Foodborne illness (food poisoning) affects 1 in 6 Americans annually (CDC). It results from consuming food contaminated with pathogenic bacteria, viruses, parasites, or their toxins. While often self-limiting, it can be severe or fatal in vulnerable populations.
| Agent | Common Sources | Incubation | Key Features |
|---|
| Norovirus | Ready-to-eat foods, shellfish, contaminated water | 12–48 hrs | Vomiting, diarrhea, highly contagious |
| Salmonella | Poultry, eggs, produce, unpasteurized dairy | 6–72 hrs | Diarrhea, fever, cramps; can cause bacteremia |
| Clostridium perfringens | Meat/gravy held at unsafe temps | 8–16 hrs | Abdominal cramps, diarrhea; no fever/vomiting |
| Campylobacter | Raw poultry, unpasteurized milk, water | 2–5 days | Bloody diarrhea, fever; antecedent to GBS |
| Staph aureus | Cream pies, potato salad, handled foods | 1–6 hrs | Rapid onset vomiting (preformed toxin) |
| E. coli O157:H7 | Undercooked beef, raw milk, produce | 1–10 days | Bloody diarrhea, HUS risk (kidney failure) |
| Listeria | Deli meats, soft cheeses, smoked fish | 1–4 weeks | Fever, myalgia; severe in pregnancy/elderly |
| Hepatitis A | Contaminated produce, shellfish, water | 15–50 days | Jaundice, fatigue, nausea; vaccine-preventable |
Symptom Spectrum
- Mild: Nausea, diarrhea, low-grade fever – resolves in 24–48 hrs
- Moderate: Prolonged vomiting/diarrhea, fever >38.5°C, signs of dehydration
- Severe (seek care): Bloody stool, high fever >39°C, dehydration (dry mouth, dizziness, oliguria), neurological symptoms (blurred vision, weakness), duration >3 days
Treatment
- Fluid replacement is paramount: Oral rehydration solution (ORS) preferred. Sip small amounts frequently.
- Antiemetics (ondansetron) if vomiting prevents oral intake.
- Antidiarrheals (loperamide) – avoid if bloody diarrhea or high fever (may prolong toxin exposure).
- Antibiotics only for specific bacterial causes (e.g., severe Campylobacter, Shigella, traveler’s diarrhea) – guided by stool culture.
- Probiotics (S. boulardii, LGG) may shorten duration modestly.
High-Risk Groups Needing Early Medical Attention
- Pregnant women
- Children <5 years
- Adults >65 years
- Immunocompromised (HIV, chemo, steroids)
- Chronic conditions (diabetes, kidney/liver disease)
Prevention: The 4 Core Practices (FDA)
- Clean: Wash hands, surfaces, produce. Separate cutting boards.
- Separate: Raw meat/poultry/seafood from ready-to-eat foods.
- Cook: Use food thermometer. Safe temps: poultry 165°F, ground meat 160°F, fish 145°F.
- Chill: Refrigerate ≤40°F within 2 hrs (1 hr if >90°F). Thaw safely (fridge, cold water, microwave).
Additional Tips
- Avoid raw/unpasteurized milk, cheese, juices, sprouts
- Reheat leftovers to 165°F
- When in doubt, throw it out
- Report suspected outbreaks to local health department
Most food poisoning resolves with supportive care. Early recognition of red flags prevents complications.
Infectious Diseases - Related Articles
