Food poisoning occurs after eating food contaminated by bacteria. The symptoms of food poisoning are basically the same as those of stomach flu: abdominal cramps, nausea, vomiting, diarrhea, and fever. But if your child and other people who have eaten the same food all have the same symptoms, the problem is more likely to be food poisoning than stomach flu. The bacteria that cause food poisoning cannot be seen, smelled, or tasted, so your child won’t know when she is eating them. These organisms include:
Staphylococcus Aureus (Staph)
Staph contamination is the leading cause of food poisoning. These bacteria ordinarily cause skin infections, such as pimples or boils, and are transferred when foods are handled by an infected person. When food is left at a specific temperature (100 degrees Fahrenheit [37.8 Celsius])—generally one that is lower than the temperature needed to keep food hot—the staph bacteria multiply and produce a poison (toxin) that ordinary cooking will not destroy. The symptoms begin one to six hours after eating the contaminated food, and the discomfort usually lasts about one day.
Salmonella bacteria (there are many types) are another major cause of food poisoning in the United States. The most commonly contaminated foods are raw meat (including chicken), raw or undercooked eggs, and unpasteurized milk. Fortunately, salmonella are killed when the food is cooked thoroughly. Symptoms caused by salmonella poisoning start sixteen to forty-eight hours after eating, and may last two to seven days.
Escherichia coli (or E. coli) is a group of bacteria that normally live in the intestines of children and adults. A few strains of these bacteria can cause food-related illnesses. Undercooked ground beef is a common source of E. coli, although raw produce and contaminated water have caused some outbreaks.
Symptoms of an infection typically include diarrhea (which can range from mild to severe) to abdominal pain, and in some cases nausea and vomiting. Some E. coli outbreaks have been quite severe and have even caused deaths in rare instances. The optimal treatment for an E. coli–related illness is rest and fluids (to counteract dehydration). But if symptoms are more severe, you should have a discussion with your pediatrician.
Clostridium perfringens (C. perfringens) is a bacterium frequently found in soil, sewage, and the intestines of humans and animals. It usually is transferred by the food handler to the food itself, where it multiplies and produces its toxin. C. perfringens often is found in school cafeterias because it thrives in food that is served in quantity and left out for long periods at room temperature or on a steam table. The foods most often involved are cooked beef, poultry, gravy, fish, casseroles, stews, and bean burritos. The symptoms of this type of poisoning start eight to twenty-four hours after eating, and can last from one to several days.
Shigella infections, or shigellosis, are intestinal infections caused by one of many types of shigella bacteria. These bacteria can be transmitted through contaminated food and drinking water, as well as via poor hygiene (in child care centers, for example). The organisms invade the lining of the intestine, and can lead to symptoms such as diarrhea, fever, and cramps.
Shigellosis and its symptoms usually subside after about five to seven days. In the meantime, your child should consume extra fluids and (if your pediatrician recommends it) a rehydrating solution. In severe cases, your doctor may prescribe antibiotics, which can shorten the duration and intensity of the infection.
One form of infectious food poisoning is caused by the bacteria Campylobacter, which a child may ingest when he eats raw or undercooked chicken, or drinks unpasteurized milk or contaminated water. This infection typically leads to symptoms such as watery (and sometimes bloody) diarrhea, cramps, and fever, about two to five days after the germs are consumed in food.
To diagnose a Campylobacter infection, your doctor will have a culture of a stool specimen analyzed in the laboratory. Fortunately, most cases of this infection run their course without any formal treatment, other than making sure that your child drinks plenty of fluids in order to replace the fluids lost from diarrhea. When symptoms are severe, however, your pediatrician may prescribe antibiotics. In most cases, your child will be back to normal in about two to five days.
This is the deadly food poisoning caused by Clostridium botulinum. Although these bacteria normally can be found in soil and water, illness from them is extremely rare because they need very special conditions in order to multiply and produce poison. Clostridium botulinum grows best without oxygen and in certain chemical conditions, which explains why improperly canned food is most often contaminated and the low-acid vegetables, such as green beans, corn, beets, and peas, are most often involved. Honey also can be contaminated and frequently causes severe illness, particularly in children under one year of age. This is the reason why honey should never be given to an infant under the age of one year.
Botulism attacks the nervous system and causes double vision, droopy eyelids, decreased muscle tone, and difficulty in swallowing and breathing. It also can cause vomiting, diarrhea, and abdominal pain. The symptoms develop in eighteen to thirty-six hours and can last weeks to months. Without treatment, botulism can cause death. Even with treatment, it can cause nerve damage.
In very uncommon situations, watery diarrhea, low-grade fever, and abdominal pain may be caused by an infection known as cryptosporidium. This infection is of special concern in children who do not have a normal immune system.
Other sources of food poisoning include poisonous mushrooms, contaminated fish products, and foods with special seasonings. Young children do not care for most of these foods and so will eat very little of them. However, it still is very important to be aware of the risk. If your child has unusual gastrointestinal symptoms, and there is any chance she might have eaten contaminated or poisonous foods, call your pediatrician.
In most cases of food-borne illnesses, all that’s necessary is to limit your child’s eating and drinking for a while. The problem will then usually resolve itself. Infants can tolerate three to four hours without food or liquids; older children, six to eight. If your child is still vomiting or her diarrhea has not decreased significantly during this time, call your pediatrician.
Also notify the doctor if your child:
- Shows signs of dehydration
- Has bloody diarrhea
- Has continuous diarrhea with a large volume of water in the stool, or diarrhea alternating with constipation
- May have been poisoned by mushrooms
- Suddenly becomes weak, numb, confused, or restless, and feels tingling, acts drunkenly, or has hallucinations or difficulty breathing
Tell the doctor the symptoms your child is having, what foods she has eaten recently, and where they were obtained. The treatment your pediatrician gives will depend on your child’s condition and the type of food poisoning. If she is dehydrated, fluid replacement will be prescribed. Sometimes antibiotics are helpful, but only if the bacteria are known. Antihistamines help if the illness is due to an allergic reaction to a food, toxin, or seasoning. If your child has botulism, she will require hospitalization and intensive care.
Most food-borne illness is preventable if you observe the following guidelines.
- Be especially careful when preparing raw meats and poultry. After you have rinsed the meat thoroughly, wash your hands and all surfaces that have come in contact with the raw meat and poultry, with hot, sudsy water before continuing your preparation.
- Always wash your hands before preparing meals and after going to the bathroom or changing your child’s diaper.
- If you have open cuts or sores on your hands, wear gloves while preparing food.
- Do not prepare food when you are sick, particularly if you have nausea, vomiting, abdominal cramps, or diarrhea.
- Carefully examine any canned food (especially home-canned goods) for signs of bacterial contamination. Look for milky liquid surrounding vegetables (it should be clear), cracked jars, loose lids, and swollen cans or lids. Don’t use canned or jarred goods showing any of these signs. Do not even taste them. Throw them away so that nobody else will eat them. (Wrap them first in plastic and then in a heavy paper bag.)
- Buy all meats and seafood from reputable suppliers.
- Do not use raw (unpasteurized) milk or cheese made from raw milk.
- Do not eat raw meat.
- Do not give honey to a baby under one year of age.
Food Preparation and Serving
- Do not let prepared foods (particularly starchy ones), cooked and cured meats, cheese, or anything with mayonnaise stay at room temperature for more than two hours.
- Do not interrupt the cooking of meat or poultry to finish the cooking later.
- Do not prepare food one day for the next unless it will be frozen or refrigerated right away. (Always put hot food right into the refrigerator. Do not wait for it to cool first.)
- Make sure all foods are cooked thoroughly. Use a meat thermometer for large items like roasts or turkeys, and cut into other pieces of meat to check if they are done.
- When reheating meals, cover them and reheat them thoroughly.