When news broke that Sacred Heart Mukumu Girls High School in Kakamega had been closed indefinitely following the death of two students after suspected food and water poisoning, there was public outcry over how this could have happened and who and what could be responsible.
Later, when Regional Education Director Jared Obiero said that investigations by the Ministry of Health were still underway to determine the possible source of the contamination and the microorganisms responsible, there was curiosity over what exactly constitutes food poisoning. The Standard Health & Science team sought the opinion of experts on the matter.
According to a medical doctor at Machakos Level 5, Peninah Musyoka, infectious organisms such as bacteria, viruses, parasites or their toxins are the most common causes of food poisoning and these spread through contaminated food or water.
Once one ingests these contaminated substances, signs of an infection can start anyway between one to eight hours.
Dr Musyoka says studies have shown that most cases of food poisoning occur in institutions or restaurants, although some incidents happen at home when food is stored at improper temperatures that make bacteria thrive.
“If food is supposed to be frozen, let it be frozen. If it is meant to be hot, then ensure it is hot. If the food was previously frozen and then it is required to be warmed, it should be thoroughly warmed to kill any bacteria,” she says.
Food poisoning also occurs when food is not handled properly, or when the person handling it is infected.
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Other factors that may contribute to food poisoning include dirty kitchens, or when raw food is mixed with cooked food, which may predispose it to contamination.
There are short-term and long-term symptoms, some of which are self-diagnosable, including cramping, nausea, vomiting and diarrhoea.
For the short-term symptoms, Dr Musyoka explains the infected person may experience diarrhoea where they may get more than three loose stools in a day. If the infection is cholera, it may cause a lot of dehydration.
Other people may experience vomiting, fever, nausea or get confused depending on the level of dehydration. The doctor says the long-term symptoms depend on the organism one has ingested.
“Some bacteria may cause renal problems, some toxins may affect the kidney hence such patients may be put on dialysis for a while or life,” she said.
Others may suffer neurological damage that manifest as seizures and convulsions; others may get nerve damage resulting in paralysis or botulism. Food poisoning may also cause shock and death through excessive loss of body fluids, including electrolytes.
Dr Musyoka says that in the hospital, food poisoning is often diagnosed based on the history of the patient, including checking the symptoms and asking questions about what they ate.
The doctor may conduct tests such as stool culture or blood test to check for parasites and identify the infectious organism.
In the United States, the Centres for Disease Control and Prevention (CDC) recently warned that a Salmonella outbreak reported in 11 states was from eating raw dough.
Experts from CDC explained that the Salmonella bacteria can be killed by thorough cooking of food.
Disease management depends on the organism causing it, but for most people, the illness resolves within a few days although others may last longer.
Dr Musyoka says that treatment will include the replacement of fluids lost to diarrhoea or vomiting because electrolytes and minerals such as sodium, potassium and calcium are found in the body's fluids.
“Some children and adults with persistent diarrhoea will require hospitalization where they are given salts and fluids intravenously to prevent dehydration.”
Doctors may also prescribe antibiotics if the organism causing the illness is a bacterium, especially if the infection occurs during pregnancy, where prompt antibiotics may help keep the infection away from the baby.
“Diarrhea in a pregnant woman can stimulate premature labour, and their infection may be severe because their immunity is mostly suppressed. However, care is given to the drugs they get to make sure they are suitable for the fetus,” Dr Musyoka explained.
However, antibiotics may worsen the symptoms if the infection is caused by a virus.
There are certain groups of people who are predisposed to food poisoning such as the elderly, usually above 60 years, pregnant women, children under five years, and people who are immune-compromised such as those living with HIV, going through chemotherapy, or having other immunosuppressant conditions.
Dr Musyoka says this is because they do not have strong immunity and when they ingest those bacteria, they can easily thrive and cause food poisoning.
Doctors advise people who have gone through food poisoning to gradually ease back into eating and ensure that the food is well prepared. They should stay away from raw seafood that is commonly associated with food poisoning and avoid eating out.
“We should be careful about what we consume, where we consume it and who has prepared it to avoid food poisoning,” Dr Musyoka said.