A common cause of Rapid onset of vomiting within hours of food due to pre-formed enterotoxins seen in exams - eaten Fried rice, Vomits then diarrhoea then better
About
- An important cause of food poisoning for exams
Source
- Frequently contaminate clinical environments, biotechnological processes, and food production
- Found in fried rice left at room temperature and vegetables,
- Less commonly in cakes, pastas and sauces
Characteristics
- Aerobic. Gram-positive spore formers - spores are resistant to boiling
- Produces emetic enterotoxins when rice is fried and badly stored
- Two toxins first cause emetic syndrome and other a diarrheal syndrome (enterotoxin)
- Due to the fact that spores of B. cereus resist the heating process, and germinate and multiply during storage of the leftover food at room temperature
Clinical
- Vomiting within 5 hours and then a diarrhoeal illness
- Resolution in 24 hours and return to normal
- Very Rarely systemic with pneumonia and endocarditis
Management
- Self-limiting. Conservative management only. Oral rehydration
- Notifiable if source is a food vendor
References
Rapid onset of vomiting within hours of food consumption occurs
after the ingestion of the pre-formed enterotoxins of B. cereus. Fried
rice or sauces are frequent sources, and enterotoxin is formed during
storage. Between 1 and 4 hrs after ingestion, brisk vomiting and
some diarrhoea occurs, with rapid resolution within 24 hrs.
If viable organisms are ingested, the toxin is produced within the
gut, leading to a longer incubation period of 12–24 hrs and watery
diarrhoea with abdominal cramps. The disease is self-limiting.
Management simply consists of fluid replacement and public health
notification.