Examining the Complex Relationship Between Tuberculosis and Other Infectious Diseases in Children

Wilderness: Shellfish Poisoning, Paralysis

Shellfish poisoning can occur after eating clams, mussels, oysters, scallops, cockles, starfish, and crustaceans that consume dinoflagellates during a red tide. During a red tide, sea waters turn a reddish color because large numbers of red organisms (dinoflagellates) are present. Dinoflagellates kill fish and other organisms by releasing toxins (poisonous substances). Consequently, shellfish take in the concentrated saxitoxin, a poison that causes paralysis.

Red tides are most common in the cold waters of North America, Europe, Africa, Asia, and Japan. A red tide rarely occurs in warmer climates. People are poisoned when they unknowingly eat shellfish contaminated during a red tide with saxitoxins.

Shellfish that is contaminated during a red tide does not have an abnormal taste, smell, or color, and the toxin is not destroyed by heating or cooking. Paralysis due to shellfish poisoning follows a similar progression to that of pufferfish poisoning.

Symptoms of shellfish poisoning begin 30 minutes to 2 hours after eating and include:

Muscle paralysis may occur. The person who has been poisoned may also develop the following conditions:

Ingesting large amounts of contaminated shellfish can result in coma and respiratory failure.

Do not induce vomiting

In case of vomiting, turn the person on their side to prevent the person from breathing in any stomach contents (vomit).

The person may become paralyzed.

Medical liquid charcoal to absorb the toxins may be given as a drink.

Artificial respiration may keep the person alive until they arrive at a hospital's emergency department.

Seek medical treatment as soon as possible.

wilderness: shellfish poisoning, paralysis; red tide; food poisoning; diarrhea; abdominal cramps; vomiting; nausea; toxicity

Food Poisoning: Signs, Symptoms, And Treatment

Food poisoning is an irritation or infection in your digestive system that you get from something you eat or drink. It's usually caused by foods or drinks contaminated with viruses, parasites, or bacteria. However, harmful chemicals can also cause food poisoning sometimes.

You can help prevent food poisoning by storing and preparing your food safely. (Photo Credit: iStock/Getty Images).

Usually, food poisoning comes on fast and doesn't last long (often less than a week), and most people get better without treatment. However, for some people, food poisoning lasts longer or causes serious complications.

Anyone can get food poisoning, but the groups of people more likely to get food poisoning include:

Older adults

Infants and children

Pregnant people

People with weakened immune systems

These groups of people are also more likely to have serious symptoms or complications.

Food poisoning vs. Stomach flu

Stomach flu usually results from a virus that you get from someone who is infected with it. In contrast, you usually get food poisoning when you eat food that wasn't cooked long enough or that sat out of the fridge for too long.

Both cause symptoms such as nausea, throwing up, and diarrhea. But there are a couple of different clues about which is causing your symptoms. One way is by how quickly your symptoms start. Food poisoning usually starts about 2-6 hours after you eat the contaminated food. Whereas, stomach flu generally starts about 1-2 days after you get exposed to the virus. Another way is by how fast you get over it. Food poisoning symptoms are usually short and intense, but stomach flu lasts a few days or longer. Also, stomach flu is less likely to cause symptoms such as fever and chills compared to food poisoning.

The most common symptoms and signs of food poisoning include:

Diarrhea, including bloody diarrhea

Vomiting (throwing up)

Stomachache and nausea

Headache

Fever

If you have a more serious type of food poisoning (such as botulism or fish/shellfish poisoning), you may also get the following symptoms:

Blurred vision

Tingling or numbness in your skin

Weakness

Paralysis

These symptoms are serious, so if you have any of these, you need to go to your doctor or ER.

How soon after food poisoning do you vomit?

Depending on the germ that causes your case of food poisoning, your symptoms may start within about 2-6 hours after you eat the contaminated food. Here are some estimated times between exposure and symptom onset by cause:

Campylobacter, 2-5 days

Escherichia coli (E. Coli), usually 3-4 days

Listeria, within 2 weeks

Salmonella, 6 hours to 6 days

Staphylococcus aureus, 30 minutes to 8 hours

Clostridium, 6-36 hours

Vibrio, within 24 hours

Norovirus, 12-48 hours

Hepatitis A, 15-50 days

How long does food poisoning last?

Food poisoning usually runs its course fairly quickly, so you should feel better within about 12-48 hours.

Several kinds of germs cause food poisoning, including bacteria, parasites, and viruses. Some of the most common germs that cause food poisoning include:

Bacteria

Bacteria grow fast when food is kept at a temperature of 40-140 F. Keep your refrigerator set to colder than 40 F to help prevent food poisoning. Also, cook your food thoroughly (internal temperature above 140 F) because this can kill most bacteria.

The main bacteria that cause food poisoning include:

Campylobacter, bacteria found in contaminated or poorly processed foods and drinks

Escherichia coli (E. Coli), usually found in raw vegetables and undercooked meat

Listeria, which can be present in deli meats and soft cheeses

Salmonella, typically found in undercooked poultry and raw eggs

Staphylococcus aureus, which can also cause staph infections

Clostridium, which can cause botulism and may infect home-canned, preserved, or fermented foods

Vibrio, which can infect raw or undercooked seafood

Viruses

You can get infected with a virus by drinking unsafe water, washing produce with contaminated water, or eating food prepared by someone infected with a virus. Two viruses that cause food poisoning include Norovirus and hepatitis A.

Parasites

You can get parasites from infected food or water. But it's rare to get infected with a parasite in the U.S. Because most water is treated. Some parasites that may cause food poisoning include:

Toxoplasma gondii, which you can get from cleaning an infected cat's litter box, eating raw or undercooked food, or getting an infected organ in a transplant or blood transfusion

Giardia, which you can get from food or surfaces contaminated with human poop

Cryptosporidium, which you can get from touching contaminated surfaces or swimming in contaminated water

Another way you may get food poisoning is through eating food containing harmful chemicals, such as:

Unwashed produce that has chemical pesticides on their surface

Fish or shellfish that has toxins produced by algae or bacteria

Some kinds of wild mushrooms

Is food poisoning contagious?

Yes, you can get food poisoning from another person if they have it and don't wash their hands after getting diarrhea or throwing up. You can get sick if you touch surfaces that they touched and then touch your eyes, nose, or mouth. Or if they touch your food without washing their hands.

You're more likely to get food poisoning during pregnancy because your immune system can't fight infections as well as it usually does. Also, your baby's immune system doesn't finish developing until a few months after they are born, so they can't really fight off infections. If you get infected with germs such as listeria, salmonella, or toxoplasma, it can make both you and your baby sick. 

Getting food poisoning when you're pregnant can cause problems with your pregnancy and baby, including:

Miscarriage

Stillbirth

Preterm labor and birth

Low birth weight in your baby

Life-threatening infections in your baby, such as meningitis (swelling in the brain) or bacteria in their blood

Eye infections in your baby

Swollen liver and spleen in your baby

Jaundice in your baby

Seizures in your baby

Fluid in your baby's brain

You can help prevent food poisoning by avoiding certain foods, such as:

Soft cheeses such as Brie, camembert, chevre, ricotta, feta, mozzarella, bocconcini, and blue-veined cheeses

Unpasteurized milk and juice

Undercooked or raw meat, fish, or seafood

Unwashed and precut fruits and vegetables

Soft-serve ice cream

Undercooked or raw eggs

You should also avoid leftovers that are more than a day old. Ensure all leftovers have been kept in a refrigerator at less than 40 F and reheated to a high enough temperature (over 140 F).

Some home remedies for food poisoning help ease your symptoms, while others help keep you hydrated.

Stay hydrated

You can lose a lot of fluid in a short time when you're throwing up, having diarrhea, or running a fever. Dehydration can cause you to feel tired and weak, and it may make your heart beat irregularly. It can even be fatal if not treated right away, especially in young kids and older adults.

Staying hydrated is one of the best ways you can support your body while it fights the infection. Try drinking hydration formulas, such as Pedialyte, which can help you stay hydrated better than water. If you have trouble keeping liquids down, you can try sucking on ice chips to stay hydrated. If you get a serious case of dehydration, you may need to go to a clinic or hospital to get fluids through an IV.

Rest your body

Another way to support your body while it fights the infection is to stay home and rest.

Eat bland foods

You may feel too sick to eat on the first day. As long as you are still throwing up, stick to liquids such as water, clear broth, diluted fruit juice, decaffeinated tea, or sports drinks.

But once you are able to eat and drink again, stick to bland foods and eat just a little bit at a time to see how your stomach reacts. The BRAT diet is gentle on your stomach and may help ease your diarrhea because it firms up your poop and replace some nutrients you may have lost through vomiting. BRAT is an acronym for:

Bananas

Rice

Applesauce

Toast

Other foods that are gentle on your stomach include dry cereal, saltine crackers, oatmeal, and potatoes. Remember, though, don't eat the BRAT diet for more than a few days at a time because it only gives you a limited amount of nutrition. For instance, it doesn't give you much protein or fiber.

Some foods may make you more dehydrated or increase your nausea and vomiting. Avoid the following until you're feeling well:

Dairy products

Fried foods

Spicy foods

Sugary foods

Caffeine

Alcohol

Take medicine to ease your symptoms

If staying hydrated, resting, and eating a bland diet don't help, you can try easing your symptoms with the help of some over-the-counter medicines, such as:

Bismuth subsalicylate (Pepto Bismol, Kaopectate) can help ease nausea and diarrhea

Loperamide (Imodium A-D) can help ease diarrhea by slowing down your digestive process

However, these medicines can be dangerous for children. Young children with nausea and diarrhea should instead drink fluids and follow a bland diet. Your pediatrician may also recommend a rehydration solution (such as Pedialyte) to keep them from getting dehydrated.

Add probiotics to your meals

Everyone has bacteria living inside of them. Some of these are helpful, and others can make you sick. You need helpful bacteria, for instance, to digest your food.

Food poisoning can throw off the balance of helpful and unhelpful bacteria in your gut. Probiotics are helpful bacteria such as the ones you already have in your body. Taking these can bring your gut bacteria back into balance, which makes your digestive system healthier and may protect you from food poisoning in the future. Once you're feeling better, you can also eat some yogurt to help keep your gut bacteria in balance.

You can treat most cases of food poisoning at home. However, you should see a doctor if:

Your fever goes above 102 F.

You see blood in your vomit or poop.

Your diarrhea lasts more than 3 days.

You're vomiting so often that you can't keep liquids down.

You have severe pain.

You have signs of severe food poisoning, such as tingling limbs or blurry vision.

You have signs of severe dehydration, such as not peeing much or a dry mouth or throat.

If your food poisoning is caused by bacteria or parasites, your doctor may prescribe antibiotics, medicines that target parasites (antiparasitics), or anti-vomiting medicines (antiemetics).

Antibiotics

You usually won't need an antibiotic unless you are very sick or have a high risk of complications, such as blood clots in your kidneys, meningitis, or sepsis. Some antibiotics that your doctor may prescribe (if you're really sick with an E. Coli infection) include:

Azithromycin (Zithromax, Zmax)

Ciprofloxacin (Cipro)

Rifamycin (Aemcolo)

Rifaximin (Xifaxan)

Antiparasitics

If your food poisoning is caused by a parasite, your doctor may prescribe you an antiparasitic medicine, such as:

Metronidazole, tinidazole, furazolidone, or albendazole (for giardia infections)

Sulfadiazine plus pyrimethamine, sulfonamides, sulfamethazine, or sulfamerazine (for toxoplasma infections)

Antiemetics (anti-vomiting medicines)

Some medicines your doctor may prescribe to control serious vomiting, include:

Chlorpromazine (Thorazien)

Metoclopramide (Reglan and Metozolv)

People get food poisoning mainly because they don't store and prepare food safely. To reduce your chances of getting food poisoning:

Wash your hands for 20 seconds in hot, soapy water before and after you handle food, especially if you handle raw meat, poultry, seafood, and eggs.

Wash raw vegetables and fruits before eating, cutting, or cooking.

Clean cooking utensils, cutting boards, dishes, and countertops.

Refrigerate or freeze perishable foods such as meat, poultry, seafood, dairy, cut fruit, and leftovers within 2 hours.

If you take food out of your fridge or pantry and it looks like it might be spoiled, throw it away.

Defrost frozen food in the microwave, refrigerator, or cold water, and cook it right away.

Keep raw meat, poultry, and seafood separate from other foods.

Use a food thermometer to ensure foods are cooked to a safe internal temperature (over 140 F).

Also, watch out for food recalls. In the U.S., the USDA and FDA issue food recalls when they find out that certain foods are making people sick. Check out foodsafety.Gov for the latest recalls.

Food poisoning is an illness you get from eating food that's contaminated with bacteria, parasites, or other germs. Usually, symptoms such as vomiting and diarrhea start within hours of eating contaminated food. However, most people get better within a day or two. You can treat food poisoning at home by staying hydrated, resting, and eating foods that are easy on your stomach. To help prevent food poisoning, wash your hands before and after cooking, and make sure to store and cook your foods at safe temperatures.

Food Poisoning Warning Signs That Demand Help

The stomach cramps started innocently enough after dinner, dismissed as typical indigestion from eating too quickly. Within hours, what seemed like minor discomfort escalated into violent illness that left the entire household questioning every meal consumed over the past few days. Food poisoning strikes millions of Americans annually, ranging from mild inconvenience to life-threatening emergencies that require immediate medical intervention.

Understanding the difference between routine stomach upset and dangerous food poisoning can mean the difference between recovery at home and hospitalization. The symptoms often develop gradually, making it challenging to recognize when professional medical care becomes necessary. Certain warning signs indicate serious complications that can become fatal without proper treatment, while other symptoms respond well to home care and time.

The complexity of food poisoning extends beyond simple stomach problems, involving multiple body systems and potentially causing long-term health consequences. Different types of foodborne pathogens produce distinct symptom patterns, treatment requirements, and recovery timelines. Recognizing these differences empowers individuals to respond appropriately and seek help when necessary.

Emergency symptoms requiring immediate medical attention

Severe dehydration represents the most immediate threat from food poisoning, developing rapidly when the body loses fluids faster than they can be replaced. Signs include dizziness when standing, decreased urination, dark yellow urine, dry mouth and lips, and skin that remains pinched when pulled up. These symptoms indicate dangerous fluid loss that can lead to kidney failure, shock, and death without prompt treatment.

High fever above 102°F (38.9°C) suggests serious bacterial infection that may require antibiotic treatment. Fever combined with severe abdominal pain, bloody stools, or persistent vomiting creates a medical emergency requiring immediate evaluation. The combination of high fever and neurological symptoms like confusion or severe headache may indicate life-threatening complications.

Blood in vomit or stool indicates significant tissue damage that requires immediate medical assessment. Bright red blood suggests active bleeding, while dark, coffee-ground appearance in vomit or black, tarry stools may indicate internal bleeding. Any visible blood in body fluids during food poisoning episodes demands emergency medical care.

Severe abdominal pain that worsens progressively or becomes localized to specific areas may indicate complications beyond simple food poisoning. Appendicitis, intestinal perforation, or other surgical emergencies can develop during severe foodborne illness episodes. Pain that prevents normal movement or causes doubling over requires immediate medical evaluation.

Progressive symptom development patterns

Food poisoning symptoms typically follow predictable patterns based on the type of pathogen involved and individual immune response. Initial symptoms often begin within hours of consuming contaminated food but may be delayed up to several days depending on the organism involved. Early recognition of symptom progression helps determine appropriate response and treatment timing.

Nausea usually develops first, often accompanied by loss of appetite and general malaise. This phase may last several hours before progressing to active vomiting. The frequency and severity of vomiting episodes provide important clues about the severity of the poisoning and need for medical intervention.

Diarrhea typically begins after vomiting has started, though some individuals experience both simultaneously. The character of diarrhea provides diagnostic information about the likely pathogen involved. Watery diarrheat suggests toxin-producing bacteria, while bloody diarrhea indicates invasive bacterial infection requiring different treatment approaches.

Abdominal cramping intensifies as the illness progresses, often becoming the most debilitating symptom. The location and character of pain can help identify the specific intestinal areas affected and guide treatment decisions. Cramping that prevents sleep or normal activities indicates more severe illness requiring medical attention.

Bacterial food poisoning characteristics

Salmonella infection produces symptoms that typically begin 12-72 hours after consuming contaminated food. The illness usually starts with nausea and cramping, progressing to frequent watery diarrhea that may become bloody. Fever commonly develops and may reach dangerous levels requiring medical treatment. Most cases resolve within a week, but some individuals develop complications requiring hospitalization.

Campylobacter poisoning often begins with flu-like symptoms including fever, headache, and muscle aches before gastrointestinal symptoms develop. The diarrhea is typically bloody from the onset and may be accompanied by severe abdominal pain. This type of food poisoning tends to last longer than other bacterial infections, sometimes persisting for two weeks or more.

E. Coli infection, particularly from dangerous strains like O157:H7, produces severe bloody diarrhea with intense abdominal cramping. The absence of fever with bloody diarrhea suggests E. Coli poisoning. Some cases progress to hemolytic uremic syndrome, a life-threatening complication affecting the kidneys and blood clotting system that requires immediate intensive care.

Clostridium perfringens poisoning typically develops within 8-12 hours of eating contaminated food and produces intense abdominal cramping with diarrhea but usually no vomiting or fever. The illness tends to be brief but can be severe in elderly individuals or those with compromised immune systems.

Viral foodborne illness patterns

Norovirus represents the most common cause of foodborne illness, producing rapid onset of violent vomiting and diarrhea. Symptoms typically begin 12-48 hours after exposure and may include low-grade fever, headache, and body aches. The illness usually resolves within 1-3 days but can cause severe dehydration due to the intensity of fluid losses.

Rotavirus primarily affects children but can cause severe illness in adults with compromised immune systems. The infection produces profuse watery diarrhea, vomiting, and fever. Dehydration develops rapidly, particularly in young children and elderly adults, requiring careful monitoring and possible medical intervention.

Hepatitis A transmitted through contaminated food produces different symptoms than typical food poisoning. Initial symptoms may include fatigue, nausea, and loss of appetite, followed by yellowing of the skin and eyes (jaundice). The illness can last several weeks and requires medical management to prevent complications.

Parasitic food poisoning manifestations

Giardia infection produces chronic diarrhea, abdominal cramping, bloating, and excessive gas. Symptoms may not appear for 1-3 weeks after consuming contaminated food or water. The illness can persist for months without treatment and may cause significant weight loss and nutritional deficiencies.

Cryptosporidium causes watery diarrhea that can be particularly severe in individuals with weakened immune systems. The infection may produce cycles of improvement and worsening that can last for weeks. Dehydration becomes a significant concern due to the prolonged nature of fluid losses.

Cyclospora produces prolonged illness with watery diarrhea, loss of appetite, weight loss, bloating, and fatigue. Symptoms may come and go in cycles and can persist for weeks or months without proper treatment. The chronic nature of the illness often requires medical diagnosis and prescription medication.

Toxin-mediated food poisoning

Staphylococcal food poisoning develops rapidly, usually within 1-6 hours of eating contaminated food. The illness produces sudden onset of severe nausea, vomiting, and abdominal cramping. Diarrhea may occur but is typically less prominent than vomiting. The rapid onset and brief duration help distinguish this type from bacterial infections.

Clostridium botulinum produces a completely different syndrome than other food poisoning organisms. Instead of gastrointestinal symptoms, botulism causes progressive muscle weakness starting with the face and head. Symptoms include double vision, difficulty swallowing, and eventual paralysis. This represents a medical emergency requiring immediate hospitalization.

Scombroid poisoning from improperly stored fish produces symptoms resembling an allergic reaction, including flushing, headache, rapid heartbeat, and sometimes gastrointestinal symptoms. The reaction typically begins within minutes to hours of eating contaminated fish and may require antihistamine treatment.

Home treatment strategies

Fluid replacement represents the cornerstone of home treatment for mild to moderate food poisoning. Clear liquids including water, broth, and electrolyte solutions help prevent dehydration while allowing the digestive system to rest. Small, frequent sips work better than large amounts that may trigger vomiting.

The BRAT diet (bananas, rice, applesauce, toast) provides easily digestible foods that can help firm loose stools while providing some nutrition. These bland foods are less likely to irritate an already inflamed digestive system. Gradual introduction of other mild foods can begin as symptoms improve.

Rest becomes crucial for recovery, allowing the immune system to fight infection while reducing stress on the body. Physical activity should be minimized until symptoms resolve completely. Sleep helps the body heal and may reduce the severity and duration of illness.

Anti-diarrheal medications should generally be avoided during bacterial food poisoning as they may prolong infection by preventing the body from eliminating harmful organisms. However, they may be appropriate for certain types of food poisoning or when diarrhea becomes severe enough to cause dangerous dehydration.

Medical treatment approaches

Healthcare providers focus primarily on preventing and treating dehydration through intravenous fluid replacement when oral intake proves insufficient. Severe dehydration requires immediate correction to prevent organ failure and other life-threatening complications. Electrolyte imbalances may also require specific correction with targeted replacement therapy.

Antibiotic treatment remains controversial for most bacterial food poisoning cases, as antibiotics may prolong bacterial shedding in some infections while providing benefit in others. Healthcare providers carefully evaluate each case to determine when antibiotic therapy is appropriate and safe.

Anti-nausea medications may be prescribed to control severe vomiting that prevents adequate fluid intake. These medications can help break the cycle of vomiting and dehydration, allowing for better recovery. Various formulations including suppositories may be used when oral medications cannot be retained.

Hospitalization becomes necessary for severe dehydration, persistent high fever, signs of complications, or inability to maintain adequate fluid intake at home. Hospital care allows for close monitoring and immediate intervention if complications develop.

Common contamination sources

Poultry products represent one of the highest risk foods for bacterial contamination, particularly with Salmonella and Campylobacter. Raw chicken and turkey require careful handling, storage, and thorough cooking to eliminate harmful bacteria. Cross-contamination from raw poultry to other foods creates additional risks.

Ground meat products carry higher contamination risks than whole cuts due to increased surface area and mixing during processing. Ground beef, pork, and turkey should be cooked to proper internal temperatures and consumed promptly after cooking. Leftover ground meat requires careful storage and reheating.

Leafy greens have been associated with numerous food poisoning outbreaks due to contamination during growing, harvesting, or processing. Thorough washing reduces but does not eliminate all risks. Pre-washed salads and other ready-to-eat greens require careful attention to expiration dates and storage conditions.

Dairy products, particularly unpasteurized varieties, can harbor dangerous bacteria including Listeria, Salmonella, and E. Coli. Proper refrigeration and attention to expiration dates help minimize risks. Soft cheeses and other high-risk dairy products require extra caution.

Prevention strategies

Temperature control represents the most critical factor in preventing food poisoning. Hot foods should be kept above 140°F (60°C) and cold foods below 40°F (4°C). The temperature danger zone between these points allows rapid bacterial growth that can reach dangerous levels within hours.

Hand hygiene before, during, and after food preparation eliminates many sources of contamination. Proper handwashing with soap and warm water for at least 20 seconds removes harmful organisms that could contaminate food. Hand sanitizers provide additional protection when handwashing is not possible.

Cross-contamination prevention requires using separate cutting boards, utensils, and preparation areas for raw meats and ready-to-eat foods. Thorough cleaning and sanitizing of all surfaces after contact with raw meats prevents spreading contamination to other foods.

Proper cooking temperatures eliminate most foodborne pathogens when reached throughout the food item. Using food thermometers ensures adequate cooking rather than relying on appearance or timing alone. Different foods require different internal temperatures for safety.

Long-term complications and recovery

Most food poisoning episodes resolve completely without lasting effects, but some infections can cause chronic health problems. Post-infectious irritable bowel syndrome may develop after severe bacterial infections, causing ongoing digestive symptoms for months or years. The condition typically improves gradually but may require dietary modifications and medical management.

Reactive arthritis can develop weeks after certain bacterial food poisoning episodes, causing joint pain and inflammation that may persist for months. The condition typically affects weight-bearing joints and may require anti-inflammatory treatment and physical therapy.

Kidney complications from certain E. Coli infections can cause permanent damage requiring ongoing medical care. Hemolytic uremic syndrome affects kidney function and blood clotting, potentially leading to chronic kidney disease or other long-term health problems.

The recovery process varies significantly based on the type of organism involved, individual health status, and promptness of appropriate treatment. Most viral infections resolve within days, while bacterial infections may take a week or longer. Parasitic infections often require specific treatment and may take months to resolve completely.

Understanding food poisoning enables appropriate response when illness strikes while implementing prevention strategies that reduce future risks. Recognition of serious warning signs ensures timely medical care when needed, while proper home treatment supports recovery from milder cases. The combination of knowledge and preparation helps protect against this common but potentially dangerous health threat.

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