infections through food contamination and food adulteration often leads poisoning like status. mortality and morbidity decides the nature and severity of poison. awareness needed for common food born infections and common food adulterants.

1. Food Poisoning
Dr Mohd Kaleem Khan
Assistant Professor
Department Of Forensic Medicine
JNMCH AMU Aligarh

2. Causes of Food Poisoning
 Bacteria and their toxins (bacterial food poisoning).
 Food poisoning through plants (natural food poisons).
 Food poisoning through animals,
 For example,
 Poisonous Fish,
 Mussel, Etc.

3.  Food poisoning through Chemicals:
Intentionally added ;
 Flavouring agents in processed food,
 Colouring agents,
 Preservatives, etc.
Accidentally added ;
 Pesticides and
 Insecticides.
Migrants ; packaging materials and metallic contaminants etc.

4. BACTERIAL FOOD POISONING
Food poisoning is an acute gastro-enteritis caused by the
ingestion of the food or drink contaminated with either living
bacteria or their toxins
Bacterial food poisoning may be divided into two groups—
 Infection type
Microorganisms that multiply in the gastrointestinal tract
producing infection, for example, Salmonella group of
organisms

5. Toxin type.
Incubation period is short (1–6 hours ),
• Toxin is usually preformed
• Staphylococcus aureus or Bacillus cereus
• Toxin can be detected in the food
Incubation period is longer(between 8 and 16 hours),
• The organism is present in the food and produces toxin
after being ingested.
• Clostridium perfringens,
• Toxin can be detected in food or stool specimens.

6. Staphylococcus aureus
• It is perhaps the commonest cause of food
poisoning.
• I.P.: 1–8 hours.
• Sources: Meat, milk, dairy products,
potato, egg, salad, etc.
• Pathogenesis: Production of enterotoxin.
• Features: Abrupt onset, intense vomiting.
• Recovery : is usually in 24–48 hours.
• Diagnosis: stool culture.
• No treatment usually necessary
• Restore fluids and electrolytes.

7. Bacillus cereus
 Two Types of Toxins.
 One is a heat-labile,
 Large molecular weight protein
 Diarrhoea
 Incubation period is 8–16 hours.
 The other toxin is a heat-stable,
 Low molecular weight peptide
 Severe emetic (vomiting)
 Incubation period is 3–6 hours.
 Sources are fried rice, dried fruit, powder milk, etc.
 Diagnosis is through culture of contaminated food.

8. Clostridium perfringens
• Spores of the organism persist in soil, dust and foods (raw
meat, poultry, fish, vegetables, legumes, gravies, etc.).
• I.P.: 8–16 hours.
• Pathogenesis: Enterotoxin produced in food and in the gut causes
hyper secretion in small intestine.
• Symptoms: Abrupt onset of profuse diarrhoea; vomiting
occasionally.
• Recovery 1–4 days.
• Clostridia demonstrable in food and faeces.

9. Clostridium botulinum
 Toxin, a heat-labile , destroyed by heat at 80° c for 10 minutes)
 Seven immunogenic types (A to G) of the toxin have been
identified.
 Types A, B and E toxins often cause human botulism
 I.P.: 6 hours to 1 week.
 Blocks acetylcholine at neuro-muscular junction ,
 Bilaterally symmetrical descending motor paralysis (bulbar
paralysis). Diplopia, dysphagia, dry mouth, dysphonia, dysarthria,
respiratory embarrassment, etc

10. • Treatment: clearing of the airways, ventilation.
• Intravenous polyvalent antitoxin.
• Toxin can be demonstrated in food and serum.
• Sources: under-processed sausages, potted meats, tinned fish,
canned acidic vegetables, fruits,

11. Postmortem Appearances
• An important feature in most cases (except botulism) is
gastrointestinal congestion.
• In some cases, there may be ulceration of intestinal
mucosa.
• Botulism fatalities are usually characterised by a lack
of postmortem findings.
• Asphyxial signs may be present

12. • Isolated cases of food poisoning may have medico
legal importance, an intended victim of homicide.
• Cases of mass food poisoning are not uncommon in
India,
• Contamination may result from unhygienic measures
during the preparation or storage of articles of food.

13.  The public health authorities must be contacted
 Doctors coming across cases of food poisoning
from public eateries such as hotels and canteens
must report them to the public health authorities.
 Botulism in India (the main source of Clostridium
botulinum) is relatively less as canned food less
popular.

14. POISONOUS FOODS
• Is restricted to poisoning by articles of food that
contain poison derived from plants, animals and
inorganic chemicals.
• Metallic contamination of food or drink and
migrants from packaging material may also be
included in this entity.

15. Lathyrus sativus (Kesari
Dal)
 This is a drought-resistant pulse.
 Staple food for low-income groups in some areas of
Central India.
 Consumption of seeds >30% of the total diet for more
than six months can cause paralysis (neurolathyrism).
 The active neurotoxic principle is β-N-oxalyl-amino-
L-alanine, or BOAA

16. • The condition manifests as a spastic paralysis of the
lower limbs probably due to a localised lesion of the
pyramidal tracts.
• In mild cases, there is only stiffness and weakness of
the legs.
• Death in the acute stage is very rare.
• Sclerosis of the lateral columns is seen o postmortem
examination.

19. Mushrooms
• Amanita phalloides and Amanita muscaria are the common
varieties of poisonous fungi.
• Active principles are
• Phalloidins (only in amanita species),
• Amatoxins (most important toxic principle)
• Virotoxins.
• Amatoxins are powerful inhibitors of cellular protein synthesis.
• Cells with high replication rates (liver, kidney, intestinal cells)
develop necrosis.
• Liver usually shows centrilobular necrosis.

20. Symptoms
 There is usually an incubation period of 6–12 hours.
 Three stages may be recognised:
Gastroenteritis stage: lasting for 24 hours and is characterised
by cholera-like diarrhoea, abdominal pain, vomiting, fever,
etc.
Latent stage: lasting for a variable period during which most
of the symptoms subside. However, a patient may return in 2–
3 days in a moribund condition.
Hepato-renal stage: showing jaundice, confusion, delirium,
metabolic acidosis, Coagulopathy, renal failure and coma.

21.  Diagnosis
 Amatoxins detected by Meixner Test.
 Treatment
 Decontamination, correction of dehydration,
 Forced diuresis and other supportive measures.

22. Argemone mexicana
• Common names: prickly poppy, pila dhatura, ujarkanta, kutila,
• Belonging to the family papaveraceae and grows wild in the
countryside all over India.
• Small black seeds, which resemble mustard seeds.
• About 1% of argemone oil as an adulterant is necessary to produce
clinical epidemic dropsy.
• Pressed on a slide, they burst with a report, whereas mustard seeds
collapse silently.

25. Active Principles
• Seeds contain
• Berberine
• Protopine,
• Oil contains
• Sanguinarine
• Dihydrosanguinarine.

26. Epidemic dropsy.
• This condition
• Presents with vomiting, diarrhoea, oedema, especially of
the feet and sometimes a generalised anasarca may be seen.
• Pleural and pericardial effusions, hepatomegaly, and
congestive heart failure with breathlessness may also be
noticed.
• Hair loss is noted in some cases.
• Death may result from myocardial damage.

27. Medicolegal Aspects
• Adulteration of mustard oil with argemone oil is
common in certain parts of India.
• The recent outbreak of epidemic dropsy in Delhi
and neighbouring states (1998) claimed nearly a
hundred lives, and has projected the catastrophic
consequences of edible oil adulteration.