Be Smart…it may be a Food-borne illness
Index case (Patient ) need to be properly identified (which can be difficult) and this is the key step in identification of the outbreak by identification of the starting case mainly by high degree of suspicion and ask leading questions to recognize the foodborne etiology of the disease.
For the diagnosis important clues to determining the etiology of a foodborne disease need to be observed (for the proper diagnosis)
- Incubation period;
- Duration of the resultant illness;
- Predominant clinical symptoms; and
- Population involved in the outbreak.
Other questions has to be asked based on the case itself in order to narrow the provisional diagnosis into certain causes, once suspicion of foodborne is high immediately specimens has to be sent for laboratory testing and reporting to the local public health authority (for the disease prevention & control and wide scale investigation) and implementing the appropriate isolation precautions based on the probable causative agent (Review Food-borne outbreak investigation)
For provisional diagnosis based on the clinical manifestation a certain presentations can be considered by certain causative agents
- Gastroenteritis: Viral Gastroenteritis, Mainly Rotavirus in infants and Norovirus in children and adult. Food poisoning e.g. Staphylococcus aureus toxin
- Non Inflammatory diarrhea: can be caused by Bacterial , viral or parasitic agents but mainly by : Enterotoxigenic E-Coli , Giardia , Cryptosporidium, Norovirus rotavirus enteric adenovirus
- Inflammatory Diarrhea : can be caused by Shigella species , campylobacter species , Salmonella species Enteroinvasive E.Coli , Enterohemorrhagic E.Coli ,E.coli o157:H7 m Entamoeba histolytica
- Persistent diarrhea more than two weeks :mainly parasites infection e.g. Entamoeba histolytica , Giardia lamblia , Cryptosporidium
- Neurological manifestations : first thinking will be Botulism ( Clostridium botulinum toxin then it can be Organophosphate pesticides , Thallium poisoning , Scormbriod fish poisoning ,Neurotoxic shellfish poisoning , Mushroom poisoning and it could also be a case of Guillain- Barre Syndrome associated with Campylobacter jejuni causing infectious diarrhea
- Systematic illness : can be caused by Brucella species , Listeria monocytogenes , Trichinella spiralis , Toxoplasma gondii , Vibrio vulnificus , Hepatitis infection ( A & E) , Salmonella Typhi and paratyphi , Amebic liver abscess
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