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Food-borne bacteria and bacterial toxins are a common cause of epidemic gastroenteritis. In general, the illness is relatively mild and self-limited, with recovery within 24 hours. However, severe and even fatal poisoning may occur with listeriosis, salmonellosis, or botulism (See Botulism) and with certain strains of Escherichia coli. Poisoning after the consumption of fish and shellfish is discussed in Food Poisoning: Fish and Shellfish. Mushroom poisoning is discussed in Mushrooms. Viruses such as the Norwalk virus and Norwalk-like caliciviruses, enteroviruses, and rotaviruses are the causative agent in as many as 80% of food-related illness. Other microbes that can cause food-borne illness include Cryptosporidium and Cyclospora, which can cause serious illness in immunocompromised patients. However, in over half of reported food-borne outbreaks, no microbiological pathogens are identified.

  1. Mechanism of toxicity. Gastroenteritis may be caused by invasive bacterial infection of the intestinal mucosa or by a toxin elaborated by bacteria. Bacterial toxins may be preformed in food that is improperly prepared and improperly stored before use or may be produced in the gut by the bacteria after they are ingested (Table II–26).

    Table II-26 Bacterial Food Poisoning

  2. Toxic dose. The toxic dose depends on the type of bacteria or toxin and its concentration in the ingested food, as well as individual susceptibility or resistance. Some of the preformed ...

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