Food poisoning is typically mild, self-limiting, and improves with supportive non-specific symptomatic treatments.
Most patients present with gastrointestinal symptoms such as abdominal pain or cramps, nausea and vomiting, and/or diarrhoea.
Foodborne disease outbreak is a cluster of at least two people with the same symptoms following ingestion of the same contaminated food or drink.
Some foodborne diseases and conditions are notifiable at a national level.
Food poisoning is illness caused by ingestion of food or water contaminated with bacteria and/or their toxins, viruses, parasites, or chemicals. Contamination usually arises from improper handling, preparation, or storage of food or drinks.
History and exam
Key diagnostic factors
- presence of risk factors
- nausea and vomiting
Other diagnostic factors
- abdominal pain
- blood or mucus in stool
- profuse rice-water stool
- reactive arthritis
- skin changes
- difficulty swallowing
- slurred speech
- hepatobiliary disease
- pulmonary symptoms
- other intestinal features
- manifestations of ectopic infection
- older people, children, and pregnant women
- chronic disease
- recent history of travel
- immunocompromised state
- history of contact with cases of food poisoning
- consumption of undercooked meat
- consumption of raw seafood
- consumption of homemade canned foods
- consumption of unpasteurised soft cheeses
- consumption of deli meats
- consumption of unpasteurised milk or juice
- consumption of raw eggs
- improper food handling and storage
- gastric acid suppression
1st investigations to order
- stool microscopy for WBC and red blood cells (RBC)
- stool culture
- stool O+P
- FBC with differential
- serum creatinine and electrolytes
Investigations to consider
- stool/serum botulinum toxin detection test
- blood culture
- serum lipase or amylase
- hepatitis A IgM antibodies
- hepatitis E IgM antibodies
- acute abdominal series
- duodenal aspirate
- polymerase chain reaction (PCR) of stool
mild to moderate disease
suspected foodborne botulism
known infecting organism
Philip Allan, MBBS, DPhil, FRCP
Department of Gastroenterology
John Radcliffe Hospital
PA has consulted for Takeda (Shire) and BaxterHealthcare. PA has received travel, accommodation, and conference fees from Takeda (Shire).
Dr Philip Allan would like to gratefully acknowledge Dr Satish Keshav, Dr Michael Bennish, Dr Willem J.S. de Villiers, and Dr Houssam E. Mardini, the previous contributors to this topic. Unfortunately, we have been made aware that Dr Satish Keshav has passed away.
MB received funds, salary, and/or research funding greater than 6 figures USD. MB declares that he has no other competing interests. WJSDV and HEM declare that they have no competing interests.
Franz Allerberger, MD, MPH
Professor of Clinical Microbiology
Austrian Agency for Health and Food Safety (AGES)
FA declares that he has no competing interests.
Nancy Crum-Cianflone, MD, MPH
Naval Health Research Center
NCC declares that she has no competing interests.
- Acute viral syndromes
- Crohn's disease
- Ulcerative colitis
- Food safety
- Communicable diseases surveillance in Singapore 2017
Diarrhoea in adults
Diarrhoea in childrenMore Patient leaflets
- Log in or subscribe to access all of BMJ Best Practice
Use of this content is subject to our disclaimer