Table B UPPER GASTROINTESTINAL SIGNS AND SYMPTOMS …

1 Table B Illnesses acquired by ingestion of contaminated foods: A condensed classification by SYMPTOMS , incubation periods, and types of agents Etiologic agent Incubation or Specimen to Factors contributing Illness and source latency perioda SIGNS and symptomsa Foods usually involvedb collect to foodborne outbreaksd UPPER GASTROINTESTINAL SIGNS AND SYMPTOMS [NAUSEA, VOMITING] PREDOMINATE. Incubation (latency) period usually less than 1 h Fungi GASTROINTESTINAL Possibly resin-like 30 min to 2 h Nausea, vomiting, retching, Many varieties of wild Vomitus Eating unknown varieties of irritating substances in some diarrhea, abdominal pain mushrooms wild mushrooms.

2 Group mushroom mushrooms (mushroom mistaking toxic mushrooms poisoning species are different for edible varieties from those cited on pages 103 and 113). Chemicals Antimony Antimony in gray Few minutes Vomiting, abdominal High-acid foods and Vomitus, stools, Purchasing/using antimony- poisoning enamelware to 1 h pain, diarrhea beverages urine containing utensils;. storing high-acid foods in chipped gray enamelware Cadmium Cadmium in plated 15 30 min Nausea, vomiting, High-acid foods Vomitus, stools, Purchasing/using cadmium- poisoning utensils abdominal cramps, and beverages; urine, blood containing utensils; storing diarrhea, shock metal-colored cake high-acid beverages in cadmium decorations containers Copper Copper in pipes and Few minutes Metallic taste, nausea, High-acid foods and Vomitus, gastric Faulty backflow preventors in poisoning utensils.

3 Old ice cream to few hours vomiting (green ice creams (ices) and washing, urine, vending machines or soda machines; old dairy vomitus), dizziness, beverages blood fountains; storing or vending white metal abdominal pain, high-acid (low pH) beverages diarrhea, chills from copper containers, pipe lines, or old equipment containing copper Fluoride Sodium fluoride in Few minutes to Salty or soapy taste, Any accidentally- Vomitus, gastric Storing insecticides in same area poisoning insecticides and 2h numbness of mouth, contaminated foods, washing as foods, mistaking pesticides rodenticides vomiting, diarrhea, particularly dry foods for powdered foods dilated pupils, spasms, (such as dry milk, flour, pallor, shock, collapse baking powder.)

4 Cake mixes). (continued). Table B (continued). Etiologic agent Incubation or Specimen to Factors contributing Illness and source latency perioda SIGNS and symptomsa Foods usually involvedb collect to foodborne outbreaksd Lead poisoning Lead in earthen-ware 30 min or longer Metallic taste, burning of High-acid foods and Vomitus, gastric Purchasing or using lead- vessels; pesticides, mouth, abdominal pain, beverages stored in washing, stools, containing vessels; storing high- paint, plaster, putty, milky vomitus, bloody or lead-containing vessels.

5 Blood, urine acid foods including wine in soldered joints black stools, foul breath, any accidentally lead-containing vessels; storing blue gum line, shock contaminated food pesticides in same area as food Tin poisoning Tin in tinned cans or 30 min to 2 h Bloating, nausea, vomiting, High-acid foods and Vomitus, gastric Storing high-acid foods in tinned containers abdominal cramps, beverages washing, urine, cans or containers in which diarrhea, headache blood, stools there is no lacquer or the lacquer had peeled.

6 Very high concentrations are required to cause illness Zinc poisoning Zinc in galvanized Few minutes to Pain in mouth and High-acid foods and Vomitus, gastric Storing high-acid foods in containers few hours abdomen, nausea, beverages washing, urine, galvanized cans vomiting, dizziness blood, stools Incubation (latency) period usually between 1 and 6 h Bacteria Bacillus cereus Exo-enterotoxin of 5 h Nausea, vomiting, Boiled or fried rice, Vomitus, stools Storing cooked foods at room gastroenteritis B. cereus; organism in occasionally cooked corn-meal temperature; storing cooked (emetic type) soil (strains differ from diarrhea dishes, porridge, foods in large containers in those cited on page 105) pasta refrigerator; preparing foods several hours before serving Staphylococcal Exoenterotoxins A, B, 1 8 h, typically Nausea, vomiting, retching, Ham, meat and poultry Ill: Vomitus, stools, Storing cooked foods at room intoxication C, D, E, F or H of 2 4 h abdominal pain, products.

7 Cream-filled rectal swabs. temperature; storing cooked foods Staphylococcus diarrhea, prostration pastries; whipped butter; Food handlers: nasal in large containers in refrigerator;. aureus. Staphylococci cheese; dry milk; food swabs, swabs of touching cooked foods; preparing from nose, skin and mixtures; high protein lesions foods several hours before lesions of human leftover foods serving; holding foods at warm beings and other animals bacterial-incubation temperatures;. and from udders of cows fermentation of abnormally low-acid foods; handling foods by persons with pus-containing infections Etiologic agent Incubation or Specimen to Factors contributing Illness and source latency perioda SIGNS and symptomsa Foods usually involvedb collect to foodborne outbreaksd Chemicals Nitrite poisoningc Nitrites or nitrates used as 1 2 h Nausea, vomiting, Cured meats.

8 Any Blood Using excessive amounts of meat curing compounds cyanosis, headache, accidentally- nitrites or nitrates in foods dizziness, weakness; contaminated food; for curing or for covering loss of consciousness; spinach exposed up spoilage; mistaking chocolate-brown colored to excessive nitrites for common salt and bloodc nitrification other condiments; improper refrigeration of fresh produce;. excessive nitrification of fertilized foods Marine Phytoplankton Diarrhetic shellfish Okadaic acid and other 12 h, usually Diarrhea, nausea, vomiting, Mussels, clams, Gastric washing Harvesting shellfish from poisoning toxins produced 4h abdominal cramps, chills scallops waters with higher than usual by dinoflagellates concentration of Dinophysis Dinophysis spp.

9 Spp. Azaspiracid shellfish Azaspiracids (polyethers) Minutes to hours Nausea, vomiting, severe Mussels, scallops, clams, Gastric washings Eating shellfish from toxic poisoning (AZP) from dinoflagellate diarrhea, and stomach crabs or vomitus to areas where Azadinium (a few outbreaks Azadinium, cramps were similar detect the dino- dinoflagellates occur from Irish mussels and it predator of those of diarrhetic flagellate species to date) Protoperidinium shellfish poisoning (West European waters (DSP); may target to date).

10 Multiple organs and be a carcinogen Incubation (latency) period usually between 7 and 12 h Fungi Cyclopeptide and Cyclopeptides and 6 12 h Abdominal pain, feeling Amanita phalloides, A, Urine, blood, Eating certain species of Amanita, gyromitrin groups gyromitrin in some of fullness, vomiting, verna, A. bisporigera, vomitus Galerina, and Gyromitra of mushroom mushrooms protracted diarrhea, Galerina autumnalis, mushrooms; eating unknown poisoning (mushroom species loss of strength, thirst, Gyromitra esculenta varieties of mushrooms.)