Makindo Medical Notes Comprehensive Medical Encyclopedia | Education for Healthcare Professionals

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Food borne disease

💩 Traveller’s Diarrhoea ⚠️ Do NOT give antibiotics in enterohaemorrhagic E. coli (EHEC) → risk of Haemolytic Uraemic Syndrome (HUS).

🌍 About

Affects 20–30% of travellers, usually within the first week of travel.
Caused by ingestion of contaminated food or water.

🦠 Aetiology

E. coli (esp. ETEC = commonest cause).
Campylobacter → acute abdomen picture, bloody diarrhoea.
Amoebic dysentery (Entamoeba histolytica) → abdominal pain + blood.
Clostridioides difficile (post-antibiotics).
Giardia → foul-smelling, greasy stools, >7 days.
Cryptosporidium → prolonged watery diarrhoea, esp. immunocompromised.
Cyclospora → relapsing/prolonged watery diarrhoea.

🤒 Clinical

Watery or bloody diarrhoea, nausea, vomiting.
Cramps, fever, dehydration.
Severe → electrolyte imbalance, HUS (EHEC).

🧪 Investigations

FBC, U&E, LFTs, CRP.
Stool MCS + OCP (ova, cysts, parasites), PCR if available.
Colonoscopy if persistent (rule out IBD, colitis).

🔍 Differential

Inflammatory bowel disease (Crohn’s, UC).
Food poisoning (short duration, meal-related).
Viral gastroenteritis (24–48 h, self-limiting).

🛡️ Prevention

💧 Drink boiled/bottled water; avoid ice.
🥗 Avoid salads/raw fruit washed in unsafe water.
🧼 Strict hand hygiene before eating.

💊 Prophylaxis

Rare; consider in high-risk groups:

Ileostomy/short bowel.
Immunocompromised (HIV, transplant).
CKD or significant comorbidity.

Agents: Ciprofloxacin or Metronidazole (per ID advice).

⚕️ Management

💧 Rehydration = cornerstone (ORS; IV fluids if severe).
💊 Antibiotics: – Ciprofloxacin / Azithromycin for severe/prolonged cases. – ❌ Avoid in EHEC (HUS risk).
🚫 Antimotility (e.g. loperamide): safe in mild watery diarrhoea, avoid if bloody diarrhoea or fever.
🔄 Watch for post-infectious IBS.

🥘 Foodborne Diseases – Quick Reference

🦠 Organism	💡 Illness	⏱️ Onset	🤒 Symptoms	📆 Duration	🍽️ Sources
Bacillus cereus	Food poisoning	10–16h	Cramps, watery diarrhoea	24–48h	Meats, stews, sauces
Campylobacter jejuni	Campylobacteriosis	2–5d	Fever, cramps, bloody diarrhoea	2–10d	Poultry, unpasteurised milk
Clostridium botulinum	Botulism	12–72h	Neuro → blurred vision, weakness	Variable	Improperly canned foods
Cryptosporidium	Cryptosporidiosis	2–10d	Watery diarrhoea ± fever	Weeks–months	Contaminated water
Giardia	Giardiasis	1–3w	Greasy, foul stools	Weeks	Contaminated water
E. coli (ETEC)	Traveller’s diarrhoea	1–3d	Watery diarrhoea, cramps	3–7d	Water/food contaminated with faeces
E. coli O157:H7	Haemorrhagic colitis	1–8d	Bloody diarrhoea, HUS risk	5–10d	Undercooked beef, unpasteurised milk
Norovirus	Viral gastroenteritis	12–48h	Vomiting, cramps, diarrhoea	12–60h	Raw produce, shellfish
Salmonella	Salmonellosis	6–48h	Fever, cramps, diarrhoea	4–7d	Eggs, poultry, dairy
Shigella	Dysentery	1–7d	Bloody/mucus diarrhoea, fever	2–7d	Contaminated food/water
Vibrio vulnificus	Severe gastroenteritis	1–7d	Diarrhoea ± sepsis, ulcers	2–8d	Raw seafood (esp. oysters)

📚 References

PLEASE NOTE LEGAL ADVICE: The contents are under continuing development and improvements and may contain errors of omission or fact. Feedback vital and always welcome at drokane at gmail.com. This is not to be used for the assessment, diagnosis or management of patients. It should not be regarded as medical advice. It is only for educational purposes. Please adhere to your local protocols. If you are unwell please seek healthcare advice from your doctor. This does not replace senior or specialist advice. If you do not accept this then please do not use the website. If you need medical advice, please consult a doctor or other appropriate medical professional. If you are a medical professional and you need advice then speak to your senior or colleagues.

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