Food Poisoning in Children - The Hindu

Food poisoning is an universal ,preventable public health problem and is an important cause of acute gastroenteritis in children .Food poisoning denotes an illness caused by ingestion of food or drink contaminated with micro organisms (bacteria, fungi , parasites) or their toxins or inorganic chemical substances. The contamination can occur at any step of production: growing, harvesting, processing, storing, shipping or preparing of the food.

Etiology: Some of the common bacterial food poisoning are due to salmonella typhimurium, cholera suis, staphylococcal toxin ,clostridium botilinum, Escherichia Coli, Cl,perfringens, Bacillus cereus, Listeria, Campylobacter, Giardia Lamblia and Norovirus. Contamination by chemicals such as fertilizers, pesticides, cadmium ,mercury, arsenic is also a cause of concern though less common than those caused by bacteria.

Clinical features: The characteristic features of food poisoning are the temporal relationship of illness to the intake of food which manifests simultaneously with a similar presentation in a majority exposed to the food .The common symptoms of food poisoning are nausea, vomiting, fever, abdominal cramps and diarrhea. Depending on whether the poisoning occurs because of toxin or bacterial multiplication in the intestine the symptoms may present within few hours of ingestion of contaminated food or after 2 to 5 days. The main complication is dehydration secondary to the loss of fluids from gastrointestinal tract.

Management: This acute self limiting illness generally lasts for 5 to 7 days The majority of older children will settle with antipyretics, antiemetics and home available fluids such as rice conjee water ,tender coconut water and clear soup .WHO oral rehydrating salts ( ORS) plays a crucial role in preventing dehydration and maintaining hydration in these children.

Indications for hospitalisation : Infants and younger children, those with blood in stools, temperature more than 101 F, persistent vomiting . diarrhea for more than 3 days and those with neurological symptoms such as blurry vision, muscle weakness and tingling in the arms, children on immunosuppressives, chemotherapy or suffering from any chronic illness may require hospitalisation. These children need to be investigated and may require intravenous antibiotics and fluids

Prevention ;

Avoidance of raw and unpasteurised food :Since food poisoning is potentially serious and life threatening in infants ,young children, those with immune deficiencies and chronic illness it is advisable to be cautious . Raw or rare meat and poultry, raw or undercooked fish or shellfish, including oysters, clams, mussels. raw or undercooked eggs or foods prepared with them,.raw sprouts, , unpasteurized juices, milk and cheese, and refrigerated meat spreads should be avoided .

How to be sure packed food is safe?: .The Food Safety and Standards Authority of India ( FSSAI ) was established in 2006 to consolidate the laws relating to food and to establish science based standards for articles of food and to regulate their manufacture, storage, distribution, sale and import, to ensure availability of safe and wholesome food for human consumption. This has definitely improved the quality of food products in India.. When purchasing food from the store check the FSSAI trade mark and also the days remaining for use of product.

Personal Hygiene : Children should be educated at home and at school regarding the importance of washing their hands clean with soap and water before eating , after eating ,playing ,using the toilet and handling pets.

Kitchen Hygiene and tips : i)Those who cook food at home should was hands well with warm, soapy water before and after handling or preparing food. ii)Use hot, soapy water to wash utensils, cutting boards and other surfaces. iii)All raw vegetables should be washed and then cooked. iv) Preferable to cook meat at the right and safe temperature v) 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. to prevents cross-contamination. vi) Refrigerate or freeze perishable foods promptly at least 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. vii) Defrosting .It is not safe to 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% power" setting, be sure to cook it immediatelyviii) Discard food when in doubt. If there is any doubt about the preparation ,storing or serving of food it is better to discard. it. .Food left at room temperature for a long period may contain bacteria or toxins that cannot be destroyed by cooking. It is advisable not to taste food when there is uncertainty even if it looks and smells fine, as it may not be safe to eat.

Industrial Hygiene : On a larger scale every aspect of food handling should be checked and supervised diligently. Inspection of meat, poultry, fish , milk, soft drinks etc, personal hygiene of staff and food handlers, food handling techniques, packing ,canning and refrigeration should be monitored very efficiently. Food Safety Act rules should be strictly adhered and those who do not comply to this should be legally punished.

Thus we see that Food poisoning in children a common problem with high morbidity should be identified promptly, treated efficiently and prevented diligently.

 

Dr. Malathi Sathiyasekaran

MD (Pediatrics),DM (Gasteroentrology),

Senior Consultant Pediatric Gastroenterologist

Rainbow Children's Hospital, Chennai.

24x7 Pediatric Emergency Contact no: 044 4860 0000

www.rainbowhospitals.in

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