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

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

Poisoning with 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 period of spawning, and only caviar and milk are poisonous at this time. Certain species of fish, usually suitable for food, sometimes become toxic in a number of water bodies due to special reasons. Currently, about 300 species of poisonous fish are known, most of which live in the Caribbean. 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 pufferfish, fugu. Caviar, milk, liver and blood of these fish have poisonous properties.

Fugu poison, tetraodotoxin, neurotropic poison, it acts on the neuromuscular synapses of the respiratory muscles. Later on to peripheral paralysis paralysis joins smooth muscle 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 freshwater poisonous fish, one should name the marinka that lives in the reservoirs of Central Asia. Its meat is quite suitable for food, only caviar, milk and black peritoneum are poisonous. Therefore, freshly caught and gutted fish is suitable for food. Marinka venom 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 the poisoning products of plant origin in the first place are poisoning poisonous mushrooms(pale toadstool, fly agaric, lines, etc.). Poisonings are seasonal and occur in autumn and spring.

Pale grebe poisoning most often occurs in the fall. This is an agaric mushroom, some of its varieties resemble champignons, others - russula and honey mushrooms. Unlike 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. Pale grebe poisoning is accompanied by high mortality. Some authors point out that even one copy of the pale grebe can cause poisoning of a family of 5-6 people.

A family of 5 people ate soup from champignons bought at the market. After 30-40 hours after that, all family members fell ill: nausea, vomiting, and diarrhea appeared. In 4 adults, the disease proceeded in mild form, a 3-year-old girl began to vomit blood after a long remission. The child died with signs of heart failure. Autopsy revealed dystrophic changes parenchymal organs, in particular fatty degeneration liver. During the investigation, it was found that during the cleaning of champignons, one of the mushrooms aroused suspicion by its resemblance to a pale toadstool. However, this fungus has not been seized and appears to have been the cause of the poisoning.

Main operating principle fungus pale toadstool is the strongest destructive poison - amanitatoxin. This fungus also contains another poison - amaditehemolysin, which is destroyed when heated to 70 ° C or from the action of digestive juices. Therefore, the effect of amanitehemolysin is often obscured by the influence of a stronger poison - amanitatoxin.

Signs of poisoning with pale toadstool appear a few hours after ingestion of mushrooms. This sharp pains in the abdomen, vomiting, diarrhea, sometimes constipation, often anuria. Sometimes the phenomena of acute gastroenteritis resemble cholera. General weakness, cyanosis, sometimes jaundice, and a drop in body temperature develop rapidly. Death occurs in a coma, children often have convulsions. Sometimes noted neuropsychiatric disorders: delirium, agitation, loss of consciousness. Protein and blood are detected in the urine.

An autopsy reveals a sharp dehydration of the corpse, the phenomena of acute gastroenteritis, the absence of rigor mortis and significant dystrophic changes in organs, especially fatty degeneration of the heart, liver, and kidneys. If the action of amanitohemolysin is manifested, then hemolyzed blood in the corpse and hemolytic nephrosis take place. Along with the described signs, there are multiple petechial hemorrhages under the serous membranes, hemorrhages in the mucous membrane of the stomach and intestines.

Fly agaric poisoning is rare, because these mushrooms are distinguished by their appearance, and their poisonous properties are well known to the population. Amanitas contain a strong poison - muscarine. The latter excites the endings vagus nerve, resulting in increased secretory activity of the glands (salivation, sweat, lacrimation), spasms of smooth muscles appear (nausea, vomiting), pupillary constriction is noted. There is a slowdown in the pulse, breathing accelerates and becomes difficult, dizziness, confusion, sometimes hallucinations and delirium appear. The toxicity of fungi, and hence 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 spring mushrooms that can cause food poisoning, lines that are very similar to edible morel mushrooms should be mentioned. The main difference between the lines is the cellular structure on the cut, while the morels on the cut have a uniform structure. The lines contain a strong poison - gelvellic acid, which causes hemolysis. In mild cases of poisoning, 1-8 hours after taking the mushrooms, nausea, vomiting with bile, abdominal pain, and weakness appear; in severe form, these phenomena are accompanied by jaundice, sometimes convulsions, indicating a poor prognosis. At the same time, headache, loss of consciousness, delirium develop.

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

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

For the diagnosis of mushroom poisoning, a botanical examination of the contents of the stomach and intestines is important to detect the remains of the fungus in them.

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

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

Clinically, in severe cases of stone fruit poisoning, in addition to nausea, vomiting, diarrhea, there is a rapid manifestation of cyanosis of the face and mucous membranes, shortness of breath, clonic and tonic convulsions. Death occurs from paralysis of the respiratory center. Poisoning can occur not only when taking fresh kernels, but also from the use of liqueurs made from these fruits, compotes 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 cyanemoglobin), pink coloration of the mucous membrane of the gastrointestinal tract, the remains of nuclei in the contents of the stomach and intestines. In a chemical study, the presence of hydrocyanic acid can be detected.

Poisoning bleached, dope and belladonna. The active principle of these plants are atropine-containing substances (hyocyamine, atropine and scopolamine). They belong to the cardio-paralytic poisons, first sharply excite the central nervous system, and then paralyze it.

Poisoning in this case often occurs when children eat leaves and berries. Ignorance of these plants leads to the fact that similar poisonings are observed in the presence of adults. Symptoms of poisoning come on very quickly, within 10-20 minutes, and are characterized by anxiety, sudden excitement, confusion. There are delusions and hallucinations of a frightening nature (“he ate too much”). Vessels of the skin of the face, and then the neck and chest expand. The pulse rises sharply bladder paralyzed. Then a coma develops and death occurs from respiratory paralysis and cardiac activity. In children fatal poisoning may occur after eating 4-5 belladonna berries.

At autopsy, apart from a sharp dilation of the pupils, nothing characteristic is found. Diagnosis is based on clinical findings and botanical examination of plant remains found in the stomach and intestines.

Poisoning with hemlock (water hemlock) is observed when the roots of this plant, which grows along the banks of reservoirs and in damp marshy places, are ingested. 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 section. Poison (cicutotoxin) is found not only in the rhizome, but also in other parts of the plant.

Cicutotoxin, like strychnine, is a convulsive 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, salivation, 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 detect in the stomach the remains of a rhizome, which has 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 means 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 cardio-paralytic poisons. It first excites and then paralyzes the central nervous system and the motor nodes of the heart. Simultaneously with paralysis of the motor nodes of the heart, the vagus nerve endings are excited, which leads to cardiac arrest in the diastolic phase.

Poisoning proceeds very quickly, within 2-4 hours, accompanied by tingling sensations in the tongue, pharynx, esophagus, stomach, then develop profuse salivation And pruritus changing to numbness. The pulse and breathing are first quickened, and then shortness of breath and bradycardia occur. Consciousness is usually preserved, convulsions are rare. The lethality is very high. At autopsy, nothing characteristic is 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 findings are negative.

Poisoning by plants that acquire toxic properties. Ordinary edible plants can sometimes turn out to be poisonous, for example, potatoes, in which poisonous glucosite - solanine accumulates during strong germination. Dangerous by high content solanine are tubers, although not sprouted, but having a green peel. In a normal potato, solanine is contained in an amount of 0.001%, with an increase in its content to 0.002%, symptoms of poisoning may already develop (bitter taste in the mouth, burning tongue, nausea, sometimes diarrhea). No deaths have been observed.

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

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

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

Food toxicity can also be associated with accidental ingestion of poisonous impurities of chemical or vegetable origin. These contaminants sometimes get into products due to improper storage, processing or otherwise, such as processing for pest control, etc. At present, the most common impurities chemical origin, most of which are pesticides.

Poisoning with pesticides. Pesticides are called pesticides chemical substances used in agriculture to control pests and diseases of cultivated plants, weeds, pests of grain stocks and food products, as well as for pre-harvest leafing of some crops.

Currently, 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 produced pesticides is increasing every year. It should be borne in mind that all pesticides used in agriculture, to some extent toxic to both animals and humans. The only difference is that, having selective action, some of them are more toxic to humans, while others are less. In connection with wide application pesticides, the number of poisonings they cause is steadily increasing.

By chemical composition pesticides can be divided into following groups: organochlorine (dexachloran, chlorindan, etc.), organophosphorus (thiophos, chlorophos, karbofos, etc.), organomercury (ethylmercury phosphate, granosan, etc.), arsenic preparations (sodium arsenite, Parisian greens, ratsid, etc.), copper preparations ( blue vitriol, Bordeaux liquid), hydrocyanic acid preparations (cyanide, sodium cyanide), alkaloids (anabazine sulfate, nicotine sulfate), etc. The mechanism of action of various pesticides on the human body is extremely diverse. In doing so, it should be taken into account that various bodies and tissues are not equally sensitive to the action of poisons, and various poisons can selectively affect certain organs or systems.

For the diagnosis of poisoning with pesticides, preliminary information, the clinical picture of poisoning, and the results should be used. laboratory research, and in the event of the 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 in poisoning with many pesticides are uncharacteristic, and methods for determining pesticides in biological materials have not yet been developed enough. To determine the biological material of pesticides and products of their transformation into Lately began to apply latest methods research: spectrophotometry, gas chromatography, polarography, etc. Among pesticides, in terms of the number of drugs used in agriculture and the frequency of cases of poisoning, organophosphorus and organochlorine pesticides are in first place.

Phosphorus organic compounds. They very sharply lower 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). Pure drug is a colorless transparent oily liquid with a slight bad 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 by ingestion, but also by inhalation of vapors and contact with 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. An external examination of the corpse shows a sharp severity of cadaveric spots, rigor mortis, as well as a significant constriction of the pupils.

An autopsy reveals cerebral edema, sometimes with petechial hemorrhages in its substance, small foci catarrhal, catarrhal-hemorrhagic pneumonia, catarrhal inflammation of the mucous membrane of the stomach and intestines, plethora of internal organs and a sharp specific smell from the contents of the stomach, reminiscent of the smell of rotting hay. To establish poisoning, forensic chemical research and determination of cadaveric blood cholinesterase activity are of great importance.

organochlorine compounds. " entrance gate» for organochlorine pesticides, in addition to the gastrointestinal tract, are the skin, mucous membranes and Airways. Most of the organochlorine preparations are lipid-soluble substances. They accumulate in adipose tissue and act toxically on the nervous system. Symptoms of acute poisoning depend on the route of its introduction into the body. If the poison enters the stomach, then nausea, vomiting, headaches, a feeling of constriction in the chest develop, the body temperature rises to 38-40 ° C. In the future, general weakness, paresthesia, tremor, convulsions, delusional state join. Protein, erythrocytes, granular cylinders are found in the urine. For poisoning through skin additionally characterized by reddening of the skin and dermatitis different intensity. Poisoning through the respiratory tract is accompanied by shortness of breath and cough. At chronic poisoning drugs of this group are observed loss of appetite, insomnia, fatigue, trembling and convulsive pain in the limbs, paresthesia, dizziness, headaches, hepatitis, gastritis, etc. The lethal dose is from 0.5 to 30 g.

Among other impurities of chemical origin, nitrites, salts of nitrous acid, should be mentioned. 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, a fall in cardiac activity and death develop. At autopsy, brown coloration is noteworthy. cadaveric spots and blood, in which methemoglobin is detected during a spectral study.

Poisoning by 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 presentation of numerous food poisonings, their sources and causes leads to the fact that in lifetime diagnostics food poisoning has been observed many bugs. On the one hand, disorders of the gastrointestinal tract that mimic food poisoning can 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. of cardio-vascular system(feeling of tightness in the chest, pain in the region of 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 should be taken into account by forensic experts when establishing the cause of death at the autopsy.

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

§ Insufficient knowledge by doctors of the food poisoning clinic;

§ reassessment of anamnestic data (“poor quality” food);

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

§ Inadequate 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.

Control questions

1. What groups are food poisonings classified into?

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

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

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

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

Poisoning with poisonous products of animal origin. They include certain species of fish, mollusks and endocrine glands of slaughtered cattle.

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

Among the poisonous fish that live in the Pacific Ocean and, in particular, off the coast of the Russian Federation, one can name the pufferfish, fugu. Poisonous properties are possessed by caviar, milk, liver and blood of these fish.

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

Among freshwater poisonous fish, one should name the marinka that lives in the reservoirs of Central Asia. Its meat is quite suitable for food, only caviar, milk and black peritoneum are poisonous. Therefore, freshly caught and gutted fish is suitable for food. Marinka venom has a neurotropic effect (gastroenteritis, headache, paralysis of peripheral muscles, including respiratory ones). Deaths from asphyxia are possible. Special processing neutralizes the product and makes it possible to eat it.

Poisoning by plant products. Among the poisonings of plant products, poisonous mushrooms (pale toadstool, fly agaric, lines, etc.) are in the first place. Poisonings are seasonal and occur in autumn and spring.

Pale grebe poisoning most often occurs in the fall. This is an agaric mushroom, some of its varieties resemble champignons, others - russula and honey mushrooms. Unlike 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 it even by specialists. Pale grebe poisoning is accompanied by high mortality. Some authors indicate that even one copy of the pale grebe can cause poisoning of a family of 5-6 people.

A family of 5 people ate soup from champignons bought at the market. 30-40 hours after ϶ᴛᴏgo, all family members fell ill: nausea, vomiting, and diarrhea appeared. In 4 adults, the disease proceeded in a mild form, in a 3-year-old girl, after a long remission, hematemesis began. The child died with signs of heart failure. An autopsy revealed dystrophic changes in parenchymal organs, in particular fatty degeneration of the liver. During the investigation, it was found that during the cleaning of champignons, one of the mushrooms aroused suspicion by its resemblance to a pale toadstool. At the same time, the ϶ᴛᴏt fungus was not seized and, apparently, was the cause of poisoning.

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

Signs of poisoning with pale toadstool will wake up a few hours after ingestion of mushrooms. These are acute pains in the abdomen, vomiting, diarrhea, sometimes constipation, often anuria. Sometimes the phenomena of acute gastroenteritis resemble cholera. General weakness, cyanosis, sometimes jaundice, and a drop in body temperature develop rapidly. Death occurs in a coma, children often have convulsions. Sometimes there are neuropsychiatric disorders: delirium, agitation, loss of consciousness. Protein and blood are detected in the urine.

At the autopsy, there will be a sharp dehydration of the corpse, the phenomena of acute gastroenteritis, the absence of rigor mortis and significant dystrophic changes in organs, especially fatty degeneration of the heart, liver, and kidneys. If the action of amanitohemolysin persists, then hemolyzed blood in the corpse and hemolytic nephrosis take place. Along with the described signs, there are multiple petechial hemorrhages under the serous membranes, hemorrhages in the mucous membrane of the stomach and intestines.

Fly agaric poisoning is rare, since these mushrooms are isolated by their species, and their poisonous properties are well known to the population. Amanitas contain a strong poison - muscarine. The latter excites the endings of the vagus nerve, as a result of which there is increased secretory activity of the glands (salivation, sweat, lacrimation), spasms of smooth muscles (nausea, vomiting) will occur, and pupillary constriction is noted. There is a slowdown in the pulse, breathing accelerates and becomes difficult, there will be dizziness, confusion, sometimes hallucinations and delirium. The toxicity of fungi, and therefore their lethal dose, depends 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, which can cause food poisoning, we should name lines that are very similar to edible morel mushrooms.
It is worth noting that the main difference between the lines will be the cellular structure on the cut, while the morels on the cut have a uniform structure. The lines contain a strong poison - gelvellic acid, which causes hemolysis. In mild cases of poisoning, 1-8 hours after taking the mushrooms, there will be nausea, vomiting with bile, abdominal pain, weakness; in severe form, jaundice joins these phenomena, sometimes convulsions, indicating a poor prognosis. It is important to note that headache, loss of consciousness, delirium develop simultaneously.

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

For the diagnosis of mushroom poisoning, a botanical examination of the contents of the stomach and intestines is important to detect the remains of the fungus in them.

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

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

At autopsy, a picture of acute death is observed: plethora of internal organs, liquid cherry-red blood (from the formation of cyangemoglobin), pink color of the mucous membrane of the gastrointestinal tract, the remains of nuclei in the contents of the stomach and intestines. In a chemical study, the presence of hydrocyanic acid can be detected.

Poisoning bleached, dope and belladonna. The active principle of these plants will be atropine-containing substances (hyocyamine, atropine and scopolamine). It is worth noting that they ᴏᴛʜᴏϲᴙ turn to cardio-paralytic poisons, first sharply excite the central nervous system, and then paralyze it.

Poisoning in this case often occurs when children eat leaves and berries. Ignorance of these plants leads to the fact that similar poisonings are observed in the presence of adults. Symptoms of poisoning come on very quickly, within 10-20 minutes, and are characterized by anxiety, sudden excitement, confusion. There will be delusions and hallucinations of a frightening nature (“henbane overeat”) The 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 paralysis and cardiac activity. Material published on http: // site
In children, fatal poisoning can occur after eating 4-5 belladonna berries.

Poisoning with hemlock (water hemlock) is observed when the roots of the ϶ᴛᴏ plant, which grows along the banks of reservoirs and in damp swampy places, are ingested. The fleshy rhizome of hemlock has a sweetish taste and resembles edible root vegetables in appearance. A distinctive feature of it will be the presence of cavities in the section. Poison (cicutotoxin) is found not only in the rhizome, but also in other parts of the plant.

Cicutotoxin, like strychnine, will be a convulsive 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, salivation, 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 detect in the stomach the remains of a rhizome, which has a characteristic cellular structure.

Aconite poisoning occurs in the Caucasus, where ϶ᴛᴏ a plant from the ranunculus family is quite widespread. The inept use of aconite preparations (infusions, decoctions, etc.) as 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 control predators and rodents, and also as an insecticide. Aconitine belongs to the group of cardio-paralytic poisons. It is worth noting that it first excites and then paralyzes the central nervous system and the motor nodes of the heart. It is important to note that simultaneously with paralysis of the motor nodes of the heart, the vagus nerve endings are excited, which leads to cardiac arrest in the diastolic phase. Poisoning proceeds very quickly, within 2-4 hours, accompanied by tingling sensations in the tongue, pharynx, esophagus, stomach, then profuse salivation and skin itching develop, followed by numbness. The pulse and breathing are first quickened, and then shortness of breath and bradycardia occur. Consciousness is usually preserved, convulsions are rare. The lethality is very high. At autopsy, nothing characteristic is determined.

Spotted hemlock poisoning. The rhizome of the ϶ᴛᴏth plant resembles horseradish, and the leaves resemble parsley. The active ingredient is coniine, an alkaloid that causes paralysis of motor nerve endings. In the clinical picture, paralysis will be characteristic, which occurs first in the legs. At high 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 findings are negative.

Poisoning by plants that acquire toxic effects. Poisonous can sometimes be ordinary edible plants, for example, potatoes, in which, with strong germination, poisonous glucosite - solanine accumulates. It is appropriate to note that tubers, although not germinated, but having a green peel, will be dangerous due to the high content of solanine. In a normal potato, solanine is contained in an amount of 0.001%, with an increase in its content to 0.002%, symptoms of poisoning (bitter taste in the mouth, burning tongue, nausea, sometimes diarrhea) can already develop. No deaths are observed.

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

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

Alimentary-toxic aleukia is associated with the fact that grain (millet, wheat), overwintered under the snow, germinates with fungi. At first, the disease, resembling sepsis, was called septic tonsillitis. The disease will stay in fever, sore throat, necrotic 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%)

Food toxicity can also be associated with accidental ingestion of poisonous impurities of chemical or vegetable origin. These contaminants sometimes get into products due to improper storage, processing or otherwise, such as processing for pest control, etc. Today, most often there are impurities of chemical origin, most of which are related to 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 leafing 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 produced pesticides is increasing every year. It should be borne in mind that all pesticides used in agriculture are to some extent toxic to both animals and humans. The only difference is that, having a selective effect, some of them will be more toxic to 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 (dexachloran, chlorindan, etc.), organophosphorus (thiophos, chlorophos, karbofos, etc.), organomercury (data of mercuric phosphate, granosan, etc.), arsenic preparations (sodium arsenite , Parisian greens, krysid, etc.), copper preparations (copper sulfate, Bordeaux liquid), hydrocyanic acid preparations (cyanide, sodium cyanide), alkaloids (anabasine sulfate, nicotine sulfate), etc. The mechanism of action of various pesticides on the human body is extremely diverse. With ϶ᴛᴏm, it should be taken into account that various organs and tissues are not equally sensitive to the action of poisons, and various poisons can selectively affect certain organs or systems.

For the diagnosis of poisoning with pesticides, preliminary information, the clinical picture of poisoning, the results of laboratory tests, and in the case of death of the victims, morphological changes in the 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 in poisoning with many pesticides are uncharacteristic, and methods for determining pesticides in biological materials have not yet been developed enough. It is worth mentioning that the latest methods of research have recently been used to determine pesticides and their transformation products in biological material: spectrophotometry, gas chromatography, polarography, etc. Among pesticides, in terms of the number of drugs used in agriculture and the frequency of cases of poisoning, organophosphorus and organochlorine pesticides.

Phosphorus organic compounds. It is worth noting that they very sharply lower 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 by ingestion, but also by inhalation of vapors and contact with the drug on the skin and mucous membranes.

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

organochlorine compounds. "Entrance 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 of the organochlorine preparations are lipid-soluble substances. It is worth noting that they accumulate in adipose tissue and act toxically on the nervous system. Symptoms of acute poisoning depend on the route of its introduction into the body. If the poison enters the stomach, then nausea, vomiting, headaches, a feeling of constriction in the chest develop, the body temperature rises to 38-40 ° C. In the future, general weakness, paresthesia, tremor, convulsions, delusional state join. Protein, erythrocytes, granular cylinders are found in the urine. It is worth saying that for poisoning through the skin, reddening of the skin and dermatitis of varying intensity are additionally characteristic. Poisoning through the respiratory tract is accompanied by shortness of breath and cough. In chronic poisoning with drugs of the ϶ᴛᴏ group, loss of appetite, insomnia, fatigue, trembling and convulsive pain in the limbs, paresthesia, dizziness, headaches, hepatitis, gastritis, etc. are observed. The lethal dose is from 0.5 to 30 g.

Among other impurities of chemical origin, nitrites, salts of nitrous acid, should be mentioned. 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 with the ϶ᴛᴏm form of poisoning is characterized by cyanosis, which is associated with the formation of methemoglobin in the blood. Shortness of breath, a fall in cardiac activity and death develop. At autopsy, the brown color of cadaveric spots and blood attracts attention, in which methemoglobin is detected during spectral examination.

Poisoning by 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 picture of numerous food poisonings, their sources and causes leads to the fact that there are many errors in the lifetime 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 abdominal 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 should be taken into account by forensic experts when establishing the cause of death at the 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 by doctors of the food poisoning clinic;

reassessment of anamnestic data ("poor quality" food);

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

inadequate 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, their causes are more numerous, and therefore the clinical and forensic diagnosis of such poisoning is more difficult.

Poisoning with poisonous products of animal origin. These include some species of fish, shellfish, and the endocrine glands of slaughter animals.

Among the poisonous fish that live in the Pacific Ocean, in particular, off the coast of the Russian Federation, one can name the pufferfish, fugu. Caviar, milk, liver and blood of these fish have poisonous properties.

Fugu poison, tetraodotoxin, neurotropic poison, it acts on the neuromuscular synapses of the respiratory muscles. In the future, paralysis of the smooth muscles of the walls of blood vessels joins peripheral paralysis, 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 freshwater poisonous fish, one should name the marinka that lives in the reservoirs of Central Asia. Its meat is quite suitable for food, only caviar, milk and black peritoneum are poisonous. Therefore, freshly caught and gutted fish is suitable for food. Marinka venom has a neurotropic effect (gastroenteritis, headache, paralysis of peripheral muscles, including respiratory). Death from asphyxia is possible. Special processing neutralizes the product and makes it possible to eat it.

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

Pale toadstool poisoning most common in autumn. This is an agaric mushroom, some of its varieties resemble champignons, others - russula and honey mushrooms. Unlike 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. Pale grebe poisoning is accompanied by high mortality. Some authors point out that even one copy of the pale grebe can cause poisoning of a family of 5-6 people.

Other poisonings may be caused various reasons. Salt poisoning is the most common heavy metals- copper, zinc, lead, etc. Their source is dishes, less often - parts of technological equipment made of the corresponding metals, and residual amounts of pesticides used in the cultivation of fruits and berries. Many of them - copper sulphate, cuprosan, copper oxychloride - are not completely removed when washing fruits and vegetables under industrial conditions.

During long-term storage and cooking of acidic food (compotes, pickles, pickles), in copper, galvanized dishes, dangerous amounts of these metals accumulate in it. It is felt by a metallic, astringent aftertaste. A few minutes or hours after eating such foods, signs of poisoning appear - weakness, nausea, vomiting. It is forbidden to use galvanized utensils for cooking 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. Not more than 8 mg of copper is allowed per 1 kg of product.

The content of tin in products is also normalized - 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 by stable food varnishes. In large quantities, tin causes digestive disorders in the human body, violations of enzymatic activity.

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

Lead calls severe poisoning. Its presence in food is unacceptable. Vessels containing lead must not be used for food purposes.

Food poisoning of a plant nature is associated with the ingestion of poisonous mushrooms (pale toadstool, panther fly agaric, lines), cockle seeds, henbane, dope, heliotrope, sophora, etc .; eating raw or undercooked 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 absolutely unacceptable.

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

Honey can also be poisonous. This is observed when the bees collect nectar from the Caucasian rhododendron, wild rosemary, henbane, dope 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 is of 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, resistant to high temperatures, which makes it impossible complete release food products from their residues. Organophosphorus compounds are partially or completely destroyed at high temperatures. They can be washed off with water, especially in the first time after treatment.

When poisoned with insecticides, nausea, vomiting, salivation, abdominal cramps, diarrhea, increased sweating, constriction of the pupils, loss of appetite, headache, confusion, disorientation in space, speech disturbance, etc. appear. Depending on the dose of pesticides, poisoning can last from 1 -3 hours to several weeks.

Food products containing pesticide residues in excess of permissible concentrations are sold after aging for a different time, depending on the group of pesticides and types of food products. The conditions for the implementation are determined by the sanitary supervision 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 acceptable standards should not be used for pickling, salting, pickling.

With a high residual content of pesticides, it is forbidden to press citrus fruits to obtain juices without first releasing them from the peel.

In case of accidental contamination of meat large quantities organophosphorus pesticides, its sale through the distribution network is unacceptable. It can be used to prepare boiled sausages which are produced at high temperatures.

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

So, 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 marmalade, jam, jam or for drying after peeling, which contains the main amount of pesticides. green onion, parsley and other leafy vegetables in the presence of pesticides should not be eaten. Cabbage, in which the residual amount of these substances is concentrated in the outer leaves, can only be used after removing four to eight outer leaves.

Milk is processed into low-fat cottage cheese and kefir, skimmed dry and condensed milk. Cream and butter, in which the residual amounts of organochlorine pesticides exceed the permissible ones, are used in confectionery and other products in such a way that their residues in the finished product do not exceed allowable norms. 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 the permissible ones can be used in the production of canned fish and vegetables.

Eggs with the presence of organochlorine pesticides are used in the confectionery industry.

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

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

Pathogenic microbes produce two types of toxins: exotoxins and endotoxins.
Exotoxins easily isolated from microbial cells environment. They strike 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 the specificity of affairs in the body cause common features poisoning.

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

Bacterial toxicoinfections - diseases caused by microorganisms such as Proteus, Escherichia, Clostridia, Enterococci, etc.
Bacterial intoxication - botulism, staphylococcal poisoning).
Mycotoxicosis - ergotism, fusariotoxicosis, aflotoxicosis.

Bacterial toxic infections- diseases in the pathogenesis of which live pathogens and toxins produced by them are involved. They are characterized by a sudden onset, rapid development, intoxication, disruption of the gastrointestinal tract. They are transmitted only in an alimentary way. Food is contaminated pathogenic microorganisms during their preparation, storage or sale. Possible endogenous contamination of meat during slaughter and cutting carcasses of sick animals. Food poisoning always associated with the consumption of either contaminated products that have not been exposed to sufficient heat treatment, or ready meals infected after preparation during storage outside the refrigerator or provided for consumption without reheating.

Bacterial intoxications are diseases resulting from the consumption of food containing toxins, as a result of the development specific pathogen. Unlike toxicoinfections, in the case of bacterial intoxication, a toxin secreted by microorganisms during their reproduction in the product enters the human body along with food products. At the same time, live microbes in the product may no longer be present or they may be contained in a small amount.

An illustrative example of bacterial intoxication is botulism - poisoning with a toxin of bacteria. Clostridium botulinum. Botulinum toxin is regarded as 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, the waste products of some microscopic (mold) fungi, into the body along with food products.

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

Mycotoxins are resistant to physical and chemical factors. The generally accepted methods of technological and culinary processing only partially reduce their content in food products. Heat, drying, freezing, exposure to radioactive and ultraviolet rays ineffective.

Symptoms of food poisoning

Most food poisonings are similar symptoms: pain in the abdomen, nausea, vomiting, fever, diarrhea, loss of coordination.

Escherichia have a short incubation period that lasts from 2 hours to 1 day. The disease begins suddenly and manifests itself in the form of a moderately pronounced intoxication syndrome (chills, general weakness, headache, muscle pain) in combination with symptoms of lesions of the gastrointestinal tract (sharp 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 Proteus have an incubation period of 4 to 24 hours after eating contaminated food. Severe cases are rare. Main Clinical signs- sharp pain in the abdomen, nausea, vomiting, fever, general weakness, disorders of the gastrointestinal tract. The illness lasts 2-3, in some cases up to 5 days. In severe cases, cyanosis, convulsions, weakening of cardiac activity are observed, mortality is observed in 1.5-1.6% of cases.

Streptococcal toxic infections appear 8-12 hours after ingestion of contaminated foods. The clinical picture is typical for toxicoinfections. Recovery occurs in 1-2 days.

Botulism is one of the most dangerous food poisoning. The incubation period of botulism lasts from 2 hours to 10 days, most often 18-24 hours, depending on the amount of toxin that has entered the body. The disease develops suddenly. The first clinical signs: visual disturbances (feeling of fog, grids, doubling, flies before the eyes), reading complications, headache, unsteady gait. Later appear the following signs: loss of voice, paralysis of the eyelids, involuntary movements eyeballs, voltage chewing muscles, paralysis soft palate, swallowing disorders and a feeling of lack of air. The temperature stays within physiological norm or drops to 35.5°C. In the absence of timely treatment, mortality reaches 70% - death occurs in 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 there is salivation, then nausea, vomiting, diarrhea. Body temperature may be subfebrile 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, convulsions, sweating, and general weakness. The degree of manifestation of these symptoms is determined mainly by the amount of toxin that has entered the body and the sensitivity of the patient. Recovery often occurs within a day, but may take several days. Deaths from staph food poisoning are extremely rare.

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

Septic angina- a disease resulting from the consumption of food products from grain that has wintered under the snow and contains toxins from the fungus Fusarium sporotrichiella. Poisoning develops within 1-4 weeks in severe form and often ends fatally. The course can be acute and end in death within a day.

Conventionally, there are three stages of the course of the disease. The first begins a few hours after eating contaminated food. It is accompanied by irritation of the mucous membrane of the oral cavity, thin whitish films are formed on it, which are easily removed. Weakness, nausea, a runny nose are felt. If the poisonous product is excluded from the diet, the disease disappears 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, 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 extends to the oral mucosa, bleeding occurs from the nose, pharynx, ears, uterus and intestines. Body temperature rises to 39-40°C. Mortality at 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 slaughtering animals, catching and processing fish, and the production of sausages;
control over the manufacture of confectionery and bakery products;
control over the production, storage and sale of ready-made meals in canteens, food units of children's institutions, buffets and catering establishments;
maximum automation and mechanization production processes at food enterprises;
ensuring production with serviceable refrigeration equipment;
use of laboratory methods of quality control food products and heat treatment;
observance of sanitary and hygienic rules and conditions of production, storage and transportation of products;
effective implementation of planned deratization activities;
bacteriological control of food products, compliance with the sanitary and hygienic regime and personal hygiene by personnel;
compliance with storage conditions and terms of sale of food products.