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Present the Concept and Know How to Classify Food Poisoning.

D. Vegetable dyes.

20. Choose fresh, clean foods except :

A. With vegetables and fruits: Choose fresh vegetables and fruits, not bruised, and without strange odors.

B. Meat must pass veterinary quarantine and meet fresh meat standards.

C. Fish and other seafood must be fresh and retain their normal color.

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D. Processed foods only need to be canned or packaged.

21. Keeping the eating and food preparation areas clean requires:

Present the Concept and Know How to Classify Food Poisoning.

A. Food processing areas do not have stagnant water, toilets or livestock areas, and waste that pollutes the environment.

B. All surfaces used for food preparation must be easy to clean, clean and dry.

C. A and B are correct.

D. A and B are wrong.

22. Prepare food cleanly and cook thoroughly except :

A. Vegetables and fruits must be soaked in clean water and then washed thoroughly under running water or in a basin, changing the water 3-4 times.

B. Frozen foods must be completely thawed and washed before cooking.

C. Pay attention to the meat near the bone. If it is still pink or bloody, it must be reboiled until fully cooked.

D. All are wrong

23. Eating food immediately after it is cooked or prepared is:

A. Cooked food left to cool at room temperature is susceptible to bacteria invasion and growth.

B. To ensure safety, you should eat hot food immediately after cooking.

C. For foods such as bananas, oranges, and melons, you should eat them immediately after peeling and cutting them.

D. All are correct.

24. Maintain good personal hygiene Is:

A. Caregivers should wash their hands with soap and clean water before feeding or handling food, after using the toilet, and after handling raw food.

B. Wear white clothes and keep your hair neat when preparing food.

C. Wash your nails thoroughly.

D. If there is a wound on the hand, it needs to be bandaged.

25. In Vietnam, among the 10 causes of death, the cause of intestinal pathogens ranks:

A. Third place

B. Second place

C. Correct 4th row

D. Ranked 1st.

LESSON: 5

FOOD POISONING PREVENTION

Time 4 periods


TARGET:

1. Present the concept and know how to classify food poisoning.

2. Describe clinical symptoms, epidemiological characteristics and preventive measures for some types of bacterial and non-bacterial food poisoning.


CONTENT:

1. GENERAL INFORMATION ABOUT FOOD POISONING:

1.1. Concept:

- Food poisoning is a disease caused by eating food contaminated with bacteria, bacterial toxins or food containing substances that are toxic to the eater.

1.2. Classification of food poisoning:

- Currently, scientists classify food poisoning based on the following causes:

- Food poisoning caused by bacteria and bacterial toxins: Common food poisoning is caused by Staphylococcus, Salmonella, Clostridium Botulinum, E.Coli...

- Non-bacterial food poisoning:

+ Benign food poisoning: is a case of hypersensitivity allergy often caused by shrimp, crab, fish, clams... only found in some people with natural allergies.

+ Food poisoning caused by food itself containing natural toxins such as poisonous mushrooms, sprouted potatoes, cassava, puffer fish, toads, etc.

+ Food poisoning is caused by food being contaminated by environmental toxins during the production, processing, and preservation of food. This category includes fungal toxins, pesticides, and additives added to food.

1.3. Risk factors (increased risk of toxicity):

- Food contamination: Poor food hygiene, cross-contamination, unclean utensils.

- Factors related to bacterial survival such as undercooked food, not reheated before eating...

- Factors related to bacterial growth such as insufficient cold storage...

2. FOOD POISONING AND PREVENTION MEASURES:

2.1. Food poisoning caused by Salmonella:

2.1.1. Characteristics:

- This is a type of infection, food poisoning, in which the patient shows signs of infection and poisoning, mainly digestive disorders, related to violations of hygiene regulations when processing, preserving, distributing and using food. The disease often occurs in the summer and occurs in all ages.

- The main causes of poisoning are paratyphoid bacteria, of which the leading are Salmonella Typhi Murium, Salmonella Cholera, Salmonella Enteritidis...

- Salmonella is a Gram (-) bacillus without spores, aerobic or facultative anaerobic, the bacteria grow at a suitable temperature of 37 o C and pH = 7.6. It is heat-resistant, can be destroyed at 50 o C within 1 hour, at 70 o C in 15 minutes and at 100 o C in 5 minutes.

- The ability to cause food poisoning due to Salmonella requires 2 conditions:

+ Food contaminated with a large amount of bacteria.

+ Bacteria entering the body release a large amount of toxins. Depends a lot on the reaction of each person's body.

- This explains the phenomenon of many people eating the same food but some get food poisoning, some don't, some get severe food poisoning, some get mild food poisoning...

2.1.2. Clinical:

- Incubation period is from 12 to 24 hours, sometimes shorter or longer than a few days.

- The first signs are: nausea, headache, discomfort, possibly mild fever, abdominal pain. Then vomiting, diarrhea many times, stools are watery, sometimes bloody. The patient returns to normal after 2 - 3 days, leaving no sequelae.

- In special cases, the patient has symptoms similar to typhoid fever such as very high fever, general fatigue, pain in the lumbar region and muscles, very mild or absent digestive symptoms, so it is easy to misdiagnose.

2.1.3. Epidemiology:

- The main sources of disease are: Animals such as cows and pigs with paratyphoid, chickens with white feces...

- The most dangerous source of infection is paratyphoid enteritis and typhoid in buffalo and cattle because it is difficult to diagnose in these animals.

- The second dangerous source is clinically healthy animals that carry and excrete bacteria in their feces, sometimes in their urine. Sources of excretion of dangerous bacteria are chickens, ducks, etc.

- Food poisoning is often food of animal origin such as meat, poultry, etc. Eggs, fish, milk, in smaller proportions.

- Foods that cause food poisoning often have high humidity, non-acidic pH, especially cooked foods used as cold foods such as pate, sausages... are often the cause of poisoning due to Salmonella.

- Waterfowl eggs can be infected with Salmonella early in the embryo, so absolutely do not eat these eggs raw or half-cooked like chicken eggs.

2.1.4. Disease prevention measures:

- Preventing the phenomenon of carrying bacteria and eliminating Salmonella bacteria in livestock farms.

- Do not kill sick and dead animals.

- Standardize slaughtering and veterinary hygiene in production at slaughterhouses.

- Food testing in meat production and delivery.

- Check the veterinary hygiene of meat and the veterinary hygiene regime in the market.

- Monitor and control hygiene at milk production and trading sites.

- Refrigerate cooked food and ingredients before processing to inhibit bacterial growth.

- Ensure proper storage of prepared food and ingredients.

- Implement separate, one-way production lines in cooked food production facilities and public dining establishments to avoid cross-contamination and bacterial spread.

- Strictly implement the medical examination and periodic examination regime for those who come into direct contact with food, especially cooked food.

- The best prevention is to cook food thoroughly and reboil it before eating.

2.2. Staphylococcal poisoning:

2.2.1. Characteristics:

- Staphylococcus is scattered in nature and is only toxic when it forms enterotoxin. The staphylococcus that produces enterotoxin is Staphylococcus aureus. Staphylococcal poisoning is not an infection but a poisoning.

- Withstand high temperatures to remove toxins, food must be boiled for 2 hours, not destroyed by alcohol, chlorine, acidic pH.

- The growth rate and toxin production of staphylococcus depend on environmental conditions. The favorable temperature for staphylococcus growth is: 37 - 40 0 ​​C, pH 4 - 9.8. At 0 4 - 6 0 C, bacteria grow slowly. At salt concentration > 12%, staphylococcus stops growing.

2.2.2. Clinical:

- Short incubation period of 1-6 hours, average is 4 hours. This is an important sign to differentiate from Salmonella poisoning.

- Full-blown period: Dizziness, nausea, severe vomiting, abdominal cramps and diarrhea, headache, rapid pulse, normal heart rate or mild fever due to dehydration. The disease completely recovers after 1 - 2 days, rarely fatal.

2.2.3. Epidemiology:

- Source of infection: The main source of staphylococcus in nature is human skin and mucous membranes, followed by dairy cows with mastitis. About 50% of healthy people carry pathogenic and non-pathogenic staphylococcus. Staphylococcus carriers are most concentrated in the nose, throat, and hands. Healthy people carry less dangerous bacteria than sick people. The conditions for infection are very easy: runny nose, coughing, sneezing, and pathogenic staphylococcus can also be found in the feces of healthy people.

- Foods often contaminated with staphylococcus:

+ Milk and dairy products: Mostly found in fresh milk (14.6%), cream

(6.8%), milk is sterilized by Pasteur method, staphylococcus is greatly reduced to only 0.66%.

+ Oily fish products: During the packaging process, ingredients such as fish can be contaminated with staphylococcus and produce toxins. When sterilized, staphylococcus can be destroyed but staphylococcus toxins remain. Therefore, cases of food poisoning due to eating canned products can still occur.

+ Cakes with cream and milk: Cakes with high sugar content > 60% bacteria and staphylococci cannot grow. Cakes with cream and milk with sugar content < 60% staphylococci can grow and produce toxins.

However, not only cakes with cream and milk can cause poisoning, but other foods such as meat and fish are also favorable environments for staphylococcus to grow and produce toxins that cause poisoning.

2.2.4. Disease prevention measures:

- Strengthen food hygiene inspection and hygiene when preparing food.

- Check the health of food service staff. People with sore throat, rhinitis, or respiratory tract infections should not come into contact with food.

- Do not use milk from cows with mastitis.

- Cooked food should be kept at 0 2 - 4 0 C.

2.3. Food poisoning caused by Clotridium Botulinum:

2.3.1. Characteristics:

- Is acute poisoning, high mortality.

- The disease occurs after eating food, sauces, pate, sausages...

- Clotridium Botulinum bacteria, absolutely anaerobic, has spores, favorable for bacterial growth at 26 - 28 o C. Bacteria's temperature resistance is poor but spores are resistant to high temperatures and salt concentrations. At 100 0 C, it can withstand 6 hours, at 120 0 C, it can withstand 5 minutes.

2.3.2. Clinical:

- Incubation period is from 6 - 24 hours or lasts for several days depending on the amount of bacterial toxins.

- The earliest sign is paralysis of the eyes, then the palate, uvula, stomach, intestines...

- The second sign is thermal dissociation (fast pulse, normal temperature).

- Lasts 4 - 8 days, if not treated early and promptly the disease will be fatal.

2.3.3. Prevention measures:

- Do a good job of refrigeration, especially cold food made from canned, salted, smoked meat and fish...

- All meat and fish products that show signs of spoilage should not be used as food or packaged.

- Do not use containers with signs of bulging lids.

- For suspicious food, boil again for at least 1 hour .

- For fish that need to be kept after being caught, gut, gills, scales must be removed, then washed, salted and refrigerated immediately.

- The best way is to boil before eating.

2.4. Prevention of non-bacterial food poisoning:

2.4.1. Mold poisoning:

- Mycotoxins are quite stable at t0 , boiling is ineffective. There is no specific medicine. - To prevent poisoning, it is necessary to ensure good food, mainly plant foods:

+ With corn, noodles, rice: keep dry, cool and free of mold.

+ With dry foods such as peanuts, sesame, coffee... These are foods that easily absorb moisture. To preserve them well, dry them with the shell intact, store them in a clean, sealed container, and occasionally dry them again.

+ With dipping sauces like soy sauce, you must check regularly.

2.4.2. Poisoning from cassava, bamboo shoots, and sprouted potatoes:

- Cassava and bamboo shoots contain Glucozid acid which produces very toxic Cyanhydric acid. This acid is easily soluble in water, volatile, and when oxidized or combined with sugar, it turns into a non-toxic substance.

- Symptoms of poisoning: Appear quickly, about 30 minutes or 1 - 2 hours after eating, the first symptoms are a burning sensation on the tongue and throat, dizziness, headache, vomiting, palpitations, rapid breathing, and cyanosis. If severe, there may be chest pain, impaired consciousness, slow pulse, low blood pressure, coma, and respiratory arrest.

- Preventive measures:

+ Cassava: Peel, remove both ends, soak thoroughly in water for 12 - 24 hours; boil thoroughly, preferably twice, when boiling the lid will break. It is best to eat cassava with sugar or eat dried cassava.

+ Bamboo shoots: Soak for a long time, wash, boil and drain many times.

+ Sprouted potatoes: Contains very toxic Solanin. Symptoms: Mild abdominal pain and diarrhea, severe cases: dilated pupils, mild paralysis of both legs, possible death due to paralysis of the respiratory center, cardiac arrest due to myocardial damage. To prevent disease, do not eat sprouted potatoes, if you want to eat them, you must dig out the sprouts and the sprouts.

2.4.3. Poisoning from eating toads:

- Toxic resin concentrates in the subcutaneous glands and viscera, especially in the liver and in the eggs.

- Symptoms: After eating a few minutes to 1 hour. Depending on the amount of poison entering the body, symptoms will appear such as: dizziness, nausea, vomiting, headache, paralysis, digestive disorders, cardiovascular disorders, then paralysis of movement, difficulty breathing due to respiratory muscle spasms, paralysis of respiratory muscles, circulation and death.

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