Beruflich Dokumente
Kultur Dokumente
Bacteria or toxins
Staphylococcus
Bacillus cereus
Clostridium perfringens, botulinum
Salmonella typhimurium, cholera-suis, enteritidis
Shigella
Vibrio vulnificus, parahaemolyticus
Chemicals
Pesticides
Rodenticides
Fertilizers
Heavy metals
Agent
Source
IP
Salmonella
typhimurium
cholera-suis
enteritidis
Meat, poultry,
12 milk &
24 h
products, eggs
Organisms
multiply in
intestine,
give rise to
enteritis,
colitis
Staph
aureus
enterotoxins
Skin, nose,
12
throat of food
36 h
handlers, boils,
pyogenic infns,
mastitis in
cows
contaminate
salads,
custards, milk
Source
IP
Mechanism
Clinical features
Clostridium
perfringens
Meat, poultry,
eggs
(food cooked
24 h or more
before
consumption,
cooled slowly
and reheated
6 -24
h
(1014 h)
Spores survive
cooking, then
germinate at
cool temp.
Multiply when
reheated upto
50oC, produce
toxins
Diarrhoea +++,
abdominal cramps +++
Fever, nausea,
vomiting uncommon
Symptoms for short
duration
C
botulinum
Exotoxin
A,B, E
Soil, dust,
12
intestine.
36 h
Spores enter
home canned
foods, pickled
fish, home
made cheese
(low acid foods)
Ingestion of
intra-dietetic
toxins
Dysphagia, diplopia,
ptosis, dysarthria,
blurred vision,
quadriplegia. Fever
absent. Death 4-8 d
due to resp/cardiac
failure
Source
IP
Mechanism
Clinical features
Bacillus
cereus
Soil, raw,
dried or
processed
foods
Rice
1-6 h
Emetic form
12-24 h
Diarrhoeal
form
Spores survive
cooking, then
germinate at
favourable temp.
Preformed toxins
Vomiting, nausea in
emetic form
Abdominal cramps,
diarrhoea, no fever
in diarrhoeal form
Ingested chemical
acts inside the body
depending on its
chemical structure
Depending on
chemical such as
organophosphates
Nausea/ vomiting
++, neuromuscular
symptoms +++
Source
IP
Mechanism
Clinical features
Cholera
Contaminatio
n of water,
food
Few
hrs
5
days
Shigella Ingestion of
12-96 Ingested organisms
contaminated h
invade distal SI, colon.
food/water/pMucosal ulcerations,
to-p
colonic crypt
microabscesses
Nausea/ vomiting
+++, abdo
cramps+++, fever
+++, blood/mucus
in stools +++
Infective
Incubation period 12 24 hrs
Predominantly diarrhoea
Preformed toxin
Incubation period 1 6 hrs
Predominantly vomiting
Epidemiological Investigation
Laboratory Studies
Circumstantial enquiry
Nause
a/
vomiti
ng
Diarr
hoea
Abdo
cram
ps
Fever Food
Mutton Dal
Item 1 curry
Matar
paneer
Rice
Alpha Y
Bravo N
Charli Y
e
Food
item
Ill
Not
ill
Total
IE
Ill
Not
Ill
Tota INE
l
RR
IE/INE
AR
IE-INE
Mutton
curry
31
40
78%
42
47
11%
7.09
67%
Matar
paneer
30
31
61
49%
20
26
23%
2.13
26%
Moong dal
27
24
51
53%
27
36
25%
2.12
28%
Chapati
32
43
75
43%
12
33%
1.30
10%
Rice
34
46
80
43%
29%
1.48
14%
Difference
between
attack rates
No. who
ate
No. ill
Attack No.
No. ill
rate % who
did not
eat
Attack
rate %
Mutton curry
109
80
73
21
14
66
-7
Dal
88
70
79
32
24
75
-4
Pulao (Rice)
95
76
80
25
18
72
-8
Raita (Curd)
98
84
85
22
-76
Potato-Pea curry
78
60
77
42
20
48
-29
Chatni(Pickle)
65
13
20
55
27
48
-28
Papad
60
10
60
24
40
-30
Sweet (Kheer)
110
77
75
10
60
-15
Viscera
Blood for culture and serology
Transportation
Sterile containers
Packed in Ice
Quickest route