Staphylococcal food poisoning (SPF) occurs due to ingestion of food containing enterotoxins produced by Staphylococcus aureus bacteria [1] [2] [3]. The bacterial growth and subsequent toxin synthesis are favored in food cooked or stored at an inadequate temperature and increase with the time during which the food was kept tepid (between 6°C and 46°C) [4].

Following the consumption of contaminated food, the onset of SFP is rapid. Symptoms can occur as soon as 30 minutes after ingestion [5] [6], although the incubation period varies among patients as well as with the toxin exposure level, and may last for up to 8 hours [5] [7]. The most typical symptoms are nausea and profuse, vigorous vomiting. Patients also experience painful abdominal cramps. Diarrhea may be present, but the absence of this symptom does not preclude the diagnosis [4] [5] [6]. Fever is usually mild or absent [5] [6]. Additionally, patients may present with nonspecific signs and symptoms such as dizziness, shivering and general weakness or even headaches, prostration and low blood pressure, depending on illness severity [5]. Excessive vomiting can lead to different levels of dehydration in susceptible patients [6]. In spite of the rapid and severe onset most cases resolve spontaneously and without hospitalization, with the potential exception of children, elderly and patients weakened by another condition [1] [7]. A majority of patients recover after 1 to 3 days, with diarrhea and general weakness being the last symptoms to resolve [5] [6].

• Fever

  Fever and bloody stools were recorded with unusual frequency. [ncbi.nlm.nih.gov]

  Usually, little or no fever is present. More common in children 4 years or younger. [fda.gov]

  Other symptoms may include abdominal cramping, diarrhea, and sometimes headache and fever. Severe fluid and electrolyte loss may cause weakness and very low blood pressure (shock). [checkorphan.org]

  A fever and low blood pressure are signs of septicemia. [mayoclinic.org]

• Pain

  Symptoms included abdominal pain and violent vomiting, followed by severe diarrhea and fever. We aim to present this food poisoning outbreak and characterize the causative agent. [ncbi.nlm.nih.gov]

  Arsenic Ingestion of pesticide and industrial chemicals Symptoms usually appear within 1 h after ingestion but may be delayed as long as 12 h Abdominal pain, watery diarrhea, vomiting, skeletal muscle cramps, profound dehydration, and shock may occur [emedicine.medscape.com]

  […] travelers’ diarrhea”) 1-3 days Watery diarrhea, abdominal cramps, some vomiting 3-7 or more days Water or food contaminated with human feces E. coli O157:H7 Hemorrhagic colitis or E. coli O157:H7 infection 1-8 days Severe (often bloody) diarrhea, abdominal pain [fda.gov]

  These symptoms include nausea, dry mouth, vomiting, abdominal pain and blurring of vision. The toxin has a paralyzing effect on the nervous system; it prevents the nerves from conducting messages from the brain. [checkorphan.org]

  Patients also experience painful abdominal cramps. Diarrhea may be present, but the absence of this symptom does not preclude the diagnosis. Fever is usually mild or absent. [symptoma.com]

• Severe Pain

  Signs and symptoms may include: Joint swelling Severe pain in the affected joint Fever When to see a doctor Go to the doctor if you or your child has: An area of red, irritated or painful skin Pus-filled blisters Fever You may also want to consult your [mayoclinic.org]

• Veterinarian

  Sources of MRSA While MRSA bacteria are usually carried on the human skin and in the nose, recent studies have shown that livestock also carry MRSA, and that it can be transmitted from these animals to farmers and veterinarians, who can then pass it on [foodborneillness.com]

• Wound Infection

  […] dose is usually 10 7 -10 9 organisms Positive stool culture Prompt replacement of fluids and electrolytes Sensitive to tetracycline, but unclear role for antibiotics V vulnificus Wound infection in salt water or consumption of raw oysters Can be lethal [emedicine.medscape.com]

• Food Poisoning

  […] in food poisoning. [scielosp.org]

  Abstract Staphylococcal food poisoning represents the most prevalent foodborne intoxication worldwide. It is caused by oral intake of enterotoxins preformed by Staphylococcus aureus in food. [ncbi.nlm.nih.gov]

• Vomiting

  Excessive vomiting can lead to different levels of dehydration in susceptible patients. [symptoma.com]

  A doctor may give a drug, either as an injection or as a suppository, to help control severe nausea and vomiting. [checkorphan.org]

  Staph food poisoning is characterized by a sudden start of nausea, vomiting, and stomach cramps. Most people also have diarrhea. [cdc.gov]

  Abstract Two waves of vomiting and/or diarrhoea affected approximately 215 of the 715 passengers on a Caribbean cruise ship. The outbreak was independently associated with eating cream-filled pastries at two separate meals. [ncbi.nlm.nih.gov]

• Nausea

  A majority of cases present with nausea and intense vomiting (potentially causing dehydration) along with abdominal cramps, while diarrhea may or may not be present. [symptoma.com]

  A doctor may give a drug, either as an injection or as a suppository, to help control severe nausea and vomiting. [checkorphan.org]

  Bacillus cereus B. cereus food poisoning 10-16 hrs Abdominal cramps, watery diarrhea, nausea 24-48 hours Meats, stews, gravies, vanilla sauce Campylobacter jejuni Campylobacteriosis 2-5 days Diarrhea, cramps, fever, and vomiting; diarrhea may be bloody [fda.gov]

  Of the 22 patients, 19 experienced with nausea, 17 came down with diarrhea, 17 with abdominal pain, 15 with vomiting, 13 with headaches and four with fevered chills. [foodsafetynews.com]

• Diarrhea

  Diarrhea may be present, but the absence of this symptom does not preclude the diagnosis. Fever is usually mild or absent. [symptoma.com]

  Escherichia coli is a common cause of traveler's diarrhea and usually presents with profuse watery diarrhea. [visualdx.com]

  Other symptoms may include abdominal cramping, diarrhea, and sometimes headache and fever. Severe fluid and electrolyte loss may cause weakness and very low blood pressure (shock). [checkorphan.org]

  […] cramps, fever, and diarrhea. [fda.gov]

  […] starts 3-4 d after ingestion Usually progresses from watery to bloody diarrhea. [emedicine.medscape.com]

• Abdominal Cramps

  A majority of cases present with nausea and intense vomiting (potentially causing dehydration) along with abdominal cramps, while diarrhea may or may not be present. [symptoma.com]

  Other symptoms may include abdominal cramping, diarrhea, and sometimes headache and fever. Severe fluid and electrolyte loss may cause weakness and very low blood pressure (shock). [checkorphan.org]

  The symptoms of SFP are abdominal cramps, nausea, vomiting, sometimes followed by diarrhea (never diarrhea alone). The onset of symptoms is rapid (from 30 min to 8 h), and usually a spontaneous remission is observed after 24 h [ 1 ]. [link.springer.com]

  Physical Findings: diarrhea abdominal cramping excessive salivation nausea Diagnosis: Physical examination according to presenting signs ans symptoms. Short incubation time characteristic of intoxication. [nursingcrib.com]

• Skin Lesion

  The presence or absence of fever in infected persons, skin lesions in food handlers, or large numbers of staphylococci in food were unreliable as diagnostic criteria. [jamanetwork.com]

  It is also a frequent cause of skin lesions on the hands. From these sources, it can readily enter food. [nursingcrib.com]

• Eczema

  […] insulin HIV/AIDS Kidney failure requiring dialysis Weakened immune systems — either from a disease or medications that suppress the immune system Cancer, especially those who are undergoing chemotherapy or radiation Skin damage from conditions such as eczema [mayoclinic.org]

  High prevalence of superantigens associated with the egc locus in Staphylococcus aureus isolates from patients with atopic eczema. Eur. J. Clin. Microbiol. Infect. Dis. 2003; 22 :306–309. [ PubMed ] [ncbi.nlm.nih.gov]

• Skin Disease

  Photo Credit Gracia Lam Personal Health A Little-Known Skin Disease That Can Disrupt People’s Sex Lives Patients deal with pain and itching and often encounter medical ignorance and mistreatment until affected tissues become irreparably scarred. [nytimes.com]

  Staph scalded skin syndrome, though, is a severe skin disease caused by the bacteria. Staphylococcus can cause infections in the ears, nose, and throat. And it can cause swimmer’s ear, an infection in the ear canal. [drgreene.com]

• Dermatitis

  […] morbidity. [1, 2] SEB is the toxin most commonly associated with classic food poisoning. [3, 4] It has also been demonstrated to cause a nonmenstrual toxic shock syndrome (TSS). [5] Researchers have implicated SEB in the pathophysiology of chronic atopic dermatitis [emedicine.medscape.com]

• Skin Rash

  Related concepts: Staphylococcus aureus, Staphylococcal infections Medical review by: Khanh-Van Le-Bucklin, Liat Simkhay Snyder Last medical review: November 11, 2013 Updated: January 31, 2017 Diseases & Conditions Top Skin & Rashes Dr. [drgreene.com]

Clinical presentation and patient history are the starting point of establishing a diagnosis of SFP poisoning. In addition to gastrointestinal symptoms (with special attention to characteristic "projectile" vomiting), the short incubation period can be indicative of SFP. In such cases, anamnesis should include detailed food history.

Food history

Staphylococcal contamination of food originates from several sources, but the common denominator usually is and inadequate temperature of storing the food at some stage. Hence, the pre-cooked food is most frequently associated with SFP. Enterotoxins have been shown to develop in sandwiches, salads, cream-filled desserts, and pastries, as well as egg, dairy, meat (especially poultry) products, and processed meats such as ham [8].

Laboratory diagnostic

Given the short duration and spontaneous recovery of patients, laboratory diagnostics is usually not performed in isolated cases. However, in case, of a suspected epidemic (especially common-source outbreak), laboratory findings are used to confirm the diagnosis [6]. Two approaches can be applied: isolating the bacteria from suitable samples or detecting one of the staphylococcal enterotoxins in suspected food samples [5] [6] [9].

The sources of contamination vary from colonized persons handling the food to unsanitary surfaces or environment and even raw materials (especially milk) used to produce the food [1] [5]. Hence, environmental swabs (including hand and nasal cavities swabs) make a good sample for isolation of Staphylococcus aureus [6]. In addition, food samples and biological material obtained from the patients (stool samples) are used for isolation [6] [10]. However, the bacteria can remain undetected by this method if the food was cooked after the toxin was produced [7]. Due to the thermostability of staphylococcal enterotoxins, they will be present in the food even after high temperature has destroyed the causative agent.

For detection of enterotoxins in contaminated food, immunoassays, bioassays and methods of molecular biology are used [5] [11].

• Staphylococcus Aureus

  It is caused by oral intake of enterotoxins preformed by Staphylococcus aureus in food. The relevance of newly described enterotoxins in outbreaks of staphylococcal food poisoning is controversially discussed. [ncbi.nlm.nih.gov]

  Staphylococcal food poisoning (SPF) occurs due to ingestion of food containing enterotoxins produced by Staphylococcus aureus bacteria. [symptoma.com]

  Detecting the enterotoxigenicity of Staphylococcus aureus strains. Appl. Microbiol., 28 :946-50, 1974. 10. TATINI, S.R.; HOOVER, D.G.; LACHICA, R.V.F. Methods for the isolation and enumeration of Staphylococcus aureus. In: Speck, M.L., ed. [scielosp.org]

• Clostridium Perfringens

  Can result in respiratory failure and death Variable Improperly canned foods, especially home-canned vegetables, fermented fish, baked potatoes in aluminum foil Clostridium perfringens Perfringens food poisoning 8–16 hours Intense abdominal cramps, watery [fda.gov]

  perfringens [Clostridium welchii] intoxication A05.3 Foodborne Vibrio parahaemolyticus intoxication A05.4 Foodborne Bacillus cereus intoxication A05.5 Foodborne Vibrio vulnificus intoxication A05.8 Other specified bacterial foodborne intoxications A05.9 [icd10data.com]

  Clostridium perfringens C. perfringens is a common organism frequently found in excreta from humans and animals and in raw meats, poultry and other foods, including dehydrated products. [virology-online.com]

Egg And Poultry Products Meats Macaroni Potato Chicken Tuna Cream Pies Cream-Filled Pastries Chocolate Eclairs Milk And Dairy Products Sandwich Fillings Custards Topped Desserts Staphylococcal Food Poisoning Treatment staphylococcal food poisoning treatment [howlongdoesfoodpoisoninglast.net]

Causative Agents Source and Clinical Features Pathogenesis Diagnosis and Treatment Staphylococci Improperly stored foods with high salt or sugar content favors growth of staphylococci. [emedicine.medscape.com]

Treatment - Staphylococcal food poisoning Treatment usually consists of only drinking an adequate amount of fluids. A doctor may give a drug, either as an injection or as a suppository, to help control severe nausea and vomiting. [checkorphan.org]

Prompt medical treatment increases their chances of making a full recovery. [healthline.com]

Prognosis - Staphylococcal food poisoning Not supplied. Treatment - Staphylococcal food poisoning Treatment usually consists of only drinking an adequate amount of fluids. [checkorphan.org]

PROGNOSIS • Symptoms may start up to 6 hours and may last up to 3 days. • It may severe in small percentage of patient with low immunity system. 21.  Wash hands and under fingernails with soap and water before handling and preparing food.  Do not prepare [slideshare.net]

This study underlines the importance of both laboratory evidence and epidemiological data for outbreak investigation. [ncbi.nlm.nih.gov]

Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 51 (‎51)‎, 390. https://apps.who.int/iris/handle/10665/221160 Journal Weekly Epidemiological Record = Relevé épidémiologique hebdomadaire, 51 (‎51)‎: 390 Language English français Collections [apps.who.int]

Thorough epidemiologic investigation remains crucial to identifying SFD and its sources. ( JAMA 1984;251:487-489) [jamanetwork.com]

Intoxication occurs in one to six hours or days Pathophysiology: Once the toxin has been ingested, it quickly triggers the brain’s vomiting reflex center; abdominal crapms and usually diarrhea then happens. [nursingcrib.com]

[…] but they may cause significant morbidity. [1, 2] SEB is the toxin most commonly associated with classic food poisoning. [3, 4] It has also been demonstrated to cause a nonmenstrual toxic shock syndrome (TSS). [5] Researchers have implicated SEB in the pathophysiology [emedicine.medscape.com]

Staphylococcal Food Poisoning Prevention I think this will be the most important part of the article. The steps which can by which prevent Staphylococcal Food Poisoning. [howlongdoesfoodpoisoninglast.net]

Centers for Disease Control and Prevention. [foodsafetynews.com]

This is the first large outbreak of its type; safeguards can and should be employed to prevent future ones. [ncbi.nlm.nih.gov]

Prevention - Staphylococcal food poisoning Careful food preparation can prevent staphylococcal food poisoning. Anyone who has a skin infection should not prepare food for others until the infection heals. [checkorphan.org]

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