Diseases and Conditions

Food poisoning
By Mayo Clinic Staff
Food poisoning, also called foodborne illness, is illness caused by eating
contaminated food. Infectious organisms including bacteria, viruses and
parasites or their toxins are the most common causes of food poisoning.
Infectious organisms or their toxins can contaminate food at any point of
processing or production. Contamination can also occur at home if food is
incorrectly handled or cooked.
Food poisoning symptoms, which can start within hours of eating contaminated
food, often include nausea, vomiting or diarrhea. Most often, food poisoning is
mild and resolves without treatment. But some people need to go to the hospital.
Food poisoning symptoms vary with the source of contamination. Most types of
food poisoning cause one or more of the following signs and symptoms:

Nausea

Vomiting

Watery diarrhea

Abdominal pain and cramps

Fever

Signs and symptoms may start within hours after eating the contaminated food, or
they may begin days or even weeks later. Sickness caused by food poisoning
generally lasts from a few hours to several days.

When to see a doctor

If you experience any of the following signs or symptoms, seek medical attention.

Frequent episodes of vomiting and inability to keep liquids down

Bloody vomit or stools

Diarrhea for more than three days

Extreme pain or severe abdominal cramping

An oral temperature higher than 101.5 F (38.6 C)

Signs or symptoms of dehydration excessive thirst, dry mouth, little or

no urination, severe weakness, dizziness, or lightheadedness

Neurological symptoms such as blurry vision, muscle weakness and

tingling in the arms

Contamination of food can happen at any point during its production: growing,
harvesting, processing, storing, shipping or preparing. Cross-contamination the
transfer of harmful organisms from one surface to another is often the cause.
This is especially troublesome for raw, ready-to-eat foods, such as salads or other
produce. Because these foods aren't cooked, harmful organisms aren't destroyed
before eating and can cause food poisoning.
Many bacterial, viral or parasitic agents cause food poisoning. The following table
shows some of the possible contaminants, when you might start to feel symptoms
and common ways the organism is spread.
Contaminant

Onset of
symptoms

Foods affected and means of transmission

Meat and poultry. Contamination occurs during

processing if animal feces contact meat surfaces.
Campylobacter
2 to 5 days
Other sources include unpasteurized milk and
contaminated water.
Home-canned foods with low acidity,
improperly canned commercial foods, smoked
Clostridium
12 to 72
or salted fish, potatoes baked in aluminum foil,
botulinum
hours
and other foods kept at warm temperatures for
too long.
Meats, stews and gravies. Commonly spread
Clostridium
8 to 16
when serving dishes don't keep food hot enough
perfringens
hours
or food is chilled too slowly.
Beef contaminated with feces during slaughter.
Spread mainly by undercooked ground beef.
Escherichia coli (E.
1 to 8 days Other sources include unpasteurized milk and
coli) O157:H7
apple cider, alfalfa sprouts, and contaminated
water.
Giardia lamblia
1 to 2 weeks Raw, ready-to-eat produce and contaminated

Contaminant

Onset of
symptoms

Hepatitis A

28 days

Listeria

9 to 48
hours

Noroviruses
(Norwalk-like
viruses)

12 to 48
hours

Rotavirus

1 to 3 days

Salmonella

1 to 3 days

Shigella

24 to 48
hours

Staphylococcus
aureus

1 to 6 hours

Vibrio vulnificus

1 to 7 days

Foods affected and means of transmission

water. Can be spread by an infected food
handler.
Raw, ready-to-eat produce and shellfish from
contaminated water. Can be spread by an
infected food handler.
Hot dogs, luncheon meats, unpasteurized milk
and cheeses, and unwashed raw produce. Can be
spread through contaminated soil and water.
Raw, ready-to-eat produce and shellfish from
contaminated water. Can be spread by an
infected food handler.
Raw, ready-to-eat produce. Can be spread by an
infected food handler.
Raw or contaminated meat, poultry, milk or egg
yolks. Survives inadequate cooking. Can be
spread by knives, cutting surfaces or an infected
food handler.
Seafood and raw, ready-to-eat produce. Can be
spread by an infected food handler.
Meats and prepared salads, cream sauces, and
cream-filled pastries. Can be spread by hand
contact, coughing and sneezing.
Raw oysters and raw or undercooked mussels,
clams, and whole scallops. Can be spread
through contaminated seawater.

Whether you become ill after eating contaminated food depends on the organism,
the amount of exposure, your age and your health. High-risk groups include:

Older adults. As you get older, your immune system may not respond as
quickly and as effectively to infectious organisms as when you were
younger.

Pregnant women. During pregnancy, changes in metabolism and

circulation may increase the risk of food poisoning. Your reaction may be
more severe during pregnancy. Rarely, your baby may get sick, too.

Infants and young children. Their immune systems haven't fully

developed.

People with chronic disease. Having a chronic condition such as

diabetes, liver disease or AIDS or receiving chemotherapy or radiation
therapy for cancer reduces your immune response.

The most common serious complication of food poisoning is dehydration a

severe loss of water and essential salts and minerals. If you're a healthy adult and
drink enough to replace fluids you lose from vomiting and diarrhea, dehydration
shouldn't be a problem.
Infants, older adults and people with suppressed immune systems or chronic
illnesses may become severely dehydrated when they lose more fluids than they
can replace. In that case, they may need to be hospitalized and receive intravenous
fluids. In extreme cases, dehydration can be fatal.
Some types of food poisoning have potentially serious complications for certain
people. These include:

Listeria monocytogenes. Complications of a listeria food poisoning may

be most severe for an unborn baby. Early in pregnancy, a listeria infection
may lead to miscarriage. Later in pregnancy, a listeria infection may lead
to stillbirth, premature birth or a potentially fatal infection in the baby after
birth even if the mother was only mildly ill. Infants who survive a
listeria infection may experience long-term neurological damage and
delayed development.

Escherichia coli (E. coli). Certain E. coli strains can cause a serious
complication called hemolytic uremic syndrome. This syndrome damages
the lining of the tiny blood vessels in the kidneys, sometimes leading to
kidney failure. Older adults, children younger than 5 and people with
weakened immune systems have a higher risk of developing this
complication. If you're in one of these risk categories, see your doctor at
the first sign of profuse or bloody diarrhea.

If you or your child needs to see a doctor, you'll likely see your primary care
provider first. If there are questions about the diagnosis, your doctor may refer
you to an infectious disease specialist.

What you can do

Preparing a list of questions will help you make the most of your time with your
doctor. Some questions to ask include:

What's the likely cause of the symptoms? Are there other possible causes?

Is there a need for tests?

What's the best treatment approach? Are there alternatives?

Is there a need for medication? If yes, is there a generic alternative to the

medicine you're prescribing?

How can I ease the symptoms?

What to expect from your doctor

Some questions the doctor may ask include:

Has anyone in your family or otherwise close to you developed similar

symptoms? If so, did you eat the same things?

Have you traveled anywhere where the water or food might not be safe?

Are you having bloody bowel movements?

Do you have a fever?

Had you taken antibiotics in the days or weeks before your symptoms
started?

When did symptoms begin?

Have the symptoms been continuous, or do they come and go?

What foods have you eaten in the past few days?

What you can do in the meantime

Drink plenty of fluids. Stick with bland foods to reduce stress on your digestive
system. If your child is sick, follow the same approach offer plenty of fluids
and bland food. If you're breast-feeding or using formula, continue to feed your
child as usual.
Ask your child's doctor if giving your child an oral rehydration fluid (Pedialyte,
Enfalyte, others) is appropriate. Older adults and people with weakened immune
systems might also benefit from oral rehydration solutions. Medications that help
ease diarrhea generally aren't recommended for children.
Food poisoning is often diagnosed based on a detailed history, including how long
you've been sick, your symptoms and specific foods you've eaten. Your doctor
will also perform a physical exam, looking for signs of dehydration.
Depending on your symptoms and health history, your doctor may conduct
diagnostic tests, such as a blood test, stool culture or examination for parasites, to
identify the cause and confirm the diagnosis.

For a stool culture, your doctor will send a sample of your stool to a laboratory,
where a technician will try to identify the infectious organism. If an organism is
found, your doctor likely will notify your local health department to determine if
the food poisoning is linked to an outbreak.
In some cases, the cause of food poisoning can't be identified.
Treatment for food poisoning typically depends on the source of the illness, if
known, and the severity of your symptoms. For most people, the illness resolves
without treatment within a few days, though some types of food poisoning may
last longer.
Treatment of food poisoning may include:

Replacement of lost fluids. Fluids and electrolytes minerals such as

sodium, potassium and calcium that maintain the balance of fluids in your
body lost to persistent diarrhea need to be replaced. Some children and
adults with persistent diarrhea or vomiting may need hospitalization,
where they can receive salts and fluids through a vein (intravenously), to
prevent or treat dehydration.

Antibiotics. Your doctor may prescribe antibiotics if you have certain

kinds of bacterial food poisoning and your symptoms are severe. Food
poisoning caused by listeria needs to be treated with intravenous
antibiotics during hospitalization. The sooner treatment begins, the better.
During pregnancy, prompt antibiotic treatment may help keep the infection
from affecting the baby.

Adults with diarrhea that isn't bloody and who have no fever may get relief from
taking the medication loperamide (Imodium A-D) or bismuth subsalicylate
(Pepto-Bismol). Ask your doctor about these options.
Food poisoning often improves without treatment within 48 hours. To help keep
yourself more comfortable and prevent dehydration while you recover, try the
following:

Let your stomach settle. Stop eating and drinking for a few hours.

Try sucking on ice chips or taking small sips of water. You might also
try drinking clear soda, clear broth or noncaffeinated sports drinks, such as
Gatorade. You're getting enough fluid when you're urinating normally and
your urine is clear and not dark.

Ease back into eating. Gradually begin to eat bland, low-fat, easy-todigest foods, such as soda crackers, toast, gelatin, bananas and rice. Stop
eating if your nausea returns.

Avoid certain foods and substances until you're feeling better. These
include dairy products, caffeine, alcohol, nicotine, and fatty or highly
seasoned foods.

Rest. The illness and dehydration can weaken and tire you.

To prevent food poisoning at home:

Wash your hands, utensils and food surfaces often. Wash your hands
well with warm, soapy water before and after handling or preparing food.
Use hot, soapy water to wash utensils, cutting boards and other surfaces
you use.

Keep raw foods separate from ready-to-eat foods. When shopping,

preparing food or storing food, keep raw meat, poultry, fish and shellfish
away from other foods. This prevents cross-contamination.

Cook foods to a safe temperature. The best way to tell if foods are
cooked to a safe temperature is to use a food thermometer. You can kill
harmful organisms in most foods by cooking them to the right
temperature.
Cook ground beef to 160 F (71.1 C); steaks, roasts chops, such as lamb,
pork and veal, to at least 145 F (62.8 C). Cook chicken and turkey to 165 F
(73.9 C). Make sure fish and shellfish are cooked thoroughly.

Refrigerate or freeze perishable foods promptly within two hours of

purchasing or preparing them. If the room temperature is above 90 F (32.2
C), refrigerate perishable foods within one hour.

Defrost food safely. Don't thaw food at room temperature. The safest way
to thaw food is to defrost it in the refrigerator. If you microwave frozen
food using the "defrost" or "50 percent power" setting, be sure to cook it
immediately.

Throw it out when in doubt. If you aren't sure if a food has been
prepared, served or stored safely, discard it. Food left at room temperature
too long may contain bacteria or toxins that can't be destroyed by cooking.
Don't taste food that you're unsure about just throw it out. Even if it
looks and smells fine, it may not be safe to eat.

Food poisoning is especially serious and potentially life-threatening for young

children, pregnant women and their fetuses, older adults, and people with
weakened immune systems. These individuals should take extra precautions by
avoiding the following foods:

Raw or rare meat and poultry

Raw or undercooked fish or shellfish, including oysters, clams, mussels

and scallops

Raw or undercooked eggs or foods that may contain them, such as cookie
dough and homemade ice cream

Raw sprouts, such as alfalfa, bean, clover and radish sprouts

Unpasteurized juices and ciders

Unpasteurized milk and milk products

Soft cheeses, such as feta, Brie and Camembert; blue-veined cheese; and
unpasteurized cheese

Refrigerated pates and meat spreads

Uncooked hot dogs, luncheon meats and deli meats

References
1. Foodborne illness, foodborne disease, (sometimes called "food
poisoning"). Centers for Disease Control and Prevention.
http://www.cdc.gov/foodsafety/facts.html. Accessed April 16, 2014.
2. Centers for Disease Control and Prevention, et al. Diagnosis and
management of foodborne illnesses: A primer for physicians and other
health care professionals. MMWR. 2004;53:1.
http://www.cdc.gov/mmwr/preview/mmwrhtml/rr5304a1.htm. Accessed
April 16, 2014.
3. Acheson DWK. Patient information: Food-poisoning (foodborne illness).
http://www.uptodate.com/home. Accessed April 17, 2014.
4. Foodborne illness. National Digestive Diseases Information
Clearinghouse.
http://www.digestive.niddk.nih.gov/ddiseases/pubs/bacteria/index.aspx.
Accessed April 16, 2014.
5. The big thaw Safe defrosting methods for consumers. Food Safety and
Inspection Service. http://www.fsis.usda.gov/wps/portal/fsis/topics/foodsafety-education/get-answers/food-safety-fact-sheets/safe-foodhandling/the-big-thaw-safe-defrosting-methods-for-consumers/CT_Index.
Accessed April 17, 2014.

6. Wanke CA. Approach to the adult with acute diarrhea in developed

countries. http://www.uptodate.com/home. Accessed April 17, 2014.
July 24, 2014
Original article: http://www.mayoclinic.org/diseases-conditions/foodpoisoning/basics/definition/con-20031705
.

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