Food poisoning of non-bacterial origin. Food poisoning of non-bacterial and bacterial origin

Food poisoning non-bacterial origins are less common than bacterial ones, their causes are more numerous, and therefore the clinical and forensic medical diagnosis of such poisonings is more difficult.

Poisoning by poisonous products of animal origin. These include some types of fish, shellfish and glands internal secretion slaughter cattle.

From poisonous fish some are always and completely poisonous, others acquire poisonous properties only during the spawning period, and only caviar and milt are poisonous at this time. Certain species of fish, usually suitable for food, sometimes become toxic in a number of water bodies for special reasons. Currently, about 300 species of poisonous fish are known, most of which live in the Caribbean Sea. Pacific and Indian oceans.

Among the poisonous fish that live in Pacific Ocean and, in particular, off the coast of the Russian Federation, one can name the pufferfish, pufferfish. The caviar, milt, liver and blood of these fish have toxic properties.

Fugu venom, tetraodotoxin, is a neurotropic poison; it acts on the neuromuscular synapses of the respiratory muscles. In the future to peripheral paralysis paralysis joins smooth muscle the walls of blood vessels, which is associated with a drop in blood pressure. At the same time, the respiratory center is depressed. Poisoning with this poison is accompanied by to a large extent lethality.

Among the freshwater poisonous fish, one should mention the marinka, which lives in the waters of Central Asia. Its meat is quite edible; only the caviar, milt and black peritoneum are poisonous. Therefore, freshly caught and gutted fish are edible. Marinka's poison has a neurotropic effect (gastroenteritis, headache, paralysis of peripheral muscles, including respiratory). Possible deaths from asphyxia. Special processing neutralizes the product and makes it possible to eat it.

Food poisoning plant origin. Among poisonings by products of plant origin, poisoning ranks first poisonous mushrooms(pale toadstool, fly agarics, lines, etc.). Poisonings are seasonal and occur in autumn and spring.

Toadstool poisoning most often occurs in the fall. This is a lamellar mushroom, some of its varieties resemble champignons, others resemble russula and honey mushrooms. Unlike the champignon, the pale grebe has a vagina (volva) at the base of the leg; its plates are always white, while in champignons the plates are white only in young specimens, then they become pink and brown. However, the pale grebe has many varieties that make it difficult to recognize even by specialists. Poisoning with toadstool is accompanied by high mortality rate. Some authors indicate that even one specimen of the toadstool can cause poisoning in a family of 5-6 people.

A family of 5 people ate soup made from champignons bought at the market. 30-40 hours after this, all family members fell ill: nausea, vomiting, and diarrhea. In 4 adults the disease progressed in mild form, a 3-year-old girl began vomiting blood after a long remission. The child died due to symptoms of cardiac weakness. At autopsy, dystrophic changes were discovered parenchymal organs, in particular fatty degeneration liver. During the investigation, it was established that during the cleaning of champignons, one of the mushrooms aroused suspicion due to its resemblance to a toadstool. However, this mushroom was not removed and, apparently, was the cause of the poisoning.

Main active principle The toadstool mushroom has a powerful destructive poison - amanitatoxin. This mushroom also contains another poison - amaditagemolysin, which is destroyed when heated to 70° or from exposure to digestive juices. Therefore, the effect of amanitagemolysin is often obscured by the influence of a stronger poison - amanitatoxin.

Signs of toadstool poisoning appear several hours after ingesting the mushrooms. This sharp pains in the abdominal area, vomiting, diarrhea, sometimes constipation, often anuria. Sometimes the symptoms of acute gastroenteritis resemble cholera. General weakness, cyanosis, sometimes jaundice, and a drop in body temperature quickly develop. Death occurs in a state of coma, and children often experience convulsions. Sometimes noted neuropsychiatric disorders: delirium, agitation, loss of consciousness. Protein and blood are detected in the urine.

An autopsy reveals severe dehydration of the corpse, symptoms of acute gastroenteritis, the absence of rigor mortis and significant degenerative changes in organs, especially fatty degeneration of the heart, liver, and kidneys. If the effect of amanitohemolysin is manifested, then hemolyzed blood in the corpse and hemolytic nephrosis occur. Along with the described signs, multiple pinpoint hemorrhages under the serous membranes and hemorrhages into the mucous membrane of the stomach and intestines are noted.

Poisoning by fly agaric mushrooms is rare, since these mushrooms are distinguished by their species, and the population is well aware of their poisonous properties. Fly agarics contain a strong poison - muscarine. Latest exciting ending vagus nerve, as a result of which there is increased secretory activity of the glands (salivation, sweat, lacrimation), spasms of smooth muscles appear (nausea, vomiting), and constriction of the pupils is noted. The pulse slows down, breathing becomes faster and more difficult, dizziness, confusion, and sometimes hallucinations and delirium appear. Toxicity of mushrooms, and therefore their lethal dose depend on many conditions and, in particular, on growing conditions (terrain, weather). The lethal dose of pure muscarine is very small (about 0.01 g).

Among the spring mushrooms that can cause food poisoning are strings that are very similar to the edible morel mushrooms. The main difference between the stitches is the cellular structure on the cut, while the morels on the cut have a uniform structure. The lines contain a strong poison - helvelic acid, which causes hemolysis. In mild cases of poisoning, nausea, vomiting with bile, abdominal pain, and weakness appear 1-8 hours after taking mushrooms; in severe cases, these phenomena are accompanied by jaundice and sometimes convulsions, indicating a poor prognosis. At the same time, headache, loss of consciousness, and delirium develop.

At forensic research corpses of persons who died from poisoning with lines, note the icteric staining of the skin and mucous membranes, multiple hemorrhages under serous membranes; the blood is thick and dark; Hemorrhages are sometimes observed under the endocardium of the left ventricle. On the part of parenchymal organs, the phenomena of fatty degeneration occur; in particular, the liver is very sharply enlarged, acquiring a lemon-yellow color. In the kidneys there is a picture of hemoglobinuric nephrosis.

Helvelic acid is extracted from mushrooms when boiled. After boiling for 10 minutes and removing the broth, the mushrooms become harmless. It should be remembered that mushroom poisons (amanitatoxin, muscarine, helwellic acid) chemically are not determined.

To diagnose mushroom poisoning, a botanical examination of the contents of the stomach and intestines to detect fungal remains is important.

Poisoning with bitter kernels of stone fruits (apricots, peaches, cherries, bitter almonds). These nuclei contain the glucoside amygdalin, which, under the action of enzymes in the intestines, is broken down into glucose, benzoaldehyde and hydrocyanic acid.

Poisoning can occur from different amounts of grains eaten. Fatal poisoning of an adult was observed from 40 pieces of apricot grains, although approximately 0.5 cups of peeled seeds is considered a lethal dose.

Clinically, in severe cases of stone fruit poisoning, in addition to nausea, vomiting, diarrhea, rapid manifestation of cyanosis of the face and mucous membranes, shortness of breath, clonic and tonic convulsions are noted. Death occurs from paralysis of the respiratory center. Poisoning can occur not only from ingesting fresh kernels, but also from consuming liqueurs and compotes made from these fruits that have been stored for a long time.

At autopsy, a picture of acute death is observed: plethora internal organs, liquid cherry-red blood (from the formation of cyanhemoglobin), pink coloring of the mucous membrane of the gastrointestinal tract, remnants of nuclei in the contents of the stomach and intestines. Chemical testing can detect the presence of hydrocyanic acid.

Poisoning with henbane, datura and belladonna. The active principles of these plants are atropine-containing substances (hyocyamine, atropine and scopolamine). They are classified as cardio-paralytic poisons; they first sharply excite the central nervous system and then paralyze it.

Poisoning in this case often occurs when children consume leaves and berries. Ignorance of these plants leads to the fact that similar poisonings are observed in the presence of adults. Symptoms of poisoning occur very quickly, within 10-20 minutes, and are characterized by anxiety, sudden agitation, and confusion. Delusions and hallucinations of a frightening nature appear (“I ate too much henbane”). The blood vessels of the skin of the face, and then the neck and chest, dilate. The pulse quickens sharply, bladder paralyzed. Then a coma develops and death occurs from respiratory and cardiac paralysis. In children fatal poisoning may occur after eating 4-5 belladonna berries.

At the autopsy, except for the sharp dilation of the pupils, nothing characteristic is found. The diagnosis is made by clinical findings and the results of botanical examination of plant remains found in the stomach and intestines.

Poisoning with hemlock (water hemlock) is observed when ingesting the roots of this plant, which grows along the banks of reservoirs and in damp swampy places. The fleshy rhizome of hemlock has a sweetish taste and appearance resembles edible root vegetables. Its distinctive feature is the presence of cavities in the cut. The poison (cicutotoxin) is contained not only in the rhizome, but also in other parts of the plant.

Cicutotoxin, like strychnine, is a convulsant poison. It stimulates reflex functions spinal cord, including the center of the vagus nerve. Poisoning is characterized rapid development symptoms: agitation, vomiting, cyanosis, severe convulsions, drooling, foaming at the mouth. Death occurs in a state of collapse from paralysis of the centers of the medulla oblongata. No specific changes were noted at autopsy. Sometimes it is possible to find in the stomach the remains of a rhizome with a characteristic cellular structure.

Aconite poisoning occurs in the Caucasus, where this plant from the buttercup family is quite widespread. Inept use of aconite preparations (infusions, decoctions, etc.) as a remedy traditional medicine leads to severe poisoning.

The active substance (aconitine) is an extremely poisonous alkaloid found in all parts of the plant. The lethal dose of pure aconitine is 0.003-0.004 g. It is used to control predators and rodents, and also as an insecticide. Aconitine belongs to the group of cardiovascular poisons. It first excites and then paralyzes the central nervous system and motor nodes of the heart. Simultaneously with paralysis of the motor nodes of the heart, the endings of the vagus nerve are excited, which leads to cardiac arrest in the diastole phase.

Poisoning occurs very quickly, within 2-4 hours, accompanied by tingling sensations on the tongue, pharynx, esophagus, stomach, then develops profuse drooling And itchy skin followed by numbness. The pulse and breathing are initially rapid, followed by shortness of breath and bradycardia. Consciousness is usually preserved, and seizures are rare. The mortality rate is very high. At autopsy, nothing characteristic was determined.

Poisoning spotted hemlock. The rhizome of this plant resembles horseradish, and the leaves resemble parsley. Active ingredient is coniine - an alkaloid that causes paralysis of the endings motor nerves. The clinical picture is characterized by paralysis that occurs first in the legs. At large doses death occurs from paralysis of the respiratory center. The course of poisoning is very fast - 1-2 hours; lethal dose 0.5-1 g. Autopsy data are negative.

Poisoning by plants that acquire toxic properties. Ordinary edible plants can sometimes turn out to be poisonous, for example, potatoes, in which, during strong germination, poisonous glucosite - solanine - accumulates. Dangerous by high content solanine are tubers that, although not sprouted, have a green skin. Normal potatoes contain solanine in an amount of 0.001%; if its content increases to 0.002%, symptoms of poisoning may develop (bitter taste in the mouth, burning tongue, nausea, and sometimes diarrhea). No deaths were observed.

Ergotism is determined by the action of ergot. The mycelium of the ergot fungus looks like grains purple, located on ears of corn. The addition of ergot to the flour from which bread is baked makes it poisonous.

Poisoning manifests itself in two forms: convulsive and gangrenous. In convulsive form there are gastrointestinal disorders and changes in the nervous system: general agitation, convulsions (“black writhing”), mental disorders, hallucinations. At severe course the picture of poisoning resembles tetanus. In the gangrenous form, in addition, there is necrosis of the fingers, ears, tip of the nose, accompanied by sharp pain.

Alimentary-toxic aleukia is associated with the fact that grain (millet, wheat) that has overwintered under the snow sprouts fungi. Initially, this disease, reminiscent of sepsis, was called septic tonsillitis. The disease manifests itself in fever, sore throat, and necrotizing sore throat. The leading symptoms are damage to the hematopoietic organs and the development of severe aleukia. Mortality is high (from 30 to 80%).

Toxicity of food can also be associated with the accidental ingestion of toxic impurities of chemical or plant origin. These impurities sometimes get into products due to improper storage, processing or other means, for example, during pest control processing, etc. Currently, the most common impurities are chemical origin, most of which are pesticides.

Poisoning with pesticides. Pesticides are called chemicals, used in agriculture to combat pests and diseases of cultivated plants, weeds, pests of grain reserves and food products, as well as for pre-harvest defoliation of some crops.

Currently, more than 500 pesticides are known (and their preparations are more than 1000) designed to combat harmful insects (insecticides), weeds (herbicides), fungal diseases (fungicides), rodents (zoocides), etc. The huge number of pesticides produced increases every year. It should be borne in mind that all pesticides used in agriculture, to one degree or another, are poisonous to both animals and humans. The only difference is that having by selective action, some of them are more toxic to humans, while others are less. Due to widespread use pesticides, the number of poisonings they cause is steadily increasing.

By chemical composition pesticides can be divided into the following groups: organochlorine (dexachlorane, chlorindan, etc.), organophosphorus (thiophos, chlorophos, karbofos, etc.), organomercury (ethylmercurophosphate, granosan, etc.), arsenic preparations (sodium arsenite, Parisian green, ratsid, etc.), copper preparations ( copper sulfate, Bordeaux mixture), hydrocyanic acid preparations (cyanoplas, sodium cyanide), alkaloids (anabasine sulfate, nicotine sulfate), etc. The mechanism of action of various pesticides on the human body is extremely diverse. It should be taken into account that various organs and tissues are not equally sensitive to the action of poisons, and different poisons can selectively affect certain organs or systems.

To diagnose toxic chemical poisoning, preliminary information, the clinical picture of poisoning, and results should be used laboratory research, and in the event of death of the victims and morphological changes from the internal organs. Diagnosis of poisoning is especially difficult in cases where the circumstances of the incident are unknown, since the clinical picture and morphological changes of poisoning with many pesticides are uncharacteristic, and methods for determining pesticides in biological materials have not yet been sufficiently developed. To determine pesticides and products of their transformation into biological material lately began to be used latest methods research: spectrophotometry, gas chromatography, polarography, etc. Among pesticides, organophosphorus and organochlorine pesticides rank first in terms of the number of preparations used in agriculture and the frequency of cases of poisoning.

Organophosphorus compounds. They very sharply reduce the activity of cholinesterase, which leads to the accumulation of acetylcholine in the body.

One of the most common organophosphate pesticides is thiophos (NIUIF-100). The pure preparation is a colorless transparent oily liquid with weak unpleasant smell. Thiophos compounds are widely used for pollination and spraying of plants.

In terms of toxicity, thiophos is not inferior to such strong poisons as hydrocyanic acid and strychnine. According to foreign authors, the lethal dose of thiophos for humans is 6.8 mg/kg, i.e. about 0.5 g for an adult. Poisoning occurs not only when ingested, but also when inhaling vapors and getting the drug on the skin and mucous membranes.

Symptoms of thiophos poisoning are very diverse: general weakness, vomiting, abdominal pain, shortness of breath, headaches, and in severe cases - generalized convulsions and coma. Death occurs from paralysis of the respiratory center. During an external examination of the corpse, a sharp expression of cadaveric spots, rigor mortis, as well as significant constriction of the pupils are noted.

At autopsy, cerebral edema is detected, sometimes with pinpoint hemorrhages in its substance, small lesions catarrhal, catarrhal-hemorrhagic pneumonia, catarrhal inflammation of the mucous membrane of the stomach and intestines, congestion of the internal organs and a sharp specific odor from the contents of the stomach, reminiscent of the smell of rotten hay. To establish poisoning, forensic chemical examination and determination of cholinesterase activity in cadaveric blood are of great importance.

Organochlorine compounds. " Entrance gate» for organochlorine pesticides, in addition to the gastrointestinal tract, are the skin, mucous membranes and respiratory tract. Most organochlorine drugs are lipid-soluble substances. They accumulate in adipose tissue and have a toxic effect on the nervous system. The symptoms of acute poisoning depend on the route of introduction into the body. If the poison enters the stomach, then nausea, vomiting, headaches, a feeling of tightness in the chest develop, and body temperature rises to 38-40°C. Later, general weakness, paresthesia, tremor, convulsions, and delirium appear. Protein, red blood cells, and granular casts are found in the urine. For poisoning through skin additionally characterized by redness of the skin and dermatitis varying intensity. Poisoning through the respiratory tract is accompanied by shortness of breath and cough. At chronic poisoning With drugs in this group, loss of appetite, insomnia, fatigue, trembling and convulsive pain in the limbs, paresthesia, dizziness, headaches, hepatitis, gastritis, etc. are observed. Lethal dose - from 0.5 to 30 g.

Other impurities of chemical origin include nitrites - salts of nitrous acid. They are used in the preparation of ham and sausages. In appearance, nitrites resemble table salt and may be mistakenly used as food. They are highly toxic (lethal dose 0.3 - 0.5 g).

Clinical picture in this type of poisoning, it is characterized by cyanosis, which is associated with the formation of methemoglobin in the blood. Shortness of breath, decreased cardiac activity and death develop. Upon opening, the brown color attracts attention. cadaveric spots and blood, in which methemoglobin is detected during spectral examination.

Poisoning with toxic impurities of plant origin is also called weed toxicosis, since it is caused by the seeds of poisonous weeds. Lawyers should remember that the wide variety of clinical presentations of numerous food poisonings, their sources and causes leads to the fact that intravital diagnosis There are many mistakes observed in food poisoning. On the one hand, gastrointestinal disorders that mimic food poisoning may be a reflex reaction when various diseases, including in the abdominal form of myocardial infarction. On the other hand, a number of food poisonings are accompanied by symptoms of a serious disorder cardiovascular system(feeling of tightness in the chest, pain in the heart, falling blood pressure etc.). They lead to significant changes in the electrocardiogram. Such disorders in food poisoning can be complicated by severe coronary insufficiency and even myocardial infarction. This circumstance must be taken into account by forensic experts when establishing the cause of death at autopsy.

As is known, the task forensic medical examination includes identifying medical errors, including in cases of food poisoning. The main reasons for such diagnostic errors are the following:

§ doctors’ insufficient knowledge of food poisoning clinics;

§ re-evaluation of anamnestic data (“poor quality” food);

§ atypical clinical course of the disease with pronounced phenomena simulating food poisoning;

§ incomplete examination of the patient due to his short stay in the hospital, the severity of the disease, as a result of the inexperience or negligence of the doctor.

Security questions

1. What groups are food poisoning classified into?

2. What are the features of food poisoning of bacterial origin?

3. What are the features of food poisoning of non-bacterial origin?

4. What are the features of food poisoning of an unknown nature?

Food poisoning of non-bacterial origin is less common than bacterial food poisoning, their causes are more numerous, and therefore the clinical and forensic diagnosis of such poisoning is more difficult.

Poisoning by poisonous products of animal origin. These include certain types of fish, shellfish and the endocrine glands of slaughter cattle.

Of the poisonous fish, some are always and completely poisonous, others acquire poisonous properties exclusively during the spawning period, and only caviar and milt are poisonous at this time. Certain species of fish, usually suitable for food, sometimes become toxic in a number of water bodies for special reasons. Currently, about 300 species of poisonous fish are known, most of which live in the Caribbean Sea. Pacific and Indian oceans.

Among the poisonous fish that live in the Pacific Ocean and, in particular, off the coast of the Russian Federation, we can name pufferfish and pufferfish. The caviar, milt, liver and blood of these fish are poisonous.

Fugu venom, tetraodotoxin, is a neurotropic poison; it acts on the neuromuscular synapses of the respiratory muscles. Later, peripheral paralysis is accompanied by paralysis of the smooth muscles of the vascular walls, which is associated with a drop in blood pressure. It is important to note that at the same time the respiratory center is depressed. Poisoning with this poison is accompanied by a high degree of mortality.

Among the freshwater poisonous fish, one should mention the marinka, which lives in the waters of Central Asia. Its meat is quite edible; only the caviar, milt and black peritoneum are poisonous. Therefore, freshly caught and gutted fish are edible. Marinka's poison has a neurotropic effect (gastroenteritis, headache, paralysis of peripheral muscles, including respiratory muscles). Deaths from asphyxia are possible. Special processing neutralizes the product and makes it possible to eat it.

Poisoning with products of plant origin. Among poisonings with products of plant origin, poisoning with poisonous mushrooms (pale toadstool, fly agarics, strings, etc.) comes first. Poisoning is seasonal and occurs in autumn and spring.

Toadstool poisoning most often occurs in the fall. This is a lamellar mushroom, some of its varieties resemble champignons, others resemble russula and honey mushrooms. Unlike the champignon, the pale grebe has a vagina (volva) at the base of the leg; its plates are always white, while in champignons the plates are white only in young specimens, then they become pink and brown. At the same time, the pale grebe has many varieties that make it difficult to recognize even by specialists. Poisoning with toadstool is accompanied by high mortality. Some authors indicate that even one specimen of the pale toadstool can cause poisoning in a family of 5-6 people.

A family of 5 people ate soup made from champignons bought at the market. 30-40 hours after the event, all family members fell ill: nausea, vomiting, and diarrhea appeared. In 4 adults the disease was mild; in a 3-year-old girl, after a long remission, bloody vomiting began. The child died due to symptoms of cardiac weakness. At the autopsy, dystrophic changes in parenchymal organs were discovered, in particular fatty liver degeneration. During the investigation, it was established that during the cleaning of champignons, one of the mushrooms aroused suspicion due to its resemblance to a toadstool. However, this mushroom was not removed and, apparently, was the cause of poisoning.

The main active principle of the toadstool mushroom is the strongest destructive poison - amanitatoxin. This mushroom also contains another poison - amaditagemolysin, which is destroyed when heated to 70° or from exposure to digestive juices. Therefore, the effect of amanitagemolysin is often obscured by the influence of a stronger poison - amanitatoxin.

Signs of toadstool poisoning will appear several hours after ingesting the mushrooms. These are acute pain in the abdomen, vomiting, diarrhea, sometimes constipation, often anuria. Sometimes the symptoms of acute gastroenteritis resemble cholera. General weakness, cyanosis, sometimes jaundice, and a drop in body temperature quickly develop. Death occurs in a state of coma, and children often experience convulsions. Sometimes neuropsychic disorders are observed: delirium, agitation, loss of consciousness. Protein and blood are detected in the urine.

An autopsy will reveal severe dehydration of the corpse, symptoms of acute gastroenteritis, the absence of rigor mortis and significant degenerative changes in organs, especially fatty degeneration of the heart, liver, and kidneys. If the effect of amanitohemolysin continues, hemolyzed blood in the corpse and hemolytic nephrosis occur. Along with the described signs, multiple pinpoint hemorrhages under the serous membranes and hemorrhages into the mucous membrane of the stomach and intestines are noted.

Poisoning by fly agarics is rare, since these mushrooms are secreted by this species, and the population is well aware of their poisonous properties. Fly agarics contain a strong poison - muscarine. The latter stimulates the endings of the vagus nerve, as a result of which increased secretory activity of the glands is noted (salivation, sweat, lacrimation), spasms of smooth muscles (nausea, vomiting), and constriction of the pupils is noted. The pulse slows down, breathing becomes faster and more difficult, there will be dizziness, confusion, and sometimes hallucinations and delirium. The toxicity of mushrooms, and therefore their lethal dose, depend on many conditions and, in particular, on the growing conditions (terrain, weather). The lethal dose of pure muscarine is very small (about 0.01 g)

Among the spring mushrooms that can cause food poisoning, we should mention the lines, which are very similar to the edible morel mushrooms.
It is worth noting that the main difference between the stitches will be the cellular structure in the section, while morels in the section have a uniform structure. The lines contain a strong poison - helvelic acid, which causes hemolysis. In mild cases of poisoning, 1-8 hours after taking mushrooms, nausea, vomiting with bile, abdominal pain, and weakness will occur; in severe cases, these phenomena are accompanied by jaundice and sometimes convulsions, indicating a poor prognosis. It is important to note that headache, loss of consciousness, and delirium develop simultaneously.

During a forensic medical examination of the corpses of persons who died from stitch poisoning, attention is drawn to the icteric staining of the skin and mucous membranes, multiple hemorrhages under the serous membranes; the blood is thick and dark; Hemorrhages are sometimes observed under the endocardium of the left ventricle. On the part of parenchymal organs, the phenomena of fatty degeneration occur; in particular, the liver is very sharply enlarged, acquiring a lemon-yellow color. In the kidneys there is a picture of hemoglobinuric nephrosis.

To diagnose mushroom poisoning, a botanical examination of the contents of the stomach and intestines to detect fungal remains is important.

Poisoning by bitter kernels of stone fruits (apricots, peaches, cherries, bitter almonds) These kernels contain the glucoside amygdalin, which, under the action of enzymes in the intestines, is broken down into glucose, benzoic aldehyde and hydrocyanic acid.

Clinically, in severe cases of stone fruit poisoning, in addition to nausea, vomiting, diarrhea, rapid manifestation of cyanosis of the face and mucous membranes, shortness of breath, clonic and tonic convulsions are noted. Death occurs from paralysis of the respiratory center. Poisoning can occur not only when ingesting fresh kernels, but also from consuming liqueurs and compotes made from these fruits, which have been stored for a long time.

At the autopsy, a picture of acute death is observed: congestion of the internal organs, liquid cherry-red blood (from the formation of cyanghemoglobin), pink coloring of the mucous membrane of the gastrointestinal tract, remnants of nuclei in the contents of the stomach and intestines. Chemical testing can detect the presence of hydrocyanic acid.

Poisoning with henbane, datura and belladonna. The active principle of these plants will be atropine-containing substances (hyocyamine, atropine and scopolamine). It is worth noting that they are related to cardiac poisons, first sharply excite the central nervous system, and then paralyze it.

In this case, poisoning often occurs when children consume leaves and berries. Ignorance of these plants leads to the fact that similar poisonings are observed in the presence of adults. Symptoms of poisoning occur very quickly, within 10-20 minutes, and are characterized by anxiety, sudden agitation, and confusion. There will be delusions and hallucinations of a frightening nature (“henbane has eaten too much”) The blood vessels of the skin of the face, and then the neck and chest, expand. The pulse quickens sharply, the bladder becomes paralyzed. Then a coma develops and death occurs from respiratory and cardiac paralysis. The material was published on http://site
In children, fatal poisoning can occur after eating 4-5 belladonna berries.

Poisoning with hemlock (water hemlock) is observed when ingesting the roots of this plant, which grows along the banks of reservoirs and in damp swampy places. The fleshy rhizome of hemlock has a sweetish taste and in appearance resembles edible root vegetables. Its distinctive feature will be the presence of cavities in the cut. The poison (cicutotoxin) is contained not only in the rhizome, but also in other parts of the plant.

Cicutotoxin, like strychnine, will be a convulsant poison. It stimulates the reflex functions of the spinal cord, incl. and the center of the vagus nerve. Poisoning is characterized by the rapid development of symptoms: agitation, vomiting, cyanosis, severe convulsions, drooling, and foaming at the mouth. Death occurs in a state of collapse from paralysis of the centers of the medulla oblongata. No specific changes were noted at autopsy. Sometimes it is possible to find in the stomach the remains of a rhizome with a characteristic cellular structure.

Aconite poisoning occurs in the Caucasus, where this plant from the buttercup family is quite widespread. Inept use of aconite preparations (infusions, decoctions, etc.) as a traditional medicine leads to severe poisoning.

The active substance (aconitine) is an extremely poisonous alkaloid found in all parts of the plant. The lethal dose of pure aconitine is 0.003-0.004 g. It is worth noting that it is used to combat predators and rodents, and also as an insecticide. Aconitine belongs to the group of cardiovascular poisons. It is worth noting that it first excites and then paralyzes the central nervous system and motor nodes of the heart. It is important to note that simultaneously with paralysis of the motor nodes of the heart, the endings of the vagus nerve are excited, which leads to cardiac arrest in the diastole phase. Poisoning occurs very quickly, within 2-4 hours, accompanied by tingling sensations on the tongue, pharynx, esophagus, stomach, then profuse salivation and skin itching develop, followed by numbness. The pulse and breathing are initially rapid, followed by shortness of breath and bradycardia. Consciousness is usually preserved, and seizures are rare. The mortality rate is very high. At autopsy, nothing characteristic was determined.

Spotted hemlock poisoning. The rhizome of this plant resembles horseradish, and the leaves resemble parsley. The active ingredient is coniine, an alkaloid that causes paralysis of motor nerve endings. The clinical picture is characterized by paralysis that occurs first in the legs. At large doses, death occurs from paralysis of the respiratory center. Note that the course of poisoning is very fast - 1-2 hours; lethal dose 0.5-1 g. Autopsy data are negative.

Poisoning by plants that acquire toxic properties. Ordinary edible plants, for example, potatoes, can sometimes turn out to be poisonous, in which, during strong germination, poisonous glucosite - solanine - accumulates. It is appropriate to note that tubers, although not sprouted, have green skin, will be dangerous due to their high solanine content. In normal potatoes, solanine is contained in an amount of 0.001%; when its content increases to 0.002%, symptoms of poisoning may develop (bitter taste in the mouth, burning tongue, nausea, sometimes diarrhea). There are no deaths observed.

Ergotism is determined by the action of ergot. The mycelium of the ergot fungus looks like purple grains located on the ears. The admixture of ergot to the flour from which bread is baked makes it poisonous.

Poisoning will occur in two forms: convulsive and gangrenous. In the convulsive form, gastrointestinal disorders and changes in the nervous system are noted: general agitation, convulsions (“black writhing”), mental disorders, hallucinations. In severe cases, the picture of poisoning resembles tetanus. In the gangrenous form, in addition, there is necrosis of the fingers, ears, and tip of the nose, accompanied by sharp pain.

Alimentary-toxic aleukia is associated with the fact that grain (millet, wheat) that has overwintered under the snow sprouts fungi. At first, a disease resembling sepsis was called septic tonsillitis. The disease will include fever, sore throat, and necrotizing sore throat. The leading symptoms will be damage to the hematopoietic organs and the development of severe aleukia. Mortality is high (from 30 to 80%)

Toxicity of food can also be associated with the accidental ingestion of toxic impurities of chemical or plant origin. These impurities sometimes get into products due to improper storage, processing or other means, for example, during pest control processing, etc. Today, the most common impurities are of chemical origin, most of which are pesticides.

Poisoning with pesticides. Pesticides (pesticides) are chemicals used in agriculture to control pests and diseases of cultivated plants, weeds, pests of grain and food stocks, as well as for pre-harvest defoliation of certain crops.

Today, more than 500 pesticides are known (and there are more than 1000 of their preparations) designed to combat harmful insects (insecticides), weeds (herbicides), fungal diseases (fungicides), rodents (zoocides), etc. The huge number of pesticides produced increases every year. It should be borne in mind that all pesticides used in agriculture are toxic to one degree or another for both animals and humans. The only difference is that, having a selective effect, some of them will be more toxic for humans, while others will be less. Due to the widespread use of pesticides, the number of poisonings caused by them is steadily growing.

According to the chemical composition, pesticides can be divided into the following groups: organochlorine (dexachlorane, chlorindan, etc.), organophosphorus (thiophos, chlorophos, karbofos, etc.), organomercury (datamercurphosphate, granosan, etc.), arsenic preparations (sodium arsenite , Parisian greens, ratsid, etc.), copper preparations (copper sulfate, Bordeaux mixture), hydrocyanic acid preparations (cyanoplastic, sodium cyanide), alkaloids (anabasine sulfate, nicotine sulfate), etc. The mechanism of action of various pesticides on the human body is extremely diverse. In this case, it should be taken into account that different organs and tissues are not equally sensitive to the action of poisons, and different poisons can selectively affect certain organs or systems.

To diagnose poisoning by pesticides, preliminary information, the clinical picture of poisoning, the results of laboratory tests, and in the event of death of victims, morphological changes in internal organs should be used. Diagnosis of poisoning is especially difficult in cases where the circumstances of the incident are unknown, since the clinical picture and morphological changes of poisoning with many pesticides are uncharacteristic, and methods for determining pesticides in biological materials have not yet been sufficiently developed. It is worth saying that to determine pesticides and their transformation products in biological material, the latest research methods have recently begun to be used: spectrophotometry, gas chromatography, polarography, etc. Among pesticides, in terms of the number of preparations used in agriculture and the frequency of cases of poisoning, organophosphorus and organochlorine pesticides.

Organophosphorus compounds. It is worth noting that they very sharply reduce the activity of cholinesterase, which leads to the accumulation of acetylcholine in the body.

It is important to note that one of the most common organophosphorus pesticides will be thiophos (NIUIF-100). The pure preparation is a colorless transparent oily liquid with a slight unpleasant odor. Thiophos compounds are widely used for pollination and spraying of plants.

In terms of toxicity, thiophos is not inferior to such strong poisons as hydrocyanic acid and strychnine. According to foreign authors, the lethal dose of thiophos for humans will be 6.8 mg/kg, i.e. about 0.5 g for an adult. Poisoning occurs not only when ingested, but also when inhaling vapors and getting the drug on the skin and mucous membranes.

An autopsy reveals swelling of the brain, sometimes with pinpoint hemorrhages in its substance, small foci of catarrhal, catarrhal-hemorrhagic pneumonia, catarrhal inflammation of the mucous membrane of the stomach and intestines, congestion of the internal organs and a sharp specific odor from the contents of the stomach, reminiscent of the smell of rotten hay. It is worth saying that to establish poisoning, forensic chemical research and determination of cholinesterase activity in cadaveric blood are of great importance.

Organochlorine compounds. The “entry gates” for organochlorine pesticides, in addition to the gastrointestinal tract, will be the skin, mucous membranes and respiratory tract. It is important to know that most organochlorine drugs are lipid-soluble substances. It is worth noting that they accumulate in adipose tissue and have a toxic effect on the nervous system. The symptoms of acute poisoning depend on the route of introduction into the body. If the poison enters the stomach, nausea, vomiting, headaches, a feeling of tightness in the chest develop, and body temperature rises to 38-40°C. Later, general weakness, paresthesia, tremor, convulsions, and delirium appear. Protein, red blood cells, and granular casts are found in the urine. It is worth saying that poisoning through the skin is additionally characterized by redness of the skin and dermatitis of varying intensity. Poisoning through the respiratory tract is accompanied by shortness of breath and cough. In case of chronic poisoning with drugs of this group, loss of appetite, insomnia, fatigue, trembling and convulsive pain in the limbs, paresthesia, dizziness, headaches, hepatitis, gastritis, etc. are observed. Lethal dose - from 0.5 to 30 g.

Other impurities of chemical origin include nitrites - salts of nitrous acid. It is worth noting that they are used in the preparation of ham and sausages. In appearance, nitrites resemble table salt and can be mistakenly used in food. It is worth noting that they are highly toxic (lethal dose 0.3 - 0.5 g)

The clinical picture of this type of poisoning is characterized by cyanosis, which is associated with the formation of methemoglobin in the blood. Shortness of breath, decreased cardiac activity and death develop. At the autopsy, attention is drawn to the brown color of cadaveric spots and blood, in which methemoglobin is detected during spectral examination.

Poisoning with toxic impurities of plant origin is also called weed toxicosis, since it is caused by the seeds of poisonous weeds. Lawyers should remember that the wide variety of clinical pictures of numerous food poisonings, their sources and causes leads to the fact that many errors are observed in the intravital diagnosis of food poisoning.
From one point of view, disorders of the gastrointestinal tract that mimic food poisoning may be a reflex reaction in various diseases, incl. with the abdominal form of myocardial infarction. On the other hand, a number of food poisonings are accompanied by symptoms of a serious disorder of the cardiovascular system (a feeling of tightness in the chest, pain in the heart, a drop in blood pressure, etc.) It is worth noting that they lead to significant changes in the electrocardiogram. It must be remembered that such disorders in food poisoning can be complicated by severe coronary insufficiency and even myocardial infarction. This circumstance must be taken into account by forensic experts when establishing the cause of death at autopsy.

As you know, the task of a forensic medical examination is to identify medical errors, incl. and in cases of food poisoning. The main reasons for such diagnostic errors will be the following:

insufficient knowledge of food poisoning clinics among doctors;

re-evaluation of anamnestic data (“poor quality” food);

atypical clinical course of the disease with pronounced phenomena simulating food poisoning;

incomplete examination of the patient due to his short stay in the hospital, the severity of the disease, as a result of the inexperience or negligence of the doctor.

Food poisoning of non-bacterial origin is less common than bacterial food poisoning; their causes are more numerous, and therefore the clinical and forensic diagnosis of such poisoning is more difficult.

Poisoning by poisonous products of animal origin. These include some types of fish, shellfish and the endocrine glands of slaughter cattle.

Of the poisonous fish, some are always and completely poisonous, others acquire poisonous properties only during the period of spawning, and only caviar and milt are poisonous at this time. Certain species of fish, usually suitable for food, sometimes become toxic in a number of water bodies for special reasons. Currently, about 300 species of poisonous fish are known, most of which live in the Caribbean Sea. Pacific and Indian oceans.

Among the poisonous fish that live in the Pacific Ocean, in particular, off the coast of the Russian Federation, we can name pufferfish and pufferfish. The caviar, milt, liver and blood of these fish have toxic properties.

Fugu venom, tetraodotoxin, is a neurotropic poison; it acts on the neuromuscular synapses of the respiratory muscles. Later, peripheral paralysis is accompanied by paralysis of the smooth muscles of the vascular walls, which is associated with a drop in blood pressure. At the same time, the respiratory center is depressed. Poisoning with this poison is accompanied by a high degree of mortality.

Among the freshwater poisonous fish, one should mention the marinka, which lives in the waters of Central Asia. Its meat is quite edible; only the caviar, milt and black peritoneum are poisonous. Therefore, freshly caught and gutted fish are edible. Marinka's poison has a neurotropic effect (gastroenteritis, headache, paralysis of peripheral muscles, including respiratory muscles). Deaths from asphyxia are possible. Special processing neutralizes the product and makes it possible to eat it.

Poisoning with products of plant origin. Among poisonings with products of plant origin, the first place is poisoning with poisonous mushrooms (pale toadstool, fly agarics, strings, etc.). Poisonings are seasonal and occur in autumn and spring.

Toadstool poisoning most often found in autumn. This is a lamellar mushroom, some of its varieties resemble champignons, others resemble russula and honey mushrooms. Unlike the champignon, the pale grebe has a vagina (volva) at the base of the leg; its plates are always white, while in champignons the plates are white only in young specimens, then they become pink and brown. However, the pale grebe has many varieties that make it difficult to recognize even by specialists. Poisoning with toadstool is accompanied by high mortality. Some authors indicate that even one specimen of the toadstool can cause poisoning in a family of 5-6 people.

Other poisonings may be caused for various reasons. The most common are salt poisoning heavy metals- copper, zinc, lead, etc. Their sources are dishes, less often - parts of technological equipment made of appropriate metals, and residual amounts of pesticides used in growing fruits and berries. Many of them - copper sulfate, cuprosan, copper oxychloride - are not completely removed when washing fruits and vegetables under production conditions.

During long-term storage and preparation of food that has an acidic reaction (compotes, fermentations, pickles), dangerous amounts of these metals accumulate in copper or galvanized utensils. This is felt by the metallic, astringent taste. A few minutes or hours after eating such foods, signs of poisoning appear - weakness, nausea, vomiting. It is prohibited to use galvanized utensils for preparing and storing food. The exceptions are dry foods and water.

Copper utensils and equipment are allowed to be used only in the confectionery and canning industry or if contact with food is short-term. No more than 8 mg of copper is allowed per 1 kg of product.

The tin content in products is also standardized - no more than 200 mg per 1 kg of product (20 mg%). Canned food with an aggressive environment in tomato filling is recommended to be produced in containers, the inner surface of which is protected with durable food varnish. In large quantities, tin causes digestive disorders and enzymatic activity disturbances in the human body.

Lead can enter food products from glazed or tinned pottery. It is included in some types of glaze: in small quantities (no more than 1%) it can be found in tin used for tinning.

Lead causes severe poisoning. Its presence in food is unacceptable. Dishes containing lead are prohibited from being used for food purposes.

Food poisoning of a plant nature is associated with the ingestion of poisonous mushrooms (pale toadstool, panther fly agaric, stitches), cockle seeds, henbane, datura, heliotrope, sophora, etc.; eating raw or insufficiently cooked beans, sprouted or green potatoes.

The amount of cockle, sophora and other seeds in grain products is strictly regulated. The admixture of heliotrope seeds is completely unacceptable.

Food poisoning is possible when eating certain fish. Thus, during the spawning period, the caviar and muscles of the abdominal part of the Central Asian fish marinka, barbel caviar, and tench acquire poisonous properties.

Honey can also have toxic properties. This is observed when bees collect nectar from Caucasian rhododendron, wild rosemary, henbane, datura and others. plants. Such honey, as a rule, does not have a toxic effect on the bees themselves.

Poisoning caused by pesticides used in agriculture poses a great danger. These include insecticides (against insects), acaricides (against mites), fungicides (against fungi), herbicides (against weeds), defoliants (to remove leaves from plants), zoocides (against rodents), bactericides (against bacteria).

Of the pesticides used, the most numerous are organophosphorus and organochlorine compounds. The most dangerous of them are organochlorines. They are practically insoluble in water and resistant to high temperatures, making it impossible complete liberation food products from their remains. Organophosphorus compounds are partially or completely destroyed at high temperatures. They can be washed off with water, especially during the first time after treatment.

Poisoning with insecticides causes nausea, vomiting, drooling, abdominal cramps, diarrhea, increased sweating, constriction of the pupils, loss of appetite, headache, confusion, disorientation in space, speech impairment, etc. Depending on the dose of pesticides, poisoning can last from 1 -3 hours up to several weeks.

Food products containing pesticide residues in excess of permissible concentrations are sold after aging for different times depending on the group of pesticides and types of food products. Sales conditions are determined by sanitary inspection authorities.

Since metaphos, chlorophos and thiophos are stored for a long time in an acidic environment, cabbage and other vegetables containing residues of these substances in excess of permissible standards should not be used for pickling, pickling, or pickling.

If there is a large residual content of pesticides, it is prohibited to press citrus fruits to obtain juices without first removing them from the peel.

In case of accidental contamination of meat large quantities of organophosphorus pesticides, its sale through the retail chain is unacceptable. It can be used for cooking boiled sausages, which are produced at high temperatures.

Given the great durability organochlorine compounds rules for using products contaminated with them are more stringent.

For example, fruits and berries in which the residual amount of such pesticides exceeds the permissible level are processed only into juices or sent for processing into jam, preserves, jam, or for drying after peeling, which contains the main amount of pesticides. Green onions, parsley and other leafy vegetables that contain pesticides should not be eaten. Cabbage, in which residual amounts of these substances are concentrated in the outer leaves, can only be used after four to eight outer leaves have been removed.

Milk is processed into low-fat cottage cheese and kefir, skim milk powder and condensed milk. Cream and butter, in which residual amounts of organochlorine pesticides exceed permissible limits, are used in confectionery and other products in such a way that their residues in the finished product do not exceed acceptable standards. Otherwise, they can only be used for technical purposes.

Small batches of meat containing organochlorine pesticides are used as additives for the preparation of sausages.

Fish with detected organochlorine pesticides in quantities no more than 4 times higher than permissible can be used in the production of canned fish and vegetables.

Eggs containing organochlorine pesticides are used in confectionery production.

The use of pesticides is currently increasing, so measures are being developed to prevent them from getting into food, as well as rules for the use and processing of products contaminated with them.

Acute diseases that occur after eating food that contains substances of bacterial and non-bacterial origin that are toxic to the body. Unlike foodborne infections food poisoning occurs in people who have consumed the same low-quality products and is not transmitted from person to person.

Pathogenic microbes produce two types of toxins: exotoxins and endotoxins.
Exotoxins easily isolated from microbial cells into environment. They amaze certain organs and tissues have a specific effect.
Endotoxins are not released from the microbial cell during its life, but are released only after its death. Endotoxins do not have specificity in the body; they cause general signs poisoning

Food poisoning of bacterial origin can be divided into three groups:

Bacterial toxic infections are diseases caused by microorganisms such as Proteus, Escherichia, Clostridia, Enterococci, etc.
Bacterial intoxication - botulism, staphylococcal poisoning).
Mycotoxicoses - ergotism, fusariotoxicosis, aflotoxicosis.

Bacterial toxic infections- diseases in the pathogenesis of which live pathogens and the toxins they produce are involved. They are characterized by a sudden onset, rapid development, intoxication, and disruption of the gastrointestinal tract. They are transmitted only through nutritional means. Food becomes contaminated pathogenic microorganisms during their preparation, storage or sale. Endogenous contamination of meat is possible during slaughter and cutting of carcasses of sick animals. Foodborne illnesses always associated with the consumption of either contaminated products that have not been exposed to sufficient heat treatment, or ready-made meals contaminated after preparation during storage outside the refrigerator or provided for consumption without repeated heat treatment.

Bacterial intoxication- these are diseases that arise as a result of eating food containing toxins, as a result of the development specific pathogen. Unlike toxic infections, in the case of bacterial intoxications, a toxin released by microorganisms during their reproduction in the product enters the human body along with food products. In this case, there may no longer be living microbes in the product or they may be contained in insignificant quantities.

An illustrative example of bacterial intoxication is botulism - poisoning by a bacterial toxin. Clostridium botulinum. Botulinum toxin is considered the most powerful poison in the world and is part of the arsenal of biological weapons.

Mycotoxicoses- food poisoning resulting from the ingestion of mycotoxins - waste products of certain microscopic (mold) fungi - into the body along with food.

Mycotoxins can enter the human body through milk, meat and fish if feed contaminated with microscopic fungi is used. By multiplying in food products, mold fungi not only poison them, but also worsen organoleptic properties, reduce nutritional value, lead to spoilage of products and make them unsuitable for technological processing.

Mycotoxins are resistant to physical and chemical factors. Conventional methods of technological and culinary processing only partially reduce their content in food products. High temperature, drying, freezing, irradiation with radioactive and ultraviolet rays ineffective.

Symptoms of food poisoning

Most food poisonings have similar symptoms: abdominal pain, nausea, vomiting, fever, diarrhea, loss of coordination.

Escherichia have a short incubation period, which lasts from 2 hours to 1 day. The disease begins suddenly and manifests itself as a moderately severe intoxication syndrome (chills, general weakness, headache, muscle pain) in combination with symptoms of gastrointestinal tract damage (severe abdominal pain, nausea, vomiting, diarrhea mixed with mucus and blood) . Body temperature is normal or slightly elevated - up to 37.5°C. The illness lasts from 1 to 3 days.

Bacteria of the genus Protea have an incubation period of 4 to 24 hours after eating contaminated food. Severe cases are rare. Basic clinical signs- sharp pain in the abdominal area, nausea, vomiting, fever, general weakness, gastrointestinal disorders. The disease lasts 2-3, in some cases up to 5 days. In severe cases, cyanosis, convulsions, weakened cardiac activity are observed, mortality is observed in 1.5-1.6% of cases.

Streptococcal toxic infections appear 8-12 hours after consuming contaminated products. The clinical picture is typical for toxic infections. Recovery occurs in 1-2 days.

Botulism is one of the most dangerous food poisonings. The incubation period of botulism lasts from 2 hours to 10 days, most often 18-24 hours, which depends on the amount of toxin that has entered the body. The disease develops suddenly. The first clinical signs: visual disturbances (feeling of fog, grids, double vision, spots before the eyes), reading complications, headache, unsteady gait. Later appear following signs: loss of voice, paralysis of eyelids, involuntary movements eyeballs, voltage masticatory muscles, paralysis soft palate, difficulty swallowing and a feeling of lack of air. Temperature remains within physiological norm or decreases to 35.5°C. In the absence of timely treatment, mortality reaches 70% - death occurs after 2-3 days as a result of paralysis of the respiratory center or heart. Immunity to the disease is not formed.

Symptoms staphylococcal intoxication can be observed 2-4 hours after enterotoxin enters the body. However initial signs may appear earlier. First, salivation is observed, then nausea, vomiting, and diarrhea. Body temperature may be low-grade or elevated. The disease is sometimes accompanied by complications: dehydration, shock, the presence of blood or mucus in the feces and vomit. Other symptoms of the disease include headache, cramps, sweating and general weakness. The severity of these symptoms is determined mainly by the amount of toxin entering the body and the sensitivity of the patient. Recovery often occurs within a day, but may take several days. Deaths due to staphylococcal food poisoning are extremely rare.

Ergotism- food poisoning of people and animals, which occurs due to the consumption of grain products containing the microscopic fungus Claviceps purpurea (horns). Once in the body, the poison affects the nervous system and causes circulatory problems. Signs of poisoning appear quickly - dizziness, chills, nausea, abdominal pain. Ergotism can occur in convulsive, gangrenous or mixed forms. In the case of a convulsive course, it is affected nervous system And gastrointestinal tract, drooling, nausea, vomiting, colic, convulsions appear various groups muscles, hallucinations, dizziness. In the gangrenous form, neurovascular formations are affected, which is accompanied by trophic disorders limbs, cyanosis, necrosis of fingers, toes and other parts of the body. Pregnant women experience miscarriage or premature birth.

Septic sore throat- a disease that occurs as a result of eating grain products that have overwintered under snow and contain toxins from the fungus Fusarium sporotrichiella. Poisoning develops within 1-4 weeks severe form and often ends in death. The course can be acute and end in death within 24 hours.

Conventionally, three stages of the disease are distinguished. The first begins a few hours after eating contaminated food. It is accompanied by irritation of the oral mucosa; thin whitish films are formed on it, which are easily removed. You feel weak, nauseous, and have a runny nose. If a poisonous product is excluded from the diet, the disease goes away in 2-3 days, and if not, the second stage begins. Changes in the blood are diagnosed, the number of leukocytes decreases by 10 or more times, and the hemoglobin content sharply decreases. The third stage is accompanied by rashes on the body, pain when swallowing, catarrhal, hemorrhagic and even gangrenous tonsillitis develops. Necrosis spreads to the oral mucosa, bleeding occurs from the nose, pharynx, ears, uterus and intestines. Body temperature rises to 39-40°C. Mortality in this stage can reach 50-80%.

Prevention of food poisoning of bacterial origin involves the implementation of a set of measures:

implementation of sanitary and sanitary-veterinary supervision and control over the processes of animal slaughter, catching and processing of fish, production of sausages;
control over the production of confectionery and bakery products;
control over the production, storage and sale of ready-made meals in canteens, catering units of children's institutions, buffets and catering establishments;
maximum automation and mechanization production processes at food enterprises;
providing production with serviceable refrigeration equipment;
use of laboratory quality control methods food products and heat treatment;
compliance with sanitary and hygienic rules and conditions of production, storage and transportation of products;
effective implementation of planned deratization measures;
bacteriological control of food products, compliance with sanitary and hygienic conditions and personal hygiene by personnel;
compliance with storage conditions and deadlines for selling food products.