Food Poisoning: Duration, Causes, Symptoms, and Prevention

Foodborne illness (food poisoning) affects 1 in 6 Americans annually. Duration and severity depend on the pathogen and host factors.

Typical Duration by Pathogen

Pathogen	Incubation	Duration	Key Features
Staph aureus (toxin)	1–6 hrs	24–48 hrs	Sudden nausea/vomiting, minimal fever. Cream pies, meats, potato salad.
Bacillus cereus (emetic)	1–6 hrs	24 hrs	Vomiting predominant. Fried rice.
Norovirus	12–48 hrs	1–3 days	Vomiting, diarrhea, low-grade fever. Highly contagious. Cruise ships.
Salmonella	6–72 hrs	4–7 days	Diarrhea, fever, cramps. Eggs, poultry, produce.
Campylobacter	2–5 days	2–5 days	Bloody diarrhea, fever. Poultry, raw milk.
E. coli O157:H7	1–10 days	5–10 days	Bloody diarrhea, **HUS risk** (children/elderly). Undercooked beef, produce.
Clostridium perfringens	8–16 hrs	24 hrs	Diarrhea, cramps (no fever/vomiting). Meat gravies, reheated foods.
Vibrio	12–24 hrs	2–8 days	Watery/bloody diarrhea. Raw shellfish (oysters). V. vulnificus → septicemia in liver disease.
Listeria	1–4 wks	Variable	Flu-like, meningitis, pregnancy loss. Deli meats, soft cheese, melons.

General Symptoms

• Nausea, vomiting, diarrhea (watery or bloody), abdominal cramps, fever, chills, fatigue, headache.

When to Seek Medical Care

• Bloody diarrhea, high fever (>38.5°C / 101.3°F), signs of dehydration (dry mouth, oliguria, dizziness).
• Diarrhea > 3 days, vomiting > 24 hrs preventing hydration.
• Pregnant, elderly, immunocompromised, infant.
• Neurologic symptoms (blurry vision, diplopia, weakness – botulism).

Management

• Oral rehydration (ORS) – WHO formula or commercial (Pedialyte).
• Loperamide (Imodium) – **avoid if bloody diarrhea or high fever** (prolongs toxin exposure).
• Bismuth subsalicylate – mild antimicrobial, antisecretory.
• Antibiotics: only for specific pathogens (Shigella, Campylobacter, traveler's diarrhea, severe Salmonella, listeriosis). **Not for STEC O157 (↑ HUS risk).**
• Probiotics (LGG, S. boulardii) may shorten duration.

Prevention (FDA "Clean, Separate, Cook, Chill")

• Wash hands/surfaces. Separate raw/meat from ready-to-eat. Cook to safe temp (poultry 165°F, ground beef 160°F, fish 145°F). Refrigerate ≤2 hrs (1 hr if >90°F).