Pediatric Food Poisoning 

  • Author: Sunil K Sood, MBBS, DCh, MD; Chief Editor: Russell W Steele, MD   more...
 
Updated: Mar 13, 2012
 

Background

Food-borne illnesses are diverse in etiology, and food poisoning can follow ingestion of infectious organisms or noninfectious substances. Food-borne diseases (FBDs) constitute a serious public health problem in the United States. FBDs encompass classic toxin-mediated food poisoning, such as botulism; gastroenteritis that follows ingestion of preformed Staphylococcus aureus toxin; ingestion of chemicals in foods; and bacterial, parasitic, and viral infections. Many FBDs are zoonoses, which implies that the infectious agent has a primary animal reservoir and that humans are affected incidentally.

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Pathophysiology

Although the GI tract is the primary target, autonomic nervous system disturbances and CNS impairment are prominent manifestations in chemical-related, plant-related, and seafood-related poisonings and in botulism. The severity of dehydration can vary depending on the pathogen.

Typically, FBDs in which severe vomiting (eg, staphylococcal-toxin gastroenteritis) and small bowel diarrhea occur, typified by Vibrio cholerae infection, can cause life-threatening dehydration. Other organs involved include the liver in hepatitis A, muscles in trichinosis, lymph nodes in toxoplasmosis, and, importantly, the kidneys in hemolytic-uremic syndrome (HUS), which follows enterohemorrhagic Escherichia coli -induced diarrhea.

See the image below.

Escherichia coli on Gram stain. Gram-negative baciEscherichia coli on Gram stain. Gram-negative bacilli.
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Epidemiology

Frequency

United States

Current US Public Health Service estimates are that 76 million people acquire FBDs annually, with 325,000 hospitalizations and 5,200 deaths. Most deaths occur in elderly persons or individuals who are immunocompromised or pregnant.

International

International statistics are probably impossible to compute, but the obvious relevance of worldwide FBDs is the risk to travelers in the very mobile American and world population and the estimated 2 million deaths in children alone.[1, 2]

Mortality/Morbidity

The epidemiologic relevance of FBD is that outbreaks can involve an immense number of individuals and have the potential to overwhelm local health care services. Death can occur in a small proportion of affected patients; therefore, practitioners must take responsibility for reporting suspected FBDs and participate in investigations by the agency (eg, by saving food or vomitus samples).

Race

No specific racial predilection is noted, except that invasive Salmonella infections are more prevalent in individuals with hemoglobinopathies, which, in turn, are more common among people of African and Mediterranean descent.

Sex

No sex predilection is known for any food-borne illness; however, Listeria infection is often severe and life threatening in pregnant women.

Age

No age predilection is known for the acquisition of food-borne illnesses, but patients at the extremes of ages experience higher morbidity and mortality.

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Contributor Information and Disclosures
Author

Sunil K Sood, MBBS, DCh, MD  Professor of Clinical Pediatrics, Department of Pediatrics, Albert Einstein College of Medicine; Chief, Pediatric Infectious Diseases, Firm Director, Pediatric Unit, Schneider Children's Hospital at North Shore, North Shore University Hospital

Sunil K Sood, MBBS, DCh, MD is a member of the following medical societies: American Academy of Pediatrics, American Society for Microbiology, Infectious Diseases Society of America, and Society for Pediatric Research

Disclosure: Nothing to disclose.

Specialty Editor Board

Rosemary Johann-Liang, MD  Medical Officer, Infectious Diseases and Pediatrics, Division of Special Pathogens and Immunological Drug Products, Center for Drug Evaluation and Research, Food and Drug Administration

Rosemary Johann-Liang, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Mary L Windle, PharmD  Adjunct Associate Professor, University of Nebraska Medical Center College of Pharmacy; Editor-in-Chief, Medscape Drug Reference

Disclosure: Nothing to disclose.

Larry I Lutwick, MD  Professor of Medicine, State University of New York Downstate Medical School; Director, Infectious Diseases, Veterans Affairs New York Harbor Health Care System, Brooklyn Campus

Larry I Lutwick, MD is a member of the following medical societies: American College of Physicians and Infectious Diseases Society of America

Disclosure: Nothing to disclose.

Robert W Tolan Jr, MD  Chief, Division of Allergy, Immunology and Infectious Diseases, The Children's Hospital at Saint Peter's University Hospital; Clinical Associate Professor of Pediatrics, Drexel University College of Medicine

Robert W Tolan Jr, MD is a member of the following medical societies: American Academy of Pediatrics, American Medical Association, American Society for Microbiology, American Society of Tropical Medicine and Hygiene, Infectious Diseases Society of America, Pediatric Infectious Diseases Society, Phi Beta Kappa, and Physicians for Social Responsibility

Disclosure: Novartis Honoraria Speaking and teaching

Chief Editor

Russell W Steele, MD  Head, Division of Pediatric Infectious Diseases, Ochsner Children's Health Center; Clinical Professor, Department of Pediatrics, Tulane University School of Medicine

Russell W Steele, MD is a member of the following medical societies: American Academy of Pediatrics, American Association of Immunologists, American Pediatric Society, American Society for Microbiology, Infectious Diseases Society of America, Louisiana State Medical Society, Pediatric Infectious Diseases Society, Society for Pediatric Research, and Southern Medical Association

Disclosure: Nothing to disclose.

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