergartens, schools), and can be life-threatening in serious cases.
How to give first aid when food poisoning is found?
Don't panic when you find food poisoning. First of all, we should immediately stop eating poisoned food and take emergency measures such as vomiting, gastric lavage and bowel cleaning. Because repeated vomiting and diarrhea are the ways for the body to excrete poisons, do not use antiemetic or antidiarrheal drugs at will within 24 hours after the symptoms of food poisoning appear. It should be noted that a large amount of water loss in the human body will cause dehydration, especially in children and young patients, and the lost liquid must be replenished in time, such as drinking water or intravenous infusion. Second, it is necessary to report to the local food hygiene supervision and inspection department in time and take patient specimens for inspection. Third, it is necessary to protect the site, seal up poisoned food or suspected poisoned food, and immediately take back the sold food for harmless treatment or destruction. Fourth, according to the different poisoned foods, the poisoned places should be disinfected accordingly, so as not to expand the scope of poisoning.
The main causes of food poisoning
First, producers and operators ignore food hygiene management and pay insufficient attention to health and safety issues in food processing, transportation, storage and sales. The incidence of this kind of poisoning is the highest, and food poisoning in school canteens and catering service units is mostly of this kind. 1September, 9991/food poisoning of some athletes in the National Games of Shengli Hotel in Xi, and food poisoning of more than ten primary and secondary schools in Xi on September1September, 999+05 were all caused by bacterial pollution in the food production and processing environment.
The second is the abuse of food additives or the use of non-food raw materials. Following 1997 methanol poisoning in Shuozhou, Shanxi, 1998 Jiangxi poisonous lard poisoning, August 9 1999. Another collective food poisoning incident occurred in Zhaoqing City, Guangdong Province, which was caused by eating edible oil mixed with liquid paraffin. The number of people poisoned was as high as 68 1, the largest food poisoning incident before the end of September, 1999.
The third is eating by mistake. It is mainly caused by eating nitrite, puffer fish, poisonous mushrooms and food contaminated by pesticides and rodenticides. This kind of poisoning occurs in a large number, and the poisoned person is in critical condition and the mortality rate is extremely high. On March 3, three children in Xincheng County, Guangxi were poisoned after eating sweet potato chips contaminated with rodenticide, and 1 person died. On May 1 1, a couple of migrant workers in Shantou City, Guangdong Province ate puffer fish poisoning by mistake, and 1 person died. /kloc-From September 0/8 to September 2 1 2008, three farmers in Huanghe Township, Shizhu County, Chongqing ate poisonous mushrooms by mistake, and all nine people were poisoned after eating them, and two of them died.
Fourth, people lack knowledge of food hygiene, improper food processing and storage, and abuse pesticides. Of the seven people who died of bacterial food poisoning last year. Six people were caused by eating fermented rice noodles that were processed and made improperly. 1March 1999 1 1 day, 478 people suffered from food poisoning in Zhoukou, Henan Province, which was caused by improper processing and cooking of mung beans. In the investigation of rodenticide poisoning in Anshun City, Guizhou Province, the health department found that due to the long-term use of fluoroacetamide to kill rats, rodenticide and bait contaminated with rodenticide were discarded everywhere, which caused serious environmental pollution. There are no chickens, dogs and cats in the village, which shows that local farmers know nothing about acute toxic rodenticide and scientific rodent control knowledge.
The fifth is poisoning. In recent years, the Ministry of Health has received many reports of food poisoning caused by poisoning. Toxic substances are often highly toxic rodenticide or nitrite. On February 2, 6 people were poisoned 1 person died in Pengshui County, Chongqing. On July 5, two children in Nanchuan, Chongqing died after drinking a drink brewed with tetramine, all of which were deliberately poisoned by criminals. These cases remind us that there are still omissions in the management of drama drugs at present.
Sixth, the management of pesticide production, management and use is not perfect. As of the end of September. The Ministry of Health * * * received three reports of food poisoning caused by pesticides1,with poisoning 1 108 people and 59 deaths, exceeding 70% of the total deaths. These poisoning incidents were caused by fluoroacetamide, tetramine, "1605", "1059" and other rodenticides and pesticides whose production and use were explicitly prohibited by the state. It can be seen that these things that should have been extinct long ago are still being produced, sold and used in some areas. In addition, improper use of pesticides leads to pesticide residues in listed crops exceeding national standards, which is also an important cause of food poisoning.
This strange disease turned out to be poisoning.
It was obviously poisoned, but my family and I knew nothing about it. I think I have some strange disease, and as a result, I often lose the opportunity of treatment, and even lead to secondary poisoning or multiple poisoning. There have been many similar reports in the media recently. In order to help everyone improve their ability of self-help and mutual aid, the following briefly introduces the common sense of identification and treatment of several food poisoning.
Kitchen tips
Do not eat dead animal meat, and separate raw and cooked meat products from seafood during processing. Only when cooked thoroughly and refrigerated at low temperature can bacterial food poisoning such as Salmonella and Vibrio parahaemolyticus be effectively prevented.
The main foods that cause salmonella food poisoning are meat, fish, poultry, milk and eggs. The main causes of poisoning are eating dead or contaminated livestock meat after slaughter, cooking utensils, containers or food storage places are not cooked or cross-contaminated, and they are not heated before eating.
Vibrio parahaemolyticus is a kind of marine bacteria, which mainly comes from fish, shrimps and crabs, shellfish and algae. Poisoned food is mainly seafood, followed by pickles and cooked meat. About half of poultry meat and eggs are pickled products. The main causes of poisoning are undercooked or undercooked during cooking, or the products cooked after pollution are not heated thoroughly. Therefore, processed seafood must be thoroughly cooked; Appropriate amount of vinegar can be added when cooking or preparing seafood and platters; Raw and cooked utensils should be separated during processing and stored at low temperature.
Self-made fermented food should be kept hygienic to prevent mildew and poisoning caused by Pseudomonas cocoanum and Clostridium botulinum.
Food poisoning caused by fermented rice flour is a kind of bacterial food poisoning with high mortality found in China. Poisoned food is mainly fermented corn flour products, such as glutinous rice flour, glutinous rice balls, rice fields, millet or sorghum rice flour products. The mortality rate is as high as 40%- 100%. Therefore, when preparing fermented grains at home, water should be changed frequently, and dried or dried into powder in time after grinding; Storage should be ventilated and moisture-proof, and do not directly contact the soil to prevent pollution.
The food poisoned by botulinum is related to eating habits, mainly fermented beans and cereal products (batter and stinky tofu) made by the family. The main cause of poisoning is that the food contaminated by botulinum toxin is not completely heated before eating. When making fermented sauce, it should be noted that the salt content should be above 14%, and the fermentation temperature should be increased to ensure sufficient oxygen supply. Do not eat raw soy sauce.
It is forbidden to pick and eat fruits and vegetables that have just been sprayed with pesticides.
Organophosphorus pesticide is one of the most widely used and varied pesticides at present, and its poisoning and death rank first among all kinds of chemical poisoning in China every year. Long-term consumption of fruits and vegetables that are not sprayed with organophosphorus pesticides, food in containers filled with organophosphorus pesticides, consumption of seeds mixed with organophosphorus pesticides, and transportation and storage of food in vehicles and warehouses contaminated with organophosphorus pesticides can all cause poisoning.
When processing bean foods such as kidney beans and soybean milk, it must be fully heated to prevent harmful substances from causing mold in food.
Kidney beans are also called lentils and green beans. Kidney beans, kidney beans, kidney beans, etc. The pathogenic substances of kidney bean poisoning are not very clear, which may be related to erythrocyte agglutinin and saponin. It is generally believed that improper cooking and processing methods and incomplete heating of kidney beans can cause food poisoning if the toxins cannot be destroyed. When processing kidney beans, we should pay attention to stir-frying evenly, cooking and stewing thoroughly, so that kidney beans lose their original green and bean smell.
The harmful substances in soybean milk may be trypsin inhibitor and saponin. When soybean milk is heated to a certain degree, foam will appear. At this time, the soybean milk has not been boiled, so we should continue to heat it until the foam disappears and the soybean milk boils, and then continue to heat it for several minutes. When the amount of soybean milk is large or thick, the soybean milk must be stirred evenly to prevent the bottom of the pot from burning and affecting the heat penetration.
Don't eat fish and mushrooms you don't know.
Eating fish containing tetrodotoxin can cause food poisoning. The ovary and liver of puffer fish are the most toxic, and the muscles and blood also contain toxins. The mortality rate of puffer fish poisoning is 40%-60%, usually 4-6 hours after onset, and the fastest death can be 10 minutes after onset. Fishermen must remove puffer fish when fishing, and shall not enter the market for sale. Consumers should also be careful not to eat fish caught or picked up in coastal areas without authorization.
There are about 100 species of poisonous mushrooms in China. According to the data, at least 10 species can kill people. Poisonous mushroom poisoning mostly occurs in summer and autumn rainy season, mainly at home. Because it is very difficult to distinguish poisonous mushrooms, we must master relevant knowledge when collecting wild fresh mushrooms to avoid poisoning by eating poisonous mushrooms by mistake. Dried poisonous mushrooms can also be poisoned.
Mackerel poisoning || methanol poisoning
What is food poisoning?
All acute toxic diseases caused by eating food contaminated by bacteria and their toxins, or ingesting food containing toxic substances (such as mercury chloride, arsenic and organophosphorus) and natural toxins of food itself (such as toadstools and poisonous fish) belong to food poisoning. Food poisoning is characterized by sudden outbreak, short incubation period and easy collective onset, and patients have a clear connection with toxic food. The causes of food poisoning can be divided into two categories.
(1) bacterial food poisoning: it is common in the following diseases:
① Salmonella food poisoning; ② Staphylococcus aureus food poisoning; ③ Proteus food poisoning; ④ Halophilic food poisoning; ⑤ Botulinum poisoning; ⑥ Pathogenic E.coli food poisoning; ⑦ Pseudomonas aeruginosa food poisoning; (8) food poisoning (heat tolerance) caused by Webster's Bacillus; Pet-name ruby fungal food poisoning.
(2) Non-bacterial food poisoning: common in the following diseases:
① acute food poisoning of plants: a. food poisoning of "smelly rice flour"; B. poisoning of sprouted potatoes; C. ginkgo poisoning; D. Cannabis poisoning; E. Poisonous mushroom poisoning (poisonous mushroom poisoning); F. tung oil poisoning; G. Xanthium sibiricum poisoning; Cattle fat poisoning.
② Acute animal poisoning: a. Poisoning by puffer fish; B. animal liver poisoning; C. fish gall poisoning.
③ Acute chemical poisoning: a. Acute organophosphorus pesticide poisoning; B. acute sodium fluorosilicate poisoning; C. acute zinc poisoning; D. acute arsenic poisoning; E. acute antimony poisoning; Acute potassium dichromate poisoning.
Prevention and control of food poisoning
The concept, characteristics and classification of food poisoning. Clinical characteristics, treatment principles and preventive measures of bacterial food poisoning. Clinical characteristics, treatment and prevention of non-bacterial food poisoning.
The case started at 4 o'clock in the afternoon on a certain day. Several residents near a county central hospital came to the hospital for medical treatment because of symptoms of gastrointestinal diseases. The patient suddenly developed nausea, vomiting, watery diarrhea, no urgency, and then severe diarrhea. Body temperature is about 38℃. At about 10 in the evening, * * * treated 96 patients, and the doctor thought it might be food poisoning. I asked about the food I ate within 48 hours and found that I once ate pig blood from a restaurant at 7 ~ 10 in the morning. Report to the county health and epidemic prevention station immediately. After investigation, the county meat joint factory processed more than 800 kilograms of pig blood the day before, cooked it and soaked it in hot water, and sold it the next day. When the pig's blood is received in the basin, the soil and feces on the pig also fall into the basin. Cooking utensils and containers for processing pig blood were not cleaned and disinfected, and the room temperature was 35 ~ 36℃ that day. Eight fecal samples, four vomit samples and five pig blood samples were collected by aseptic operation, and the pathogenic bacteria were isolated and cultured. Salmonella was detected in all specimens, and no other pathogens were found. No one who doesn't eat pig blood is sick.
Since its establishment 40 years ago, People's Republic of China (PRC) has done a lot of work to prevent food poisoning, taken effective preventive measures and established a food poisoning investigation and reporting system. Especially since the implementation of the Food Hygiene Law, the incidence of food poisoning has dropped significantly, but it still happens from time to time.
Among all kinds of food poisoning in China, bacterial food poisoning accounts for the majority, accounting for about 58.6% of the total food poisoning, among which salmonella food poisoning accounts for the first place.
Food poisoning is obviously regional, and more than 90% of botulism occurs in Xinjiang. Pufferfish poisoning mostly occurs in coastal areas and the lower reaches of the Yangtze River. Common pesticide poisoning, crude cottonseed oil poisoning and tung oil poisoning in rural areas.
The incidence of bacterial food poisoning is high, and the mortality rate is low except botulism, which is mostly caused by contaminated animal food. The incidence of other food poisoning is low, but the mortality rate is high and the incidence is scattered.
Section 1 Concept, Characteristics and Classification of Food Poisoning
I. The concept of food poisoning
Any disease with acute infection or poisoning as the main clinical feature caused by normal intake of "toxic food" (referring to animal and plant food contaminated by pathogenic bacteria and their toxins, chemical poisons or toxins) by healthy people. Collectively referred to as food poisoning. Acute gastroenteritis caused by eating inedible food (immature fruit, etc.). ) and overeating; Food-borne diseases, such as infectious diseases, parasitic diseases, human and animal infectious diseases, or diseases that occur after people with gastrointestinal diseases and allergies eat certain foods, do not belong to this category. No matter one-time or long-term continuous intake of "toxic food", it is not food poisoning characterized by chronic poisoning.
Second, the characteristics of food poisoning
Although the causes and symptoms of food poisoning are different, they generally have the following epidemiological and clinical characteristics: ① The incubation period is short, usually ranging from a few minutes to several hours, and a group of patients appear almost at the same time in a short time after eating "toxic food", which is fierce, quickly forms a peak and is explosive; ② The clinical manifestations of patients are similar, most of them are acute gastrointestinal symptoms; ③ The onset is related to eating some food. The patient has eaten similar "toxic food" recently, and the incidence range is consistent with the food distribution. People who don't eat will not get sick, and there will be no new cases soon after they stop eating this kind of food. (4) there is no infection between people. The incidence curve shows a trend of sudden increase and sudden decrease, and there is no aftermath in the epidemic of infectious diseases. ⑤ There is obvious seasonality. Bacterial and toxic animal and plant food poisoning often occurs in summer and autumn; Botulinum poisoning and nitrite poisoning mostly occur in winter and spring.
Third, the classification of food poisoning
Food poisoning is usually divided into:
(1) bacterial food poisoning
1. Infectious food poisoning includes food poisoning caused by Salmonella, Proteus, Vibrio parahaemolyticus, pathogenic Escherichia coli and Clostridium welchii.
2. Toxin food poisoning includes food poisoning caused by Clostridium botulinum toxin and staphylococcal enterotoxin.
(2) Food poisoning caused by poisonous animals and plants
1. Food poisoning caused by toxic animal poisoning, such as puffer fish, toxic shellfish, fish histamine, animal viscera (liver of wolves and dogs in winter) and glands (thyroid gland, etc. ).
2. Poisonous plant poisoning, such as food poisoning caused by toadstools, cassava, green beans, sprouted potatoes, fresh day lilies and raw soybean milk.
(3) Chemical food poisoning
Food is polluted by some metals, metalloids and their compounds, nitrite and pesticides. Or food poisoning is caused by eating by mistake.
Mycotoxin food poisoning
Food poisoning caused by eating food contaminated by a large number of mycotoxins, such as scab wheat and moldy sugarcane.
Fourth, the causes of food poisoning
The main causes of food poisoning are: ① raw materials are not strictly selected, the food itself may be toxic, or contaminated by a large number of live bacteria and their toxins, or the food has deteriorated; (2) Food pollution is caused by carelessness in the process of production, processing, transportation, storage and sales, and food is not sufficiently heated before eating; (3) improper food preservation can lead to potato germination, increased nitrite content in food and mildew of food, all of which can cause food poisoning; 4 improper processing and cooking, such as the meat is too big, the internal temperature is not enough, and the bacteria are not killed; ⑤ Food employees themselves carry bacteria, and their personal hygiene is not good, resulting in food pollution; ⑥ Toxic chemicals are mixed into food to reach toxic dose.
Investigation and treatment of food poisoning
Once a food poisoning incident occurs, it should be carefully investigated in time to find out the reasons and put forward improvement measures to avoid similar incidents from happening again.
First, clearly diagnose and rescue patients.
By asking about the medical history and physical examination, the doctor initially judges whether it is food poisoning and what kind of food may be caused, and reports the situation to the health and epidemic prevention station in time, and informs the relevant canteens and restaurants to temporarily seal the suspicious food to protect the scene. At the same time, rescue patients as soon as possible, focusing on the elderly, children and critically ill patients. People who eat suspicious food but have no symptoms should also be closely observed.
Second, on-site investigation
Investigation of (1) poisoning
After receiving the report, the local health and epidemic prevention station and relevant departments immediately organized personnel to go to the scene for investigation, so as to learn more about the onset process, main clinical manifestations, location, unit, time, number of poisoned people, number of severe cases and deaths, suspicious food, edible range and incidence trend, measures taken and problems to be solved.
(2) Investigation on the general health situation at the site
Understand whether tableware, cookers, utensils and equipment meet the hygiene requirements, the chef's personal hygiene habits and health status, and the dining system. And analyze the causes and conditions that may cause poisoning.
(3) Determine the poisoned food
1. Learn more about the recipes of every meal eaten by patients within 24 ~ 48 hours before onset, and find out suspicious foods.
2. Further understand the source, transportation, storage, production process and the possibility of pollution-free in sales of suspicious food.
(4) Sampling inspection
Check suspicious food residue, stains on tableware and utensils, patient's excrement, chef's hands, etc. Find the pathogen.
Third, on-site treatment
After determining the type of food poisoning, immediately deal with the scene according to the causes to prevent the incident from expanding: ① destroy the food that caused the poisoning; (2) Promptly urge rectification according to the causes of pollution; Cooking staff suffering from infectious diseases should be temporarily transferred from catering service posts, and a health management system should be formulated and improved; ③ Guide on-site disinfection.
Four, conscientiously implement the food hygiene law
Strengthen health education, enhance personal hygiene awareness, strictly implement the food hygiene law and food hygiene standards, and do a good job in food hygiene.
See table 5- 1 for other food poisoning and prevention points.
Table 5- 1 Prevention and control points of other common food poisoning