FitSugar

5 Things: Grilling and Marinating Meat

FitSugar — Mon, 25 May 2009 04:00:00 -0700

Barbecue season is upon us so let's celebrate by grilling, since it's an easy and lowfat way to cook. If you're grilling meat, protect your health by marinating your meat. Here are five things on the whys and hows of marinating.

Marinating meat, fish, and poultry significantly decreases the amount of carcinogenic heterocyclic amines (HCAs) produced when the meat is cooked at high temperatures, like in grilling. Marinades can reduce HCAs by as much as 99 percent.
Marinades may slow the growth of harmful bacteria, like listeria.

Learn a few more tips about marinades when you read more.

Marinating meat with naturally acidic ingredients, like vinegar or citrus juices, tenderizes the meat, making your protein easier to digest. Plus marinades will help lock in moisture so your meat won't dry out and toughen up.
To keep the calorie count down, only use a half cup of marinade to every pound of meat. This will be enough to coat the meat, but cuts down on excess.
Never marinate meat at room temperature. Although marinade can slow the growth of harmful bacteria, it cannot stop them completely, so marinate your meat in the fridge.

Do you have a great marinade recipe? Share it in the comments section below.

Source

Food Poisoning From Vacuum-Packed Food!?!

FitSugar — Mon, 18 Jun 2007 08:45:00 -0700

Those perfectly sealed shiny packs of sliced cheese, raw meat, and deli cold cuts won't seem so perfect after you hear this: The packaging could be responsible for a deadly type of food poisoning.

Vacuum-packed foods are deprived of oxygen to keep them fresh and boost their shelf life, but according to new research, the lack of oxygen is what this bacteria, known as Listeria monocytogenes, loves most. Listeria monocytogenes a super-bacteria of sorts can even grow in the cold temperatures found in refrigerators.

This oxygen-deprived Listeria gets 100 times stronger compared to when it does have oxygen. It makes sense since this bacteria likes to live inside your gut, which has no oxygen. The worst part is that this stronger form of Listeria is responsible for killing 25% of the people it infects.

Food microbiologists say that NOT vacuum-packing foods could lead to other problems, so they're not planning on having us ditch these shiny packages any time soon. Although they are definitely going to have to think of a new method to seal our food in a safer way.

Fit's Tips: If you don't want to avoid all food found in this type of packaging including raw meats, raw veggies, raw and cooked poultry, raw and smoked fish and soft cheeses like Brie and feta, make sure these foods are cooked thoroughly before you eat them.

Source

Oscar Mayer Chicken Recalled, Among Others

FitSugar — Mon, 19 Feb 2007 11:05:34 -0800

Yet another popular food item has been recalled due to being infected with a deadly bacteria.

Carolina Culinary Foods has recalled 52,650 pounds of fully cooked chicken breasts produced on Jan. 9 and distributed nationwide to retailers. The six-ounce packages are labeled OSCAR MAYER/LOUIS RICH CHICKEN BREAST STRIPS WITH RIB MEAT, GRILLED, FULLY COOKED -- READY TO EAT. Each package has the number "P-19676" inside the USDA inspection mark on front and a use-by-date of "19 Apr 2007" on back.

According to a statement from the U.S. Department of Agriculture, a sample of the meat tested in Georgia was contaminated by Listeria monocytogenes, which can cause listeriosis, a rare but serious infection. Currently there have been no reported cases of illness linked to the recalled chicken. Anyone with questions about the recall should contact Kraft Consumer Response at (800) 871-7117.

The chicken recall follows a string of food recalls including peanut butter due to salmonella as well as baby food and cantaloupe.

Listeria Hysteria at Jamba Juice

FitSugar — Wed, 06 Dec 2006 15:10:50 -0800

Consumers in the U.S. Southwest are being warned that Jamba Juice Co. smoothies containing strawberries may be contaminated with the potentially deadly Listeria monocytogenes bacterium (commonly known just as Listeria), which can cause potentially deadly infections in children, the elderly and other people with weakened immune systems. It is also known to cause still births and miscarriages in pregnant women.

While there have been no reports of illness, the smoothie maker has stopped shipments from the supplier of the contaminated strawberries as well as removed all strawberries supplied by that company.

Produce Cleaners?

FitSugar — Tue, 22 Sep 2009 14:30:00 -0700

At the grocery store, I noticed a bottle of fruit and veggie wash. If you've seen it too, I bet you've wondered if it's necessary to use in order to clean produce effectively?

While it's very important to wash your produce since you don't know how many hands have touched your tomatoes or manhandled your melons, there's no need for a special cleaner. Soaps or washes can leave a residue, and they aren't any better than plain water, so save your money.

Even if your produce is organic, it still needs to be washed since bacteria such as listeria, salmonella, and E. coli can lurk on all fruits and veggies. Wait to wash your fruits and veggies until right before you're about to eat or prepare them. Wash all produce, even the ones that are pre-packaged and say "pre-washed." Wash all parts including rinds and peels you won't eat and stems you throw away since bacteria can be transferred from those parts to the parts you eat. Wash all fruits and veggies under running water and gentle scrub each one with your fingers for 60 seconds. It may take extra time, but it's better than getting sick.

Food poisoning

FitSugar — Wed, 08 Oct 2008 17:35:25 -0700

HEALTH GUIDE REFERENCE FROM A.D.A.M

Food poisoning is the result of eating food contaminated with bacteria or other toxins. Symptoms include diarrhea, vomiting, and stomach cramps, and generally start 4 - 36 hours after eating contaminated food. While many cases are caused by bacteria, some cases can result from eating poisonous plants (some mushrooms, for instance) and animals (pufferfish). Food poisoning is not uncommon, especially during summer when food may not be kept cold enough to prevent bacteria from growing.

Signs and Symptoms

The typical signs of food poisoning are nausea, vomiting, abdominal cramping, and diarrhea. Specific bacteria may cause these signs and symptoms:

Clostridium botulinum (C. botulinum, or botulism): weakness, blurred vision, sensitivity to light, double vision, paralyzed eye nerves, difficulty speaking, trouble swallowing, paralysis that spreads downward, respiratory failure, death
Salmonella spp., Shigella spp., and Campylobacter jejuni (C. jejuni): fever, chills, bloody diarrhea
Escherichia coli (E. coli): hemorrhagic colitis (diarrhea with very little stool and large amounts of blood). E. coli symptoms may appear as long as 3 days after eating contaminated food.
Mushroom poisoning can affect the liver, the neurological system (brain), or the gastrointestinal tract. Symptoms include stomach flu, delirium (confusion), vision difficulties, heart muscle problems, kidney failure, and death of liver tissue. It causes death in about half of the people affected unless treated right away.

Fish poisoning causes nausea, vomiting, diarrhea, abdominal pain, dizziness, and headache. Specific types of fish poisoning can cause other signs and symptoms, such as:

Ciguatera: numbness or tingling around the mouth, feeling of loose teeth, impaired touch sensation of hot as cold and cold as hot, itching, muscle and joint pain, slow heart rate, low blood pressure. Caused by toxins in some fish, including grouper, snapper, mackerel, barracuda.
Pufferfish poisoning: numbness or tingling around the mouth, trouble coordinating movement, difficulty swallowing, excess saliva, twitching, loss of ability to talk, convulsions, paralysis that spreads upward, respiratory failure, death
Shellfish poisoning: numbness or tingling around the mouth or in the arms and legs, trouble swallowing, difficulty speaking. Caused by toxins in algae that are then eaten by shellfish.

What Causes It?

Usually bacteria and algae cause food poisoning. But sometimes poisonous plants and animals are the cause.

Common bacterial toxins include:

E. coli in undercooked hamburger, unpasteurized apple juice or cider, raw milk, contaminated water (or ice), vegetables fertilized by cow manure; can be spread from person to person.
Listeria monocytogenes (L. monocytogenes) in cole slaw, dairy products (mostly soft cheeses from outside the United States), and cold, processed meats
Salmonella spp. in poultry, beef, eggs, or dairy products
Shigella spp. from raw vegetables or cool, moist foods (such as potato and egg salads) that are handled after cooking
Staphylococcus aureus(S. aureus) in salad dressing, ham, eggs, custard-filled pastries, mayonnaise, and potato salad. Usually from the hands of food handlers.
C. jejuni in raw milk and chicken
C. botulinum in improperly home-canned foods. In children under 1 year of age, mostly from honey but also from corn syrup.
Clostridium perfringens(C. perfringens) in meat and poultry dishes and gravies, mostly foods that were cooked more than 24 hours before eating and were not reheated well enough
V. cholerae in bivalve (two-shelled) shellfish (such as mussels, clams, oysters, and scallops), raw shellfish, and crustaceans (such as lobsters, shrimp, and crabs)

Common types of fish poisoning include:

Scombroid poisoning from bacteria in dark-meat fish (tuna, bonito, skipjack, mahi-mahi, mackerel) that are not refrigerated well
Ciguatera poisoning in tropical fish (grouper, surgeonfish, snapper, barracuda, moray eel) that have eaten toxic plankton
Puffer fish poisoning from the organs and flesh of puffer fish
Poisoning from shellfish that feed on certain algae

Mushroom poisoning occurs from eating wild poisonous mushrooms, especially Amanita phalloides.

Who's Most At Risk?

Infants and the elderly are at greater risk for food poisoning. Other risk factors include:

Having a pre-existing medical condition, such as chronic kidney failure or diabetes
Taking antibiotic or antihistamine medicines
Having sickle-cell anemia and other problems with red blood cells
Weakened immune system
Traveling in an area where contamination is more likely

Listeriosis is most common in pregnant women, fetuses, and people with immune problems. When a fetus is infected with listeria, the fetus may be born prematurely or die.

What to Expect at Your Provider's Office

Your health care provider will examine you for signs and symptoms of food poisoning, such as stomach problems, and of dehydration. Your health care provider may also ask about foods you have eaten recently, where you may have traveled, and if you have had contact with people showing similar symptoms. Tests of your vomit, blood, and stool can identify the cause. In the case of botulism, electromyography (a test to measure electric impulses in the muscles) may be done to confirm the diagnosis. A lumbar puncture (spinal tap) may be done to check for signs and symptoms related to central nervous system disorders.

Treatment Options

Prevention

These steps can help prevent food poisoning:

Wash your hands and clean any dishes or utensils when you are making or serving food.
Promptly refrigerate any food you will not be eating right away.
If you take care of young children, wash your hands often and dispose of diapers carefully so that bacteria can't spread to other surfaces or people.
If you make canned food at home, make sure to follow proper canning techniques to prevent botulism.
Don't feed honey to children under 1 year of age.
Don't eat wild mushrooms.
When traveling where contamination is more likely, eat only hot, freshly cooked food. Boil water before drinking. Don't eat raw vegetables or unpeeled fruit.
Always refrigerate fish.
Don't eat tropical fish caught during blooms of poison plankton.
Eat pufferfish only in specially licensed restaurants with chefs trained to cook it.
Don't eat shellfish exposed to red tides.

If others also may have eaten a food that made you sick, let them know. If you think the food was contaminated when you bought it from a store or restaurant, tell the staff and your local health department.

Treatment Plan

Treatment for most cases consists of rehydration -- replacing fluids and electrolytes (such as sodium, potassium, magnesium, and chloride). While experiencing vomiting and diarrhea, the person should avoid solid food but increase clear liquids. In more severe cases, a person may need help either breathing or stopping vomiting. In most cases, health care providers do not prescribe antibiotics because they may prolong diarrhea. If you have eaten certain toxins (such as from mushrooms or shellfish), your health care provider may take steps to clean out your stomach (a process called lavage, or pumping the stomach) and administer activated charcoal, which can help absorb the remaining toxin.

Drug Therapies

Depending on the symptoms and the cause of food poisoning, a health care provider may prescribe drugs, including:

Antibiotics, in certain cases
Antitoxin to neutralize toxins from C. botulinum (only given within the first 72 hours)
Amitriptyline to control the numbness and tingling from ciguatera poisoning
Apomorphine or ipecac syrup to cause vomiting and help rid the body of toxin
Atropine for mushroom poisoning
Diphenhydramine and cimetidine for fish poisoning
Mannitol for nerve-related symptoms of ciguatera poisoning

Complementary and Alternative Therapies

Anyone suffering from severe food poisoning should seek conventional medical treatment. Complementary and alternative therapies are best used to strengthen the body and aid in the prevention of food poisoning. For example, animal studies have shown that certain vitamins and nutrients may be effective in protecting against some food toxins while others may actually worsen the effects of toxins. Milk thistle is an herb commonly used in Europe as a primary treatment for mushroom poisoning. Homeopathy may help in the treatment of diarrhea in children (which is sometimes caused by food poisoning) in developing countries.

Nutrition

The following general nutritional guidelines may be helpful in the case of food poisoning:

Drink plenty of fluids (to prevent dehydration).
Drink barley or rice water (to soothe inflamed stomach or intestine).
Probiotics, such as Lactobacillus acidophilus and Lactobacillus bulgaricus, can help restore the balance of good bacteria in the intestine. If you are traveling to an area where the food and water may be contaminated, in addition to taking the precautions above, taking probiotics both before and during your trip may help maintain intestinal health.
Apple cider vinegar is a traditional remedy that has not been studied scientifically, but may have some antimicrobial properties. Mix 2 tsp. in one cup warm water and drink several times a day.

For specific types of food poisoning:

Alpha-lipoic acid -- Several reports indicate that alpha-lipoic acid, an antioxidant commonly found in broccoli, spinach, and beef, may be helpful in the treatment of Amanita (mushroom) poisoning, especially when combined with milk thistle (Silybum marianum). It is important to receive medical treatment if you suspect mushroom poisoning. Do not try to self-treat.
Vitamin A -- Studies with rats seem to show that vitamin A offered some protection against salmonella. Rats infected with Salmonella appeared to eliminate the bacteria from their bodies faster when pretreated with vitamin A than with placebo, according to one study. They also gained more weight and had a greater immune response than rats given placebo.
Calcium phosphate -- One animal study suggests that rats receiving calcium phosphate supplements may be protected from Salmonella poisoning. Researchers theorize that calcium phosphate helps boost Lactobacillus, the good bacteria found in the intestine, which helps fight off Salmonella.

Supplements to avoid:

Fish oil -- In a study of mice infected with the bacteria Listeria, animals that regularly consumed diets rich in fish oil had significantly more bacteria in their spleens than animals that consumed diets rich in lard or soybean oil. Until researchers can determine what these results mean to humans, people with Listeria infection should avoid foods containing fish oil.

Herbs

Various herbs have been used traditionally to treat different types of food poisoning, though in most cases scientific studies on their effectiveness are lacking.

Milk thistle (Silybum marianum) is often used for liver disorders and is widely used in Europe to treat Amanita mushroom poisoning. Studies have shown that patients with Amanita poisoning can be effectively treated with silibinin (the primary active component of milk thistle) up to 48 hours after eating the deadly mushrooms.

Animal studies of Chinese and Japanese combination herbal remedies used for Listeria suggest they may be effective for food poisoning. A few of the active ingredients include:

Asian ginseng (Panax ginseng)
Astragalus root (Astragalus membranaceus)
Chinese cinnamon bark (Cinnamomum aromaticum)
Ginger root (Zingiber officinale)
Licorice ( Glycyrrhiza glabra)
Peony root (Paeonia officinalis)
Skullcap (Scutellaria lateriflora)

Seek the advice of a trained and licensed herbalist or practitioner of Traditional Chinese Medicine who will guide your individual treatment. Do not self-treat with these herbs. Some of these herbs should not be taken if you have heart disease or high blood pressure or take blood-thinning medication. In addition, some of these herbs interact with other herbs, supplements, and prescription medications, so it is important to make sure all your health care providers know what you are taking.

Laboratory (test tube) studies suggest that the following herbs have antibacterial or antimicrobial properties, although there is no evidence they are effective for treating food poisoning in humans.

Bittervine (Mikania micrantha)
Goldenseal (Hydrastis canadensis)
Oregon grape (Mahonia aquifolium)
Chamomile (Matricaria recutita)

Barberry (Berberis vulgaris) has also been used traditionally to treat diarrhea from infectious causes such as E. coli and V. cholera.

Homeopathy

No studies have examined the effectiveness of homeopathic remedies for food poisoning. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and intellectual makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for a particular individual. Below are some more common remedies for food poisoning or diarrhea.

Arsenicum album -- for foul-smelling diarrhea from food poisoning or traveler's diarrhea with burning sensation in the abdomen and around the anus. This remedy is most appropriate for individuals who feel exhausted yet restless and whose symptoms tend to worsen in the cold and improve with warmth. Vomiting may also occur. Arsenicum may also be used to prevent diarrhea when traveling.
Chamomilla -- for greenish, frothy stool that smells like rotten eggs. Used primarily for children, especially those who are irritable, argumentative, and difficult to console.
Calcarea carbonica -- for children who fear being in the dark or alone and who perspire heavily while sleeping. Sools have a sour odor.
Podophyllum -- for explosive, gushing, painless diarrhea that becomes worse after eating or drinking. Exhaustion often follows bowel movements, and the individual for whom this remedy is appropriate may experience painful cramps in lower extremities.
Sulphur -- for irritable and weepy children. May have a red ring around the anus and diarrhea with the odor of rotten eggs.

Prognosis/Possible Complications

Most cases of food poisoning are mild and clear up on their own. However, with mushroom poisoning, up to half of people may die. With botulism, less than 10% die. Some people may need help breathing for months afterwards. More than half of poisonings from pufferfish are fatal. Death is rare in other fish poisonings, but nerve-related symptoms can continue for months.

The following are some possible after-effects of food poisoning:

After shigellosis, white blood cell problems and kidney problems
After E. coli infection, kidney problems and bleeding problems
After botulism, long hospital stays (1 - 10 months) with fatigue and difficulty breathing for 1- 2 years or respiratory failure
After salmonellosis, Reiter syndrome (an arthritis-like disease) and inflammation of the heart lining
After campylobacteriosis, Guillain-Barré syndrome (a nerve disease)

Following Up

For a severe case of food poisoning, you may need to stay in the hospital to receive fluids and electrolytes, and so health care providers can monitor your breathing. Doctors may need to intubate (insert a tube down the throat) or connect you to a machine to help with breathing. Dialysis may be required. Cathartics (substances that help the body remove waste), enemas, and lavage may help eliminate toxins.

Supporting Research

Beers MH, Porter RS, et al. The Merck Manual of Diagnosis and Therapy. 18th ed. Whitehouse Station, NJ: Merck Research Laboratories; 2006:1642-1644.

Blumenthal M, Goldberg A, Brinckmann J, eds. Herbal Medicine: Expanded Commission E Monographs. Boston, Mass: Integrative Medicine Communications; 2000:257.

Bovee-Oudenhoven IM, Wissink ML, Wouters JT, Van der Meer R. Dietary calcium phosphate stimulates intestinal lactobacilli and decreases the severity of a salmonella infection in rats. J Nutr. 1999;129:607-612.

Duncan SH, Flint HJ, Stewart CS. Inhibitory activity of gut bacteria against Escherichiacoli 0157 mediated by dietary plant metabolites. FEMS Microbiol Lett. 1998;164:238-288.

Facey PC, Pascoe KO, Porter RB, Jones AD. Investigation of plants used in Jamaican folk medicine for anti-bacterial activity. J Pharm Pharmacol. 1999;51:1455-1460.

Fauci AS, Braunwald E, Isselbacher KJ, et al., eds. Harrison's Principles of InternalMedicine. 14th ed. Vol. 1. New York, NY: McGraw-Hill; 1998:796-801, 876-880, 904-905.

Fritsche KL, Shahbazian LM, Feng C, Berg JN. Dietary fish oil reduces survival and impairs bacterial clearance in C3H/Hen mice challenged with Listeria monocytogenes. Clin Sci. 1997;92:95-101.

Gabriel EP, Lindquist BL, Abud RL, Merrick JM, Lebenthal E. Effect of vitamin A deficiency on the adherence of fimbriated and nonfimbriated Salmonella typhimurium to isolated small intestinal enterocytes. J Ped Gastroenterol Nutr. 1990;10:530-535.

Hatchigian EA, Santon JE, Broitman SA, Vitale JJ. Vitamin A supplementation improves macrophage function and bacterial clearance during experimental Salmonella infection. PSEBM. 1989;191:47-54.

Hruby K, Csomos G, Fuhrmann M, Thaler H. Chemotherapy of Amanita phalloides poisoning with intravenous silibinin. Hum Exp Toxicol. 1983;2(2):183-195.

Irons R, Anderson MJ, Zhang M, Fritsche KL. Dietary fish oil impairs primary host resistance against Listeria monocytogenes more than the immunological memory response. J. Nutr. 2003 Apr;133:1163-1169.

Jacobs J, Jiménez M, Malthouse S, Chapman E, Crothers D, Masuk M, Jonas WB. Homeopathic treatment of acute childhood diarrhea: results from a clinical trial in Nepal. J Altern Complement Med. 2000;6(2):131-139.

Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New York, NY: Warner Books; 1996: 218-220.

Murray PR, et al. Manual of Clinical Microbiology. 7th ed. Washington, DC: ASM Press; 1999:356-359.

Rabbani GH, Butler T, Knight J, Sanyal SC, Alam K. Randomized controlled trial of berberine sulfate therapy for diarrhea due to enterotoxigenic Escherichia coli and Vibrio cholerae. J Infect Dis. 1987 May;155(5):979-984.

Rosen P, et al. Emergency Medicine: Concepts and ClinicalPractice. 4th ed. Vol. 3. St. Louis, Mo: Mosby; 1998:1931-1938, 2513-2516, 2178-2179.

Sabeel AI, Kurkus J, Lindholm T. Intensive hemodialysis and hemoperfusion treatment of Amanita mushroom poisoning. Mycopathologia. 1995;131(2):107-114.

Ullman D. Homeopathic Medicine for Children and Infants. New York, NY: Penguin Putnam; 1992: 75-77.

Ullman D. The Consumer's Guide to Homeopathy. New York, NY: Penguin Putnam; 1995: 243-245.

Verma RJ, Shalini M. Ochratoxin A-induced cytotoxicity to human red blood cells and its prevention by certain vitamins. Med Sci Res. 1997;25(12):833-834.

Yonekura K, Kawakita T, Mitsuyama M, Miura O, Yumioka E, Suzuki A, Nomoto K. Induction of colony-stimulating factor(s) after administration of a traditional Chinese medicine, xiao-chai-hu-tang (Japanese name: shosaiko-to). Immunopharmacol Immunotoxicol. 1990;12(4):647-667.

Yonekura K, Kawakita T, Saito Y, Suzuki A, Nomoto K. Augmentation of host resistance to Listeria monocytogenes infection by a traditional Chinese medicine, ren-shen-yang-rong-tang (Japanese name: ninjin-youei-to). Immunopharmacol Immunotoxicol. 1992;14(1-2):165-190.

Review Date:
12/17/2006
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

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Meningitis

FitSugar — Wed, 08 Oct 2008 17:35:11 -0700

Overview

Signs and Symptoms
What Causes It?
Who's Most At Risk?
What to Expect at Your Provider's Office
Treatment Options
Prognosis/Possible Complications
Following Up
Special Considerations
Supporting Research

HEALTH GUIDE REFERENCE FROM A.D.A.M

Meningitis results from the inflammation of the meninges (the thin membranes surrounding the brain and spinal cord). It is usually caused by a viral or bacterial infection. Most cases of meningitis are viral, but it can be hard to tell the difference without medical tests. It is extremely important to determine the type of infection (and bacteria), because bacterial meningitis tends to be much more serious and requires emergency treatment. Viral meningitis usually clears up on its own and does not cause any permanent harm. Bacterial meningitis can cause brain damage, learning disabilities, hearing loss, or even death without treatment for the specific type of bacteria. Meningitis can also be caused by fungal infections (cryptococcus), but that is rare.

Signs and Symptoms

Early symptoms of meningitis can easily be mistaken for the flu.

In newborns, signs and symptoms include the following:

Irritability
High-pitched cry
Poor feeding
Vomiting
Fever
Seizures
Bulging fontanelle ("soft spot" in the skull) or stiff neck (less common)

In children and young adults, signs and symptoms include the following:

High fever
Severe headache
Vomiting or nausea
Stiff neck
Sensitivity to light
Drowsiness
Skin rash (in cases of meningococcal meningitis -- see section titled What Causes It?)
Confusion
Seizures
Clouding or loss of consciousness

Older adults may have no signs or symptoms other than altered mental state and lethargy. Often they have no fever.

What Causes It?

Bacterial meningitis is not as common as viral meningitis, but it is more serious. Several types of bacteria can cause meningitis. Knowing the right type is crucial for proper treatment:

Neisseria meningitidis causes meningococcal meningitis, a common form of meningitis in children and young adults, and the only type that occurs in outbreaks. It is highly contagious.
Haemophilus influenzae was the most common cause in infants and children under 6 years old before 1986, when a vaccine (HiB) was introduced. The vaccine has mostly eradicated this kind of meningitis in countries where it is given to infants.
Streptococcus pneumonia is the most common cause of bacterial meningitis in children. It may occur along with an ear or sinus infection or pneumonia.
Listeria monocytogenes is a common form of bacteria that can be found all around us. It does not tend to infect most people, but the very young and very old, as well as pregnant women, can be at risk.
Staphylococcus aureus may be seen following a head injury or brain surgery.

Viral meningitis can be caused by several types of viruses, but by far the most common are enteroviruses (which cause stomach flu and multiply in the intestinal tract). Other viruses that can cause meningitis include:

Arboviruses -- carried by arthropods, such as ticks or mosquitoes
Mumps virus -- seen in children between age 5 - 9 who have not had the MMR vaccine
Herpesviruses
Human immunodeficiency virus (HIV) -- meningitis may be the first sign a person is infected with HIV.

Who's Most At Risk?

These conditions and characteristics increase the risk for bacterial meningitis:

Living in a crowded setting, such as a dormitory or child-care facility (for meningococcal meningitis)
Age -- children, young people and older adults are more likely to develop meningitis.
Significant head injury, skull trauma, or cerebrospinal rhinorrhea (flow of cerebrospinal fluid from the nose after a head injury)
A suppressed immune system (for pneumococcal meningitis)
Never receiving the HiB vaccine (see section titled What Causes It?)
Doing laboratory work that requires handling rats, hamsters, and mice; or working with animals on a farm or ranch (for listeria)

What to Expect at Your Provider's Office

If you or your child has symptoms of meningitis, seek emergency treatment. Early diagnosis is the key to treating meningitis successfully. Doctors will ask for a detailed medical history and may order a lumbar puncture (spinal tap). In this test, doctors remove cerebrospinal fluid from the spine through a needle so that the fluid can be tested for infection and to identify the kind of bacteria responsible. If your doctor suspects bacterial meningitis, your doctor may start you on antibiotics right away, even before the test results are available.

Treatment Options

Prevention

Children should be vaccinated against H. influenzae and mumps. People over 65 and those whose immune systems are compromised should receive a pneumococcal vaccine (PPV). A meningococcal vaccine may be given to control epidemics in dormitories, for example. Because meningitis is usually contagious, practicing good hygiene, such as washing your hands frequently -- and teaching children to do the same -- can reduce your risk of catching the disease.

Drug Therapies

The length and type of treatment varies depending on the kind of meningitis being treated, ranging from one to three weeks. The treatment for most cases of viral meningitis is aimed at reducing symptoms of fever and aches; sometimes acyclovir, an antiviral drug, may be given. If bacterial meningitis is suspected, antibiotics must be started immediately, even before results from lab tests have been returned. Some of the medications used for bacterial meningitis are:

Antibiotics, often in combination, including ampicillin, cephalosporins, gentamicin, vancomycin, or trimethoprim-sulfamethoxazole
Corticosteroids to reduce inflammation
Diazepam or phenytoin if seizures occur
Rifampin is given to family members to reduce their risk of contracting the disease.

Complementary and Alternative Therapies

Bacterial meningitis must be treated with conventional medical therapies, especially antibiotics. Because it is usually impossible to distinguish between bacterial and viral meningitis without lab tests, you should always seek conventional medical care for symptoms of meningitis. Complementary and alternative therapies should be used only with conventional treatment, not in place of it, and only with the guidance of a qualified health professional. Some supplements and herbs may help strengthen the immune system, and homeopathic remedies may help relieve symptoms that accompany meningitis.

Nutrition and Supplements

Several nutrients can help strengthen the immune system, possibly helping to prevent meningitis or to build up the immune system after meningitis has been treated, though scientific studies have not examined these nutrients specifically for meningitis. Talk to your doctor before taking any supplements, and never treat a child without talking to your doctor first.

Vitamin A (up to 10,000 IU per day for adults)
B complex vitamins (dose varies)
Vitamin C (1,000 mg two to six times per day for adults. Lower dose if diarrhea develops.)
Quercetin (400 - 500 mg per day), an antioxidant found in plants
Omega-3 essential fatty acids (found in fish oil, 1 - 2 g per day)

Herbs

Some herbs may help support your immune system, although there is no evidence they can prevent or treat meningitis. Meningitis is a medical emergency and should never be treated with herbs alone.

American ginseng (Panax quincefolius, 100 - 300 mg two times per day) -- may have anti-inflammatory and antibacterial effects. Ginseng interacts with several medications and other herbs, so talk to your doctor before taking it. Do not take ginseng if you take blood-thinning medication, have diabetes, high blood pressure, or heart disease.
Astragalus (Astragalus membranaceus, 4 - 7 g per day) --preliminary test tube studies suggest astragalus may stimulate the immune system. It is often taken as a tea -- steep 1 tsp. root in one cup boiling water, strain, and cool. Drink three or four times per day. Do not take astragalus if you have diabetes or high blood pressure, or if you take blood-thinning medication or diuretics (water pills).
Garlic (Allium sativum, 600 - 1,200 mg per day in two or three divided doses) -- has antibacterial properties and can help support the immune system. In laboratory tests, it has also been shown to stop the growth of and even kill the fungus Cryptococcal neoformans. A small study of five people with cryptococcal meningitis suggested that it may be effective in people, but more research is needed. Do not take garlic is you take blood-thinning medication.
Echinacea (Echinacea purpurea, 200 mg two times per day) -- is traditionally used for immune system support. In animal studies, echinacea significantly reduced the amount of bacteria and increased survival rate for those infected with L. monocytogenes. It's not clear whether the same would be true in humans.
Elderberry (Sambucus nigra) -- has antiviral properties. It is usually taken as either tincture (alcohol extract) or glycerite (glycerin extract). Doses vary with different preparations, so consult your health care provider to establish a dose that's right for you.

Homeopathy

Although few studies have examined the effectiveness of specific homeopathic therapies, professional homeopaths may consider the following remedies to help alleviate symptoms of meningitis, in addition to standard medical care. Before prescribing a remedy, homeopaths take into account a person's constitutional type -- your physical, emotional, and psychological makeup. An experienced homeopath assesses all of these factors when determining the most appropriate remedy for each individual.

Apis mellifica --for meningitis in children with such intense head pain that they bore their heads into a pillow
Arnica montana --for meningitis following surgery or an injury to the head. This remedy is most appropriate for individuals who often insist that there is nothing wrong with them.
Belladonna --for a sudden onset of high fever which accompanies meningitis. This remedy is most appropriate for individuals who are hot and flushed with wide pupils, and may have nightmares and delusions.
Bryonia --for meningitis with impaired consciousness and a characteristic movement of the mouth in which the jaw moves side to side quite rapidly in a somewhat contorted manner
Helleborus --for meningitis with impaired consciousness and stupor. Individual may also be anguished and pleading for help. Shaking or rolling of the head may also occur.
Hyoscyamus -- for meningitis with violent spasms that occur with shrieking and grinding of the teeth

These treatments must not be used for meningitis without direction and supervision by an appropriately trained and certified homeopathic doctor.

Prognosis/Possible Complications

About 25 - 30% of people with bacterial meningitis die from it. Sixty percent of infants who survive bacterial meningitis have brain damage, hearing problems, or developmental difficulties. Most people who get viral meningitis recover completely without any problems.

Complications of meningitis may include hearing loss, seizures, cerebral edema (brain swelling), weakness on one side of the body, speech problems, visual impairment or blindness, difficulty coordinating movements, trouble breathing, respiratory arrest, and recurring meningitis.

Following Up

For the first 1 - 2 days, patients should be monitored in the intensive care unit to be sure that the medication is working, to watch for any seizures, and to watch for breathing difficulties. If signs and symptoms do not improve after 1 - 2 days, health care providers should check the cerebrospinal fluid again.

Special Considerations

Pregnant women often carry L. monocytogenes and S. agalactiae without having symptoms and may pass these infections to their children during birth. Pregnant women should not take rifampin to prevent meningitis because it is not clear whether this drug may harm the fetus.

Supporting Research

Andes DR, Craig WA. Pharmacokinetics and pharmacodynamics of antibiotics in meningitis. Infect Dis Clin North Am. 1999;13(3):595-618.

Ashwal S, Perkin RM, Thompson JR, Schneider S, Tomasi LG. Bacterial meningitis in children: current concepts of neurologic management. Curr Prob Pediatr. 1994;24(8)267-284.

Ashwal S, Tomasi L, Schneider S, Perkin R, Thompson J. Bacterial meningitis in children: pathophysiology and treatment. Neurology. 1992;42(4):739-748.

Chowdhury S, Kumar R, Ganguly NK, Kumar L, Walia BN. Effect of vitamin A supplementation on childhood morbidity and mortality. Indian J Med Sci. 2002 Jun;56(6):259-64.

Coyle PK. Overview of acute and chronic meningitis. Neurol Clin. 1999;17(4):691-710.

Davis LE, Shen J, Royer RE. In vitro synergism of concentrated Alliumsativum extract and amphotericin B against Cryptococcus neoformans. Planta Med. 1994;60(6):546-549.

Davis LE, Shen JK, Cai Y. Antifungal activity in human cerebrospinal fluid and plasma after intravenous administration of Allium sativum. Antimicrob Agents Chemother. 1990:34(4)651-653.

Destro RL, Sharma V. An appraisal of vitamin C in adjunct therapy of bacterial and "viral" meningitis. Clin Pediatr. 1977;16(10):936-939.

Gold R. Epidemiology of bacterial meningitis. Infect Dis Clin North Am. 1999;13(3): 515-525.

Harborne, J. B., and C. A. Williams. Advances in flavonoid research since 1992. Phytochemistry. 2000;55: 481-504.

Hasbun R, Aronin SI, Quagliarello VJ. Treatment of bacterial meningitis. Compr Ther. 1999;25(2):73-81.

Hernandez M, Mejia GI, Trujillo H, Robledo J. Effectiveness of the antibiotics chloramphenicol and rifampin in the treatment of Streptococcus pneumoniae-induced meningitis and systemic infections. Biomedica. 2003 Dec;23(4):456-61.

Jonas WB, Jacobs J. Healing with Homeopathy: The Doctors' Guide. New York, NY: Warner Books; 1996: 168.

Kaplan SL. Clinical presentations, diagnosis, and prognostic factors of bacterial meningitis. Infect Dis Clin North Am. 1999;13(3):579-594.

Klugman KP, Madhi SA. Emergence of drug resistance. Impact on bacterial meningitis. Infect Dis Clin North Am. 1999;13(3):637-646.

Lauritsen A, Oberg B. Adjunctive corticosteroid therapy in bacterial meningitis. ScandJ Infect Dis 1995;27(5):431-434.

LeFrock JL. Acute bacterial meningitis. In: Conn RB, Borer WZ, Snyder JW, eds. Current Diagnosis 9. Philadelphia, Pa: W.B. Saunders Company; 1997:821-825.

Peltola H. Prophylaxis of bacterial meningitis. Infect Dis Clin North Am. 1999;13(3):685-710.

Pfister HW, Scheld WM. Brain injury in bacterial meningitis: therapeutic implications. Curr Opin Neurol. 1997;10(3):254-259.

Pong A, Bradley JS. Bacterial meningitis and the newborn infant. Infect Dis Clin North Am. 1999;13(3):711-733.

Quagliarello VJ, Scheld WM. Treatment of bacterial meningitis. N Engl J Med. 1997;336(10):708-716.

Rockowitz J, Tunkel AR. Bacterial meningitis. Practical guidelines for management. Drugs. 1995;50(5):838-853.

Roesler J, Steinmuller C, Kiderlen A, Emmendorffer A, Wagner H, Lohmann-Matthes ML. Application of purified polysaccharides from cell cultures of the plant Echinaceapurpurea to mice mediates protection against systemic infections with Listeria monocytogenes and Candida albicans. Int J Immunopharmacol. 1991;13(1):27-37.

Rosen P, et al. Emergency Medicine: Concepts and Clinical Practice. Vol 3. 4th ed. St. Louis, Mo: Mosby; 1998:2198-2209.

Saez-Llorens X, McCracken GH Jr. Antimicrobial and anti-inflammatory treatment of bacterial meningitis. Infect Dis Clin North Am. 1999;13(3):619-636.

Schaad UB, Kaplan SL, McCracken GH Jr. Steroid therapy for bacterial meningitis. ClinInfect Dis. 1995;20(3):685-690.

Scheld WM. Bacterial meningitis. In: Conn RB, et al, eds. Conn's Current Therapy. Philadelphia, Pa: W.B. Saunders Company; 1999:102-108.

Sormunen P, Kallio MJ, Kilpi T, Peltola H. C-reactive protein is useful in distinguishing Gram stain-negative bacterial meningitis from viral meningitis in children. J Pediatr. 1999;134(6):725-729.

Spach DH, Jackson LA. Bacterial meningitis. Neurol Clin. 1999;17(4):711-735.

Steinmuller C, Roesler J, Grottrup E, Franke G, Wagner H, Lohmann-Matthes ML. Polysaccharides isolated from plant cell cultures of Echinaceapurpurea enhance the resistance of immunosuppressed mice against systemic infections with Candidaalbicans and Listeria monocytogenes. Int J Immunopharmacol. 1993;15(5):605-614.

Swartz MN. Bacterial meningitis. In: Cecil Textbook of Internal Medicine. Vol. 2. 21st ed. Philadelphia, Pa: W.B. Saunders Company; 2000:1645-1654.

Yonekura K, Kawakita T, Mitsuyama M, et al. Induction of colony-stimulating factor(s) after administration of a traditional Chinese medicine, Xiao-chai-hu-tang (Japanese name: Shosaiko-to). Immunopharmacol Immunotoxicol. 1990;12(4):647-667.

Yonekura K, Kawakita T, Saito Y, Suzuki A, Nomoto K. Augmentation of host resistance to Listeria monocytogenes infection by a traditional Chinese medicine, Ren-shen-yang-rong-tang (Japanese name: Ninjin-youei-to). Immunopharmacol Immunotoxicol. 1992;14(1-2):165-190.

Review Date:
12/17/2006
Reviewed By:
Steven D. Ehrlich, N.M.D., private practice specializing in complementary and alternative medicine, Phoenix, AZ. Review provided by VeriMed Healthcare Network.

A.D.A.M. Copyright

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Listeriosis

admin — Wed, 03 Sep 2008 17:56:08 -0700

Overview

Definition
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention
References

Illustrations

Antibodies

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Listeriosis is a dangerous infection caused by eating food that's contaminated with a bacteria called Listeria monocytogenes (L. monocytogenes).

Causes, incidence, and risk factors

According to the U.S. Centers for Disease Control and Prevention, listeriosis is an important public health problem in the United States.

The bacteria (L. monocytogenes) that causes this disease is common in wild animals, domesticated animals, and in soil and water. The bacteria makes many animals sick and commonly leads to miscarriage and stillbirth in domestic animals.

Vegetables, meats, and other foods you eat can get infected with the bacteria if they come in contact with contaminated soil or manure. Raw milk or products made from raw milk may carry the bacteria.

If you eat the contaminated products, you may get sick. Pregnant women, developing fetuses, newborns, and adults with weakened immune systems are at increased risk. The bacteria most often causes a generalized blood infection (septicemia) or inflammation of the covering of the brain (meningitis).

Infection of a pregnant woman early in pregnancy generally leads to miscarriage. The bacteria may cross the placenta and infect the developing baby. Infections in late pregnancy may lead to stillbirth or death of the infant within a few hours of birth. About half of infants infected at or near term will die.

Symptoms

In infants, symptoms of listeriosis may be seen in the first few days of life and may include:

Loss of appetite
Lethargy
Jaundice
Vomiting
Respiratory distress (usually pneumonia)
Shock
Skin rash
Increased pressure inside the skull (due to meningitis) possibly causing suture separation

Late-appearing infection in the infant (symptoms appear age 5 days or older) and infection in children is often seen as meningitis.

In adults, the disease may take many forms depending on what organ or organ systems are infected. It may occur as meningitis, pneumonia, septicemia, and endocarditis, or in milder form as abscesses, skin lesion, and conjunctivitis.

If a pregnant woman becomes infected, it can lead to:

Stillbirth
Death of a newborn within a few hours of birth

Signs and tests

Laboratory tests may be done to detect the bacteria in amniotic fluid, blood, and urine. A CSF culture may be performed.

Note: There are no special clinical signs to tell the difference between menigitis caused by listeria from other types of meningitis.

Treatment

Antibiotics are prescribed to kill the bacteria that is causing the infection.

Expectations (prognosis)

Listeriosis in a fetus or infant results in a poor outcome with a high death rate. Healthy older children and adults have a lower death rate.

Complications

Infants who survive listeriosis may have long-term neurological damage and delayed development.

Calling your health care provider

Call your health care provider if signs or symptoms of Listeriosis develop in you or your child.

Prevention

Pregnant women should avoid contact with wild and domestic animals. Listeria is well controlled in American food products, but food-associated outbreaks have occurred.

Pregnant women should avoid consumption of soft cheeses, deli meats, and cold salads from salad bars. Foreign food products such as nonpasteurized soft cheeses have also been implicated in outbreaks of listeriosis. Food should always be adequately cooked.

References

Mead P, Slutsker L, Dietz V, et al. Food-Related Illness and Death in the United States. Emerg Infect Dis. 1998; 5(5):607-625.

Tappero J, Schuchat A, Deaver K, Mascola L, Wenger J, for the Listeriosis Study Group. Reduction in the incidence of human listeriosis in the United States: Effectiveness of prevention efforts? JAMA. 1995; 273(14):1118-1122.

Review Date: 8/16/2007

Reviewed By: Arnold L. Lentnek, MD, Division of Infectious Disease, Kennestone Hospital, Marietta, GA. Review provided by VeriMed Healthcare Network.

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Neonatal sepsis

admin — Thu, 04 Sep 2008 19:21:14 -0700

Overview

Definition
Alternative Names
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention
References

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Neonatal sepsis is a blood infection that occurs in an infant younger than 90 days old. Early-onset sepsis is seen in the first week of life. Late-onset sepsis occurs between days 8 and 89.

Alternative Names

Sepsis neonatorum; Neonatal septicemia

Causes, incidence, and risk factors

A number of different bacteria, including E.coli, Listeria, and certain strains of Streptococcus, may cause neonatal sepsis.

Early-onset neonatal sepsis most often appears within 24 hours of birth. The baby gets the infection from the mother before or during delivery. The following increases an infant's risk of early-onset sepsis:

Group B Streptococcus infection during pregnancy
Preterm delivery
Rupture of membranes (placenta tissue) that lasts longer than 24 hours
Infection of the placenta tissues and amniotic fluid (chorioamnionitis)
Frequent vaginal examinations during labor

Babies with late-onset neonatal sepsis get infected after delivery. The following increase an infant's risk of sepsis after delivery:

Contaminated hospital equipment
Exposure to medicines that lead to antibiotic resistance
Having a catheter in a blood vessel for a long time
Staying in the hospital for an extended period of time

Symptoms

Infants with neonatal sepsis may have the following symptoms:

Body temperature changes
Breathing problems
Diarrhea
Low blood sugar
Reduced movements
Reduced sucking
Seizures
Slow heart rate
Swollen belly area
Vomiting
Yellow skin and whites of the eyes (jaundice)

Signs and tests

Laboratory tests can help diagnose neonatal sepsis and identify the bacteria that is causing the infection. Blood tests may include:

Blood culture
C-reactive protein
White blood cell count

If a bacterial infection is strongly suspected, other tests may include lumbar puncture, urine tests, and chest x-rays.

Treatment

Antibiotics are given to kill the bacteria. If the baby is septic and gravely ill, intravenous immune globulin may be given.

Because early treatment is so valuable, often doctors will ordering lab tests and start treatment before the results are even back. This practice has saved many lives.

Expectations (prognosis)

With prompt treatment, many babies with these bacterial infections will recover completely with no remaining problems. Nevertheless, neonatal sepsis is a leading cause of infant death. The more quickly an infant receives treatment, the better the outcome.

Complications

Disability
Death

Calling your health care provider

Seek immediate medical help if your infant shows symptoms of neonatal sepsis.

Prevention

Preventative antibiotics may be given to pregnant women who have a Group B Streptococcus infection or who have previously given birth to an infant with sepsis due to the bacteria.

Preventing and treating infections in mothers, providing a clean birth environment, and delivering the baby within 24 hours of rupture of membranes, where possible, can all help lower the chance of neonatal sepsis.

References

Mandell GL, Bennett JE, Dolin R. Principles and Practice of Infectious Diseases. 6th ed. London: Churchill Livingstone; 2005.

Schrag S, Gorwitz R, Fultz-Butts K, Schuchat A. Prevention of perinatal group B streptococcal disease. Morbidity and Mortality Weekly Report. 51(RR-11): 1–22, 2002.

Schrag S. Prevention of neonatal sepsis. Clin Perinatol. Sept 2005; 32(3): 601-15.

Review Date: 8/20/2007

Reviewed By: Alan Greene, MD, FAAP, Department of Pediatrics, Stanford University School of Medicine, Lucile Packard Children's Hospital; Chief Medical Officer, A.D.A.M., Inc. Also reviewed by Deirdre O’Reilly, M.D., M.P.H., Neonatologist, Division of Newborn Medicine, Children’s Hospital Boston and Instructor in Pediatrics, Harvard Medical School, Boston, Massachusetts.

A.D.A.M. Copyright

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Source Doc: 1_007303

Food poisoning

admin — Thu, 04 Sep 2008 18:48:57 -0700

Overview

Definition
Causes, incidence, and risk factors
Symptoms
Signs and tests
Treatment
Expectations (prognosis)
Complications
Calling your health care provider
Prevention
References

Illustrations

Food poisoning

Antibodies

HEALTH GUIDE REFERENCE FROM A.D.A.M

Definition

Food poisoning is the result of eating organisms or toxins in contaminated food. Most cases of food poisoning are from common bacteria such as Staphylococcus or E. coli.

Causes, incidence, and risk factors

Food poisoning can affect one person or it can occur as an outbreak in a group of people who all ate the same contaminated food.

Food poisoning tends to occur at picnics, school cafeterias, and large social functions. In these cases, food may be left out of the refrigerator too long or food preparation techniques may not be clean. Food poisoning often occurs from eating undercooked meats, dairy products, or food containing mayonaise (like coleslaw or potato salad) that have sat out too long.

Food poisoning can be caused by:

Bacillus cereus
Botulism
Campylobacter
Cholera
E. coli enteritis
Fish poisoning
Listeria
Mushroom poisoning
Staph aureus
Salmonella
Shigella
Yersinia

Botulism is a very serious form of food poisoning that can be fatal. It can come from improper home canning.

Infants and elderly people have the greatest risk for food poisoning. You are also at higher risk if:

You have a serious medical condition, such as kidney disease or diabetes
You have a weakened immune system
You travel outside of the U.S. to areas where there is more exposure to organisms that cause food poisoning

Pregnant and breastfeeding women have to be especially careful.

Symptoms

The symptoms from the most common types of food poisoning generally start within 2 - 6 hours of eating the food. That time may be longer (even a number of days) or shorter, depending on the cause of the food poisoning.

Possible symptoms include:

Abdominal cramps
Diarrhea (may be bloody)
Fever and chills
Headache
Nausea and vomiting
Weakness (may be serious and lead to respiratory arrest, as in the case of botulism)

Signs and tests

Your health care provider will examine you for signs of food poisoning, such as stomach problems and dehydration. Your provider will also ask about foods you have eaten recently.

Tests to find the cause may be done on your:

Blood
Leftover food
Stool
Vomit

Even if you have food poisoning, however, these tests may not be able to prove it.

In rare but possibly serious cases, your doctor may order one or more of the following procedures:

A thin, tube-like tool placed in the anus to look for the source of bleeding or infection (sigmoidoscopy)
A test to measure electric impulses in the muscles (electromyography) to check for botulism
A test of fluid from the spine (lumbar puncture) if you have signs of a nervous system disorder

Treatment

You will usually recover from the most common types of food poisoning within a couple of days. The goal is to make you feel better and avoid dehydration.

Don't eat solid foods until the diarrhea has passed, and avoid dairy products, which can worsen diarrhea.
Drink any fluid (except milk or caffeinated beverages) to replace fluids lost by diarrhea and vomiting.
Give children an electrolyte sold in drugstores.

If you have diarrhea and are unable to drink fluids (for example, due to nausea or vomiting), you may need medical attention and intravenous fluids. This is especially true for young children.

If you take diuretics, you need to manage diarrhea carefully. Talk to your doctor -- you may need to stop taking the diuretic while you have the diarrhea. NEVER stop or change medications without talking to your doctor and getting specific instructions.

For the most common causes of food poisoning, your doctor would NOT prescribe antibiotics. Antibiotics can make diarrhea last longer and keep the organism that caused the poisoning in your body longer.

If you have eaten toxins from mushrooms or shellfish, you will need medical attention right away. The emergency room doctor will take steps to empty out your stomach and remove the toxin.

Expectations (prognosis)

Most people fully recover from the most common types of food poisoning within 12 - 48 hours. Serious complications can arise, however, from certain types of food poisoning.

Complications

Dehydration is the most common complication. This can occur from any of the causes of food poisoning.

Less common but much more serious complications include:

Arthritis (Yersinia and Salmonella)
Bleeding disorders (E. coli and others)
Death (from mushrooms, certain fish poisonings, or botulism)
Kidney problems (Shigella, E. coli)
Nervous system disorders (Botulism, Campylobacter)
Pericarditis (Salmonella)
Respiratory distress, including the need for support on a breathing machine (botulism)

Calling your health care provider

Call your doctor if:

Diarrhea lasts for more than 2 - 3 days.
There is blood in your stools.
You are on diuretics and have diarrhea, nausea, or vomiting.
You have diarrhea and are unable to drink fluids due to nausea or vomiting.
You have a fever over 101°F.

Call 911 if:

Bleeding is excessive or your stools are maroon or black.
You are short of breath or having trouble breathing.
You have any nervous system symptoms such as weakness, double vision, difficulty speaking, or paralysis.
You have signs of dehydration (thirsty, dizzy, lightheaded, faint).
You have trouble swallowing.
You may have poisoning from mushrooms, fish, or botulism.
Your heart is racing, pounding, or skipping.

Prevention

To prevent food poisoning, take the following steps when preparing food:

Carefully wash your hands and clean dishes and utensils.
Use a thermometer when cooking. Cook beef to at least 160°F, poultry to at least 180°F, and fish to at least 140°F.
DO NOT place cooked meat or fish back onto the same plate or container that held the raw meat, unless the container has been completely washed.
Promptly refrigerate any food you will not be eating. Keep the refrigerator set to around 40°F and your freezer at or below 0°F. DO NOT eat meat, poultry, or fish that has been refrigerated uncooked for longer than 1 to 2 days.
DO NOT use outdated foods, packaged food with a broken seal, or cans that are bulging or have a dent.
DO NOT use foods that have an unusual odor or a spoiled taste.

Other steps to take:

If you take care of young children, wash your hands often and dispose of diapers carefully so that bacteria can't spread to other surfaces or people.
If you make canned food at home, be sure to follow proper canning techniques to prevent botulism.
DO NOT feed honey to children under 1 year of age.
DO NOT eat wild mushrooms.
When traveling where contamination is more likely, eat only hot, freshly cooked food. Drink water only if it's been boiled. DO NOT eat raw vegetables or unpeeled fruit.
DO NOT eat shellfish that has been exposed to red tides.
If you are pregnant or have a weakened immune system, DO NOT eat soft cheeses, especially imported from countries outside the U.S.

If other people may have eaten the food that made you sick, let them know. If you think the food was contaminated when you bought it from a store or restaurant, tell the store and your local health department.

References

Diagnosis and management of foodborne illnesses: a primer for physicians. Atlanta, Ga. American Medical Association, Centers for Disease Control and Prevention, Center for Food Safety and Applied Nutrition, Food and Drug Administration, Food Safety and Inspection Service, US Department of Agriculture; 2001. MMWR Recomm Rep; 50(RR-2): 1-69.

Tam CC. Campylobacter coli - an important foodborne pathogen. J Infect. 2003; 47(1): 28-32.

Tintinalli JE, Kelen GD, Stapczynski JS, eds. Emergency Medicine: A Comprehensive Study Guide. 6th ed. New York, Ny :McGraw Hill Professional; 2003.

Review Date: 2/27/2008

Reviewed By: Stephen C. Acosta, MD, Department of Emergency Medicine, Portland VA Medical Center, Portland, OR. Review provided by VeriMed Healthcare Network. Also reviewed by David Zieve, MD, MHA, Medical Director, A.D.A.M., Inc.

A.D.A.M. Copyright

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Source Doc: 1_001652