Staph aureus: Cool to look at. . . not so cool to have.

Recently I’ve taken care of a few kids who came into the clinic with vomiting that suspiciously started soon after eating a hamburger (two at school and one at a fast food restaurant).  Is this food poisoning or a routine viral infection?  What is “food poisoning” and what causes it?  What should parents do if they suspect their child has food poisoning?  Read on to find out.

Food poisoning is caused by eating food that is contaminated with bacteria and their toxins. The most common bacteria causing illness are Staphylococcus aureus, Salmonella, Escherichia coli, Shigella, and Campylobacter, among others.  These bacteria generally cannot be detected via taste or smell prior to eating the food.  The bugs are most often transmitted via food handled by an infected person, consumption of undercooked beef, chicken, eggs, unpasteurized milk, or contaminated water.  Toxin producing bacteria, such as Staph and Clostridium, also thrive in food that is left at room temperature for long periods of time.

With minor variations, once infected, a person will experience relatively abrupt onset of vomiting, diarrhea, crampy abdominal pain, and fever. Toxin producing bacteria tend to produce symptoms within a few hours of consumption of the contaminated food and last for one to three days. Other infections may start up to a few days after consumption of the offending food and last up to one week.

It is often difficult to tell whether vomiting and diarrhea is caused by food poisoning or a routine viral infection (viral gastroenteritis in medical parlance). If multiple family members become ill, regardless of whether they ate the same food, the infection is likely viral. If, on the other hand, only people eating a certain menu item develop symptoms, food poisoning is probably the culprit. Food poisoning may be more abrupt and explosive in onset than a viral infection, but this is not always the case.

Regardless of the type of infection, preventing dehydration is the mainstay of treatment. This is especially true for infants and young children, who may become dehydrated more easily than healthy adults. If your child is ill with vomiting and diarrhea, offer small sips of liquids such as pedialyte and dilute juice frequently. If your child is still breastfeeding definitely continue through the illness. Go slowly. Check out Dr. Wendy Sue Swanson’s recent post for some other great tips on how to manage the “stomach flu”. If your child develops severe symptoms, bloody stool, or prolonged fever, it is time to see the doctor. If they are not urinating as much as usual, cannot keep anything down (even sips of water), or have other signs of dehydration, it is time to seek care as well.

Many parents ask about antibiotics or other medications to stop the diarrhea and vomiting. Most routine food poisoning does not require antibiotic treatment. The body will clear the infection on its own. There are a couple of anti-emetic (anti-vomiting) and anti-diarrheal medications on the market. Remember that vomiting and diarrhea are the body’s way of getting rid of the offending agent. These medications are rarely used in children for this reason, and because they sometimes can have significant adverse effects. Talk to your doctor before giving any medications to stop diarrhea or vomiting. Often, the best treatment is a little TLC. Dr. Claire McCarthy recently had a lovely post about how to deal with the vomit, and be a little magic to your little one while they are sick.

In this case prevention is definitely key to avoiding a lot of misery (and mess). Try to observe the following:

• Wash your hands! Especially after using the bathroom or changing a child’s diaper.
• Don’t prepare food for others when you are sick.
• Keep a clean kitchen, especially when preparing meat. For great tips on this, and to be a little amazed by how many bacteria are around, check out Two Peds in a Pod’s post on this topic. You’ll never look at a kitchen sponge in the same way again.
• Buy all meats and seafood from reputable suppliers and cook them thoroughly.
• Don’t let prepared food sit out more than two hours. Eat leftovers within four days (or freeze them).  For more information on specific foodborne illnesses, the CDC website is a great source of information.

Finally, take a deep breath and remember that “this too shall pass”. Hang in there, give your child a big hug. . . and then go wash your hands.