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Ptomaine pterrors.

Despite our tremendous advances in public health, food poisoning seems to be a continuing threat in our lives, but it can be avoided by taking reasonable precautions. Contaminated food or drink is not the only cause of acute gastroenteritis, however, and a sudden attack of nausea, vomiting or diarrhea may have nothing to do with that mystery stew eaten in some strange "greasy spoon." Even when food is the culprit, it may not be the last meal you ate that did you in, so don't immediately blame last night's raw oysters for this morning's attack (although anyone who eats raw oysters deserves such an attack).

One of the most common offenders is staphylococcus, a bacterium that does not itself attack the GI tract, but does so through a poison it produces in foods that provide just the right culture medium, such as cream-filled pastries, custards, cream gravies, etc. Staph bacteria are everywhere in the environment, but in the kitchen, they usually come from a minor infection on the hand of a food handler. If food is not refrigerated or cooked soon after being contaminated, the staph will grow rapidly at room temperature. Because the toxin is not destroyed by heat, the food is still dangerous after it has been cooked. The victim of staph food poisoning can be sure it came from the meal previous to the attack because the time between ingestion and the onset of symptoms (the "incubation period") is usually two to four hours, but may be even

Salmonella, a member of the typhoid family, is the bacterium found too often in poultry. It may also contaminate other food handled by a "carrier" (one who carries the organism in his intestinal tract) who fails to wash his hands after using the toilet. Other bacteria and some viruses also cause food poisoning (coliform bacilli, shigella, rotoviruses, etc.), as do some chemicals that may get into food by accident, but staph and salmonella are the main culprits-and the easiest to avoid.

Refrigerating food promptly after preparation (and leftovers after meals) and washing all utensils-specially wooden cutting boards-with soap and hot water after use will do much to prevent food poisoning. "Ptomaine poisoning," by the way, is an outmoded term once used to describe gastroenteritis supposedly caused by toxic substances produced in decaying food. In earlier days, when home canning was more in vogue, a particularly deadly form of food poisoning, botulism, was not uncommon. Botulism cases resulting from home-canned foods are rare today-since pressure cookers are used more often for canning-and even more rare in commercially prepared products.

What to do when food poisoning does occur? Usually nothing, other than what nature forces one to do, since the vast majority of cases are self-limiting, and recovery occurs in a few days at most. Fluid replacement and Immodium for diarrhea will usually tide one over, but if symptoms persist, a stool culture and an appropriate antibiotic may be required. If food poisoning occurs in a group of persons who have shared a common meal, the local health department should be notified at once to investigate the possibility that a particular food handler may be at fault.
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Title Annotation:food poisoning
Publication:Medical Update
Date:Feb 1, 1990
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