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48
Major Food Borne Diseases: predominant clinical features
Predominant symptoms Associated Approxim Appropriate
organism or toxin ate time to samples required
onset of from food
symptoms handlers
Lower gastrointestinal tract symptoms (abdominal cramps, diarrhea) occur first or
predominate
Abdominal cramps, diarrhea, Clostridium 2–36 Rectal swabs,
sometimes nausea and perfringens, (mean 6– stool
vomiting. Bacillus cereus, 12) hours
Streptococcus
faecalis, S. faecium
Fever, abdominal cramps, Salmonella spp, 6–96 Rectal swabs,
diarrhea, vomiting, headache. Shigella, hours stool
Aeromonas, (usually1–
Enteropathogenic 3 days)
E. Coli
Abdominal cramps, diarrhea, Vibrio cholerae 6 hours to Stool
vomiting, fever, malaise, (O1 and non-O1), 5 days
nausea, headache, V. vulnificus,V.
dehydration. Sometimes fluvialis, V.
bloody or mucoid diarrhea, parahaemolyticus
cutaneous lesions associated
with Vibrio vulnificus
Diarrhea (often bloody), Enterohaemorrha 1–10 Stool, rectal
abdominal pain, nausea, gic E. coli (median swabs
vomiting, malaise, fever (including E. coli 3–4) days
(uncommon with E. coli O157). O157)
Campylobacter
vomiting, watery Rotavirus, 3–5 days Stool, vomit
noninflammatory diarrhea. astrovirus, enteric
adenovirus
Fever, diarrhea, abdominal Yersinia 3–7 days Stool
pain. Can mimic acute enterocolitica
appendicitis.
Mucoid diarrhea (fatty stools) Giardia lamblia 1–6 weeks Stool
abdominal pain, flatulence,
weight loss.
59
Abdominal pain, diarrhea, Entamoeba 1 to Stool
constipation, headache, histolytica several
drowsiness, ulcers, variable weeks
/often asymptomatic.
Nervousness, insomnia, Taenia saginata, T. 3–6 Stool, rectal swab
hunger pains, anorexia, weight solium months
loss, abdominal pain,
sometimes gastroenteritis
Upper gastrointestinal tract symptoms (nausea, vomiting) occur first or predominate
Nausea, vomiting, retching, Staphylococcus 1–6 (mean Stool, vomit,
diarrhea, abdominal pain, aureus and its 2–4) hours (swabs from
prostration. enterotoxins nostril, skin
Lesions)
Vomiting, abdominal cramps, Bacillus cereus 8–16 hour Rectal swab, stool
diarrhea, nausea (2–4 hours
if emesis
Predomina
nt)
Nausea, vomiting, diarrhea, Mycotoxins 6–24 Urine, blood
thirst, dilation of pupils, (Amanita sp. hours (SGOT, SGPT),
collapse, coma. fungi) vomit
Nausea, vomiting, watery non- Norovirus 12–48 hours Stool
bloody diarrhea, dehydration (median
36) hours
Sore throat and respiratory symptoms occur
Sore throat, fever, nausea, Streptococcus 12–72 Rectal swab, stool
vomiting, rhinorrhea, pyogenes hours
sometimes a rash.
Neurological symptoms (visual disturbances, vertigo, tingling, paralysis)
Neurological and/or Shellfish toxin Less than Gastric washing
gastrointestinal symptoms. (see final section 1 hour
of this table)
Vertigo, double or blurred Clostridium 2 hours to gastric washing
vision, loss of light reflex, botulinum and its 6 days, Blood, stool,
difficulty in swallowing, neurotoxins usually
speaking and breathing, dry 12–36
mouth weakness, respiratory hours
paralysis. Characteristic
syndrome is descending,
bilateral flaccid paralysis,
starting with cranial nerves
and with preserved sensorium.
Allergic symptoms (facial flushing, itching)
Headache, dizziness, nausea, Histamine Less than Vomit
vomiting, peppery taste in (scombroid) 1 hour
mouth, burning of throat, facial
60
swelling and flushing, stomach
pain, itching of skin.
Numbness around mouth, Monosodium Less than Vomit
tingling sensation, flushing, glutamate 1 hour
dizziness, headache, nausea.
Generalized infection symptoms (fever, chills, malaise, prostration, aches, swollen
lymph nodes)
Gastroenteritis, fever, oedema Trichinella spiralis 4–28 Serum, muscle
around eyes, perspiration, (mean 9) tissue (biopsy)
muscular pain, chills, days
prostration, laboured-
breathing.
Malaise, headache, fever, Salmonella typhi 7–28 Rectal swab, stool
cough, nausea, vomiting, (mean 14)
constipation, abdominal pain, days
chills, rose spots, bloody
stools.
Fever, headache, myalgia, rash. Toxoplasma 10–13 Lymph node
gondii days biopsy, blood
Gastrointestinal and/or neurological symptoms
Tingling, burning, numbness, paralytic shellfish 0.5–2 gastric washing
drowsiness, incoherent poisoning (PSP) hours
speech, respiratory paralysis. mussels. clams
61
62
