intoksikasi intoksikasi intoksikasi
TRANSCRIPT
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IO 1
Food Intoxication
Dr. dr. I Gede Arinton,SpPD-KGEHThe Internal Medicine DepartmentFKIK Unsoed/Margono Hospital
Purwokerto,2010.
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IO 2
Introduction
Classifying Foodborne Illness : Foodborne Infections – Result when a person eats food containing
pathogens, which then grow in the intestines and cause illness
Foodborne Intoxications– Result when a person eats food containing toxins
that cause illness Foodborne Toxin-Mediated Infections– Result when a person eats food containing
pathogens, which then produce illness-causing toxins in the intestines
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IO 3
Introduction
Adverse reactions to food :
Food intolerance (most common) :
– toxins
– infections
– pharmacological properties of food
– host factors (lactase deficiency)
Food allergy (hypersensitivity)
Food aversion (phobia)
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IO 4
Introduction
Toxicology = the science of poisons/toxicants/toxins- substance capable of causing harm - = seriously injuring or, ultimately, causing the death
Food toxicology - substances found/contaminate food - consume sufficient quantities - harmful
Poisons were known and studied by the ancient Greeks.
The fundamental concept of toxicology - Paracelsus (1493 - 1541) - his commentary :
– all substances are potential to be a poison poisons
– the right dose - cure.
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IO 5
TOXICANTS IN FOODS
Potential sources of toxicants in food
Nutrients :
– = A food substance that provides energy or is necessary for growth and repair.-- Ex. vitamins, minerals, carbohydrates, fats, and proteins.
Natural food toxicants:
– plants and some animals that are sources of food
Contaminants- Chemical & pathogen
Chemicals or substances - food additives- food reservation+ processing.
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IO 6
GIT Physiology
The primary function of the GI tract :
– break down complex food components into substances
appropriate for absorption into the body.
– waste removal
– keep substances that are of no value or are potentially
dangerous out of the body.
Food enters the mouth- chewing mixes it with saliva -
Amylase - destroys some of the bacteria.
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IO 7
GIT Physiology
The stomach - hormone gastrin is released- stimulates the release of HCl & pepsinogen- pH ≤ 2.0 critical defense & protects from many pathogens by the partial denaturation of proteins- eg. Salmonella
4 - 6 h chyme - intestine - absorption
Bile- Enterohepatic circulation- excretion toxicants metabolic degradation to urinary excretion - eliminates the toxicant from the body.
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IO 8
Food microbiology
Bacteria :• Salmonellosis• Shigellosis• Vibrio Gastroenteritis• Hemorrhagic Colitis• Staphylococcal Intoxication• Botulism
Virus- Hepatitis A Parasite Fungus Two groups of food contaminates
– Pathogen (cannot see or smell or taste)– Spoilage (can be seen or smelled or tasted)
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IO 9
Food microbiology
Staphylococcal food intoxication :– most prevalent foodborne disease.– Onset may 30 min - 8 hrs– Symptoms: nausea, vomiting, cramps, sweating, chills,
weak pulse, shallow respiration, subnormal body temperature.
– Recovery usually occurs within 24-48 hrs. – Source of infections:
• infected wounds and lesions of food handlers• coughing and sneezing
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IO 10
Food microbiology
Salmonellosis :
– 40% of all recorded foodborne diseases
– usually self limiting acute gastroenteritis
– the incubation period 6-48hrs (12-36hrs]
– symptoms: diarrhea, abdominal cramps, vomiting and
fever. Generally last 1-7 days.
– Associated both with animals both wild and domestic
– Food associated: beef, turkey, home-made ice cream, pork,
chicken and raw eggs.
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IO 11
Food microbiology
Clostridium botulinum
– Sporeforming anaerobic bacteria that produces very potent
toxin
– Symptoms: double vision, inability to swallow, speech
difficulty, progressive respiratory paralysis.
– Onset: after 12-36 hrs or even 8 days.
– Food implicated: canned low-acid food, smoked fish
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IO 12
Outbreaks
E. coli 0157:H7 (Northwest)
Cryptosporidium (Milwaukee)
Norwalk virus (Cruise ships)
Vibrio cholerae (South America)
Listeria (New York, New Jersey, CT)
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IO 13
Prevention
Application of heat
Adequate refrigeration
Adequate time and storage conditions
Sanitation
Safe thawing practices
Food additives (antimicrobials)
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IO 14
Manifestations of food allergy
SKIN: urticaria – angioedema > eczema
RESPIRATORY: rhinitis – asthma
GI TRACT: diarrhea – vomiting
GENERAL: anaphylactic shock
OTHER: migraine, hyperactivity, sleep disturbances etc… ?
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IO 15
Sensitization to food…
eating, touching and
smelling…
peanutsfishhen’s egg
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IO 16
Future immunomodulatory therapies for food allergy
Humanized monoclonal anti-IgE
Mutated allergen protein immunotherapy
Peptide immunotherapy
Immuno-stimulatory sequences
Probiotics