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Like every other infection, food poisoning also have an incubation period. Incubation period means the time duration between point of infection with certain organisms and development of disease symptoms. The range of incubation period is wide, from one to even three months in some cases depending upon the causative agent. But the general incubation range is from several hours to three days. The victims may have any or all of the following set of symptoms usually- nausea, vomiting, abdominal pain, diarrhoea, fever, headache and fatigue. The feature may often resemble acute gastroenteritis. But individuals suffering from a common cause of infection usually present with a common and similar kind of symptoms by which expert physicians are often able to diagnose the probable cause of infection even before any laboratory diagnosis can be made. Now we shall try to give a generally idea how individual causative usually appear before us in terms of symptoms.

   A. Campylobacter :-

          i. Nausea and vomiting.

         ii. Diarrhoea, may be occasionally bloody.

        iii. Abdominal cramps.

       iv. General uneasiness.

        v. Fever.

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Food poisoning, or food borne illness or food born diseases are any kind of illness resulting from consumption of food products which are contaminated. It is one of the most common diseases we encounter in our day to day life. It is often very mild attack that we mostly tag as a stomach upset and goes away by itself in few days without the help of any medicines or help of doctors. But sometimes, it becomes very distressing when the attack is moderate to serious as it affects many people at a time and produces serious symptoms. There are also many examples when people die from such attacks, often in groups, mimicking a cholera outbreak. The symptoms may range from mild intestinal discomforts to bloody dysentery and severe dehydration.

There are two types of food poisoning depending upon the cause. These are toxic food poisoning and infectious food poisoning. Toxic food poisoning of food intoxication means consumption of food or food products which contain some kind of toxins in it including exotoxins produced by certain bacteria or other organisms over and above the natural or chemical toxin present in certain foods. The organisms may not be necessarily present in the food during consumption, or even if present, they may not be infectious by themselves. Only their toxins are enough to cause an illness. On the other hand infectious food poisoning means disease caused due to infection with certain organisms contaminating the food.

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SIGNS AND SYMPTOMS:-

The incubation period of the disease (time period between infection and appearance of symptoms) is usually two days although it may be as long as five days in maximum. Most patients show certain amount of disease symptoms, although there may be cases not infrequently where the patient passes on the disease without showing any signs of the disease. In majority of cases, the intensity of disease is mild, presenting with only common diarrhoea, without any big trouble. But of course, severe cases are also not at all rare. The onset is sudden and violent. The disease may start with only mild abdominal pain without any other trouble, and gradually the classical feature develops. The main feature is diarrhoea with abdominal pain, often followed by vomiting. The diarrhoea is serious cases is very severe, and frequent, producing large quantities of pale, flaky, rice watery stool. There may be mild fever along with it. Vibrio cholerae causes profuse secretion of body fluid into the intestinal tract, and thus unchecked cholera often causes even several gallons of fluid loss per day. If the fluid loss is not replaced by rehydration therapy, the patient may go in hypovolumic shock and neurological trouble (due to electrolyte loss) and may die within a very short time. Child may also develop convulsions and cardiac arrest due to electrolyte imbalance.

Bad signs in cholera:-

· Fluid loss exceeding 5 to 10 litters if not replaced.

· Flabby skin, muscle cramps and hoarse voice (signs of severe dehydration).

· Decreasing level of consciousness.

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CAUSATIVE ORGANISM:-

The disease is caused by the toxins of a bacteria called Vibrio cholerae . They are gram negative, anaerobic rods, straight or curved, and motile in nature. They have single polar flagellum with whom they can move. Most species are oxidase positive. Vibrionaceae,  Pseudomonadaceae and Enterobacteriaceae are all landed in the  Gammaproteobacteria. But vibrionaceae differs from pseudomonads by being fermentative and oxidative, and they differ from enterobacter by being oxidase positive and motile. Of all vibrios related to human clinically, vibrio cholerae is the cause of cholera and is the most important and dangerous. They are one of the most common organisms of surface water and they can survive in fresh as well as marine water, in association with some aquatic animals or organisms. That is why contaminated water is one of the major sources of cholera infection. When the organisms enter our stomach, most of them can’t survive in the acidic media. But few of them, when survived ultimately exit the stomach and reach the small intestine where they can thrive. V. cholerae bacteria start up production of the hollow cylindrical protein flagellin to make flagella, the curly whip-like tails that they rotate to propel themselves through the mucus of the small intestine. Once the bacteria reach small intestine, they stop producing the flagellin as they no longer need to propagate and start producing the toxic proteins which give the infected person watery diarrhoea. This carries the multiplying new generations of V. cholerae out into the drinking water and food of the next host if proper sanitation measures are not in place. The toxins interact with the intestinal mucous membrane to pump chloride ions into the small intestine and thus an ionic pressure is created which prevents sodium ions from entering the cell. The chloride and sodium ions create a salt-water environment in the small intestines, which can pull out as much as six litres of water per day through the intestinal cells, creating the massive amounts of diarrhoea. The patient becomes rapidly dehydrated unless an appropriate and immediate rehydration therapy is not started, to replace the water and salts lost in the diarrhoea.

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INTRODUCTION:-

Cholera, frequently known as Asiatic cholera or Epidemic cholera, is one of the deadly diarrhoeal diseases caused by bacterial infection. But the dangerous not only because it is life threatening, but because it is one of the most highly contagious or infectious disease mankind has ever had. It produces severe diarrhoea followed by vomiting, produces severe dehydration within a very small time and kills the patient within hours if not treated early. Meanwhile, the disease gets contaminated speedily in the community and infects a large number of populations, and many of them even suffer death before they may receive any treatment. Apart from remaining as one of the most leading cause of death in the world, cholera also remains as one of the leading cause of developing human consciousness towards community and preventive medicine, and it is one of the oldest diseases to be used in epidemiological study. Cholera is not really a tropical disease, but it's related to standards of hygiene and the quality of drinking water.

ORIGIN, SPREAD AND HISTORY:-

The great epidemic got its origin in South Asian continent, and more preciously registered its homeland as Bengal, an eastern state of India, as early as early nineteen century. It was previously restricted to the same area of origin, but later began to spread to the rest of the world through different tread routs. It first reached Europe via Russia, and to North America via Europe. As impure water supply and unhealthy sanitation is the prime factor for the spread of the disease, the disease got rich soil for its growth in most part of the world. But with the development of filtering and chlorination of drinking water and proper sanitation, cholera is no longer a pressing threat to the health care system of Europe and North America, although the picture is not much changed in under developed and developing countries.

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MEDICINAL TREATMENT :-

Though the necessity and importance of rehydration management along with proper diet protocol is hugely emphasised in discussing the treatment of acute gastroenteritis, the role of medicinal elements can’t be ruled out. Medicines along with appropriate management of diarrhoeal disease bring about much better result than any of tried alone. Medicines help reducing the span of illness, increase the resistance and makes recovery faster. It also helps to reduce the suffering of illness like excessive vomiting, frequency of motion and intensity of the pain.

Several times it happen that the parents or adult patients themselves the physicians to prescribe them some medicines for their distressing diarrhoea or vomiting. Antiemetic is usually given to reduce the excessive vomiting although their effectiveness is still controversial. As the vomiting is mostly self limiting and usually improves with rehydration, they are preferably not used in children. It is because they are supposed to contribute to some severe side effects in children like allergy, sedation, dystonic reactions and some neurological symptoms.

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TREATMENT AND MANAGEMENT :-

Acute gastroenteritis is a self limiting disease condition and doesn't mostly require any medicinal treatment, and mostly respond well only with some simple managements. This does not however deny the medicinal of medicinal treatment in the recovery of gastroenteritis. With the help of appropriate medication, most cases of gastroenteritis recover early and mortality and the intensity of the sufferring is also less signified, but the real benefit of the medicines is only obtained when the are complemented with proper management of the case.

Now coming to management of acute gastroenteritis, it is one of the most challenging campaign for all the healthcare officials and comminutes service providers to prompted worldwide. A seemingly simple a mild for of diarrhoeal disease takes away millions of lives every year throughout the world including the so called developed countries, though the disease responds quite well to the simple preventive and treatment procedures. The main cause of this is either ignorance and failure in part of community health workers and physicians to provide accurate managements protocol, in the village front, or in the private clinic or hospital setup, or due to failure in perceiving the real importance of supplementary managements along with medicines, even when it is known or taught. Once this simple management of acute gastro enteritis is well popularized and implemented, we end up with much less number of unfortunate infant and children death from the disease.

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DIAGNOSIS :-

Diagnosis of acute gastroenteritis does not mostly require any investigation procedure, and presentation of the patient(s) is sufficient for diagnosis, by excluding other diseases. But in cases where sufficient symptoms and signs are lacking, several investigations may be required to exclude other gastro intestinal diseases. Otherwise, only stool examination for ova, parasite and cyst is enough to diagnose acute gastroenteritis with complete information.

Diagnosis is based on presenting features of the patient, a complete medical history of the condition and through physical examination of the patient. As AGE is normally very infectious and in many cases affects a large number of people in a thickly populated area of people sharing a common type of foods as in any function, a thorough and accurate medical history will provide sufficient data about what exactly has happened prior to the diarrhoeal attack, what kind food was taken, is there any other patient suffering from such condition, how is the condition of health of other members who had shared the same food along with the patient will give enough idea about the diagnosis.Complete medical history will also include history of any travelling, history of any kind of poisoning, any sudden change in the food habit, nature of food preparation and any medication taken etc.

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DEFINITION :-

One of the common gastrointestinal tract diseases that people mostly suffer from in the summer and rainy season is acute gastroenteritis. It is an inflammatory condition of the stomach and small intestine resulting in sudden and violent diarrhoea with or without accompanying symptoms like nausea, vomiting, abdominal pain and fever. There is increased stool frequency and normal consistency is altered. It is also very popularly known as Gastric flu though it is not any way related to influenza. It is a worldwide very common cause of mortality and morbidity in all age group, and one of the leading causes of under five children mortality in non industrialised countries. It is often a emergency condition requiring medical supervision and hospital management.

CAUSATION :-

The inflammation of the gastro intestinal tract is most commonly caused by viruses, to a lesser extent by some bacteria, by their toxins, parasites and also due to some unusual component in diet or medicines. Each type differs from the other by some slight or obvious variations, but main complaint of sudden and severe diarrhoea is always present. Contact and use of contaminated food or water is the major source of spread of infection.

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