Food Poisoning Not all diarrhoea and vomiting is related to Norovirus! Making Bath & North East Somerset an even better place to live, work & visit
What is the problem? » 500,000 cases of food poisoning a year » People may need to be admitted to hospital particularly those are who are vulnerable » 280,000 cases of Campylobacter a year the most common » 80,000 cases of Clostridium Perfringens » 2,500 hospital admissions due to Salmonella food poisoning Source Food Standards Agency, 2014 Making Bath & North East Somerset an even better place to live, work & visit
What are the sources? » Poultry meat linked to most cases of food poisoning » Vegetables fruits and seeds » Food prepared in large quantities and left to keep warm before serving » Chilled ready to eat foods such as cooked sliced meats, pates, pre packaged sandwiches and soft cheese Making Bath & North East Somerset an even better place to live, work & visit
Symptoms » Feeling sick » Vomiting » Diarrhoea » Stomach cramps » Lack of energy weakness » Loss of appetite » High temperature Making Bath & North East Somerset an even better place to live, work & visit
What to consider » When did the symptoms start? » Did everyone start showing symptoms at the same time? » Did cases eat from the same place? » Take a sample per patient Making Bath & North East Somerset an even better place to live, work & visit
Page 17 of the Out Break Information Pack for Care Homes Page 18 questions that a Environmental Health officer may ask Making Bath & North East Somerset an even better place to live, work & visit
Making Bath & North East Somerset an even better place to live, work & visit
Remember Making Bath & North East Somerset an even better place to live, work & visit
Norovirus Making Bath & North East Somerset an even better place to live, work & visit
What is it? » Commonly known as the winter vomiting bug » Causes sudden onset of feeling sick, diarrhoea and projectile vomiting » Usually lasts 24-72 hours Making Bath & North East Somerset an even better place to live, work & visit
Why is it a problem? 3,000 people admitted to hospital Very easily spread Close contact with someone with norovirus Touching contaminated surfaces or objects – the virus can survive outside the body for several days Eating contaminated food, this can happen if an infected person doesn't wash their hands before handling food Making Bath & North East Somerset an even better place to live, work & visit
Apply this procedure Making Bath & North East Somerset an even better place to live, work & visit
Cleaning During Outbreak » Frequency of cleaning should be increased compared to routine cleaning » Effective hand hygiene » Cleaning of hand contact points » Keep infected laundry separate Page 21 of pack gives details of effective cleaning. Making Bath & North East Somerset an even better place to live, work & visit
How can Environmental Health Officers help during an outbreak? » Investigation of the outbreak if likely to be food borne » Interview staff » Advise on good hygiene practices » Advise on preventative measures Making Bath & North East Somerset an even better place to live, work & visit
Any Questions? Making Bath & North East Somerset an even better place to live, work & visit
Clostridium Difficile Making Bath & North East Somerset an even better place to live, work & visit
C. difficile, What is it? » C. difficile is a type of bacteria. Other members of the same family include: » C. botulinum causes botulism. » C. perfringens causes food poisoning to gas gangrene. » C. tetani causes tetanus. » Cause clinical symptoms by releasing toxins. Making Bath & North East Somerset an even better place to live, work & visit
Signs & Symptoms » Significant diarrhoea ("new onset of > 3 partially formed or watery stools per 24 hour period") and one other of the following: » Recent antibiotic exposure. » Abdominal pain » Foul stool odour. » The presence of any one of these findings has a sensitivity of 80% Making Bath & North East Somerset an even better place to live, work & visit
C. difficile » Produces spores that are resistant to: » Ultraviolet, » gamma radiation, » desiccation, » temperature, » starvation and » chemical disinfectants. Making Bath & North East Somerset an even better place to live, work & visit
What’s the problem » C. diff is a commensal bacterium in 2-5% of the population. » Long-term hospitalization or residence in a nursing home increases the chances of C. diff colonisation. » After/during a course of broad spectrum antibiotics the natural intestinal flora is disrupted causing an overgrowth of C. diff. e.g. Clindamycin, Ciprofloxacin and Augmentin1 » Community acquired C. diff is on the rise (2.8 – 30%, unclear but rising). Making Bath & North East Somerset an even better place to live, work & visit
What’s the problem Making Bath & North East Somerset an even better place to live, work & visit
What’s the problem C. difficile infection rates per 100,000 population by NHS England Area Team, 2014/15. Source: PHE Making Bath & North East Somerset an even better place to live, work & visit
Diagnosis IF ANY PATIENT HAS LOOSE STOOLS GREATER THAN TWO TIMES IN ONE DAY YOU SUSPECT AN INFECTIVE CAUSE WITH NO CLEAR ALTERNATIVE. THEN YOU SHOULD ALWAYS CONSIDER CDI Making Bath & North East Somerset an even better place to live, work & visit
Making Bath & North East Somerset an even better place to live, work & visit
Turn to page 14 in your Outbreak Information Pack Making Bath & North East Somerset an even better place to live, work & visit
Making Bath & North East Somerset an even better place to live, work & visit
SUMMARY Making Bath & North East Somerset an even better place to live, work & visit
Treat any CDI seriously Making Bath & North East Somerset an even better place to live, work & visit
ANY QUESTIONS ? Making Bath & North East Somerset an even better place to live, work & visit
THANK YOU Making Bath & North East Somerset an even better place to live, work & visit
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