by James Hubbard, MD, MPH

What does food poisoning have to do with the holidays? If you don’t know, then you’ve been rather lucky. Plenty of food, cooked hours ahead of time, left out? Leftovers not refrigerated promptly? Bacteria paradise.

Omit the part about the plenty of food, and add unreliable refrigeration, and the same thing could happen during a disaster. No, not the one where the turkey burns or where you leave Uncle Joe and Cousin Willie in the same room too long. I’m talking about the kind when the electricity goes out.

How to Treat Food Poisoning

No matter the cause (and there are many) the initial treatment for food poisoning is usually aimed at one purpose: to avoid dehydration.

To tell the truth, in most cases, at least initially, there’s really not much you can do to lessen the diarrhea or vomiting. In fact, antidiarrhea medicine and antibiotics can actually prolong the symptoms in some cases. And, since many bouts of food poisoning are over in about 24-48 hours, time will often be the ultimate cure.

So, if you get a case of the runs and heaves, here are some suggestions:

  1. When it starts, don’t do anything. I’ve seen so many people start trying to eat and drink right away, and all they do is have more vomiting and diarrhea. In my opinion, that only makes things worse because, in addition to expelling what you took in you actually lose more fluids and electrolytes than you would otherwise.
  2. After a few hours, take a sip of water, or suck on a chip of ice. No gulping, or you’re more likely to bring the fluids right back up.
  3. Rest. You have an infection or have been poisoned with bacteria toxin. Allow your body to use its various defenses to fight it off and not have to worry about using energy for less essential activities.
  4. When you can keep down the sips, gradually drink more fluids. Water’s great. So is Pedialyte. Or make your own rehydration solution. (See how in the sidebar here.)  Broth or tea will work. Sports drinks can have a little too much sugar for your gut to handle and make the diarrhea worse, so dilute them in half with water.
  5. Don’t be in a big hurry to start solid food for at least the first 24 hours. If you get hungry within those 24 hours, try something on the BRAT diet: bananas, rice, applesauce, or toast. No butter. I’d also stay away from other dairy products for a few days. Some people who usually have no problems can become lactose intolerant for a few days.
Some Reasons to Seek Medical Attention

People who are elderly or very young (babies) or who have chronic medical problems, such as heart disease or diabetes, should seek medical attention for food poisoning since they can get quickly dehydrated before anyone starts to notice. Some signs symptoms that other people should seek it are:

Staph, the Real Food “Poisoning”

There are many, many potential causes of food poisoning. I wrote about salmonella in a past post. Staph is another.

Staph is particularly interesting, at least to me, since it’s not the bacteria per se that cause the symptoms. Rather, the bacteria produce a toxin which causes a true “poisoning.”

The bacteria that cause botulism, the serious foodborne illness most feared by home canners, does the same. That toxin is much stronger but can be destroyed with a good boiling for about 15 minutes, depending on your altitude. (Note: Boiling doesn’t kill the spores, so if you don’t eat the food right away, more toxin can form.) A certain amount of heat can kill most other causes of food poisoning too.

Heat does not destroy the staph toxin though. So, say you leave the raw food or leftovers on the counter for over a couple of hours—an environment bacteria like staph love. Then you cook it or reheat it. If you reheat it enough, the bacteria may be killed, but the toxin is not.

Staph’s Usual Suspects

According to the Centers for Disease Control and Prevention, improperly refrigerated or unrefrigerated meats, potato and egg salads, and cream pastries are the foods staph is most commonly found in.

Symptoms

Symptoms of staph food poisoning are sudden vomiting and cramping that comes on 30 minutes to six hours after you’ve eaten. (Symptoms caused by Clostrdium perfringens, the bacterial culprit of a lot of food poisoning cases, can come on this soon also, but this bacteria produces no toxin, and proper cooking or reheating to an internal temperature of 165 F kills the bacteria.) The symptoms due to staph go away in about one to three days.

Is It Contagious?

No. Unlike some other types of staph infections, like MRSA, foodborne staph is not passed from person to person.

  • Profuse vomiting and diarrhea that’s not letting up after a few hours, which can mean severe dehydration and that this is not your run-of-the-mill food poisoning. In fact, cholera (rare in the U.S. right now) can sometimes cause so much fluid loss that some people die within hours.
  • Bloody diarrhea. It’s not always a bad sign. Some pretty common diarrheas can do this. But it’s tough to discern the culprit without expert testing.
  • Fever over 101 F orally, which may mean, again, this is not your common food poisoning.
  • Unrelenting abdominal cramps. This could be a really bad case of food poisoning, or it could mean something else is going on, like a leak in the intestine.
  • Symptoms not letting up after about a day. Many cases of food poisoning may last longer, but after a day or so, you’re probably getting dehydrated and have lost a lot of electrolytes, so it’s time for testing and more vigorous treatment.
  • Confusion or looking particularly ill, which can be from dehydration or a really bad infection.
  • Dehydration, which can damage your kidneys, affect your heart, and lessen blood flow to other vital organs. In its extreme, it can cause death. Some signs of dehydration are feeling faint after sitting up or standing up (do the latter slowly and carefully no matter what) or having decreased urination or an extremely and constantly dry mouth.
What the Experts Can Do That You Can’t
  • Do blood work to monitor your kidney function and electrolytes.
  • Give IV fluids.
  • Better find the specific cause and treat accordingly. That may mean antibiotics, if needed, but even if the cause is bacterial, these are only given in especially severe cases and depending on the bacteria.
  • Suppress the vomiting. If you’re having trouble at both ends, you may be only able to take something in injection form. However, there is one vomit suppressor you can let melt under your tongue (ondansetron).

 

Bottom line: Don’t keep food unrefrigerated for over two hours. Even then, you have to depend on how the food was stored prior to buying it.

What about you? Have you or someone you know ever had food poisoning? What do you think caused it? What did you do?

 

For more on treatment for general vomiting and diarrhea when medical care is scarce, click here.

Photo credits: Outhouse: Flickr/msmail. Turkey: Turkey Platter 01 With Fruit and Vegitables Clip … from Vector.me.