Dear doctor,

Last week I went for an evening out with my female friends at a popular hotel. We enjoyed different dishes including pork and fish. However, after a few hours, all of us suffered from diarrhea and vomiting, among other things, which we were told was food poisoning. Does it mean someone had poisoned the food? What is the immediate remedy for food poisoning?Grace Abatoni,  Kanombe

---------------------------------------Dear Grace,I am sorry that your evening out was followed by sickness as a sequel. But what you all suffered was illness which occurs due to food or water being contaminated with microbes causing infection in the stomach and or intestines. This is popularly known as food poisoning, the poison being the germs present in numbers sufficient to cause sickness. When an individual swallows bacteria through contaminated food or drinks, even water, these bacteria enter the digestive system. They cause sickness after a time known as incubation period. The severity of illness produced depends on the amount of microbes ingested and the state of general health of the person. If food poisoning occurs, one suffers from diarrhea, vomiting, cramp like abdominal pain and sometimes fever. There may be one or many of these symptoms. Severe food poisoning can be fatal due to dehydration and electrolyte imbalance produced in the body. Common food poisoning producing microbes are salmonella, campylobacter, escherichia coli (E. coli), clostridium botilinum e.t.c. As such, any food item which is cooked poorly can be a source of food poisoning but common sources are contaminated milk and meat products.  It is always better to prevent food poisoning rather than suffer from it. Any food item should be washed thoroughly before being cooked. Vegetables which are to be eaten raw need to be cleaned with hot water or water which is clean enough for drinking purposes. Persons cooking meals should also maintain good hygiene. Their nails should be trim because germs tend to settle below nails.  They should wash their hands before cooking food.   Ideally, freshly cooked food should be consumed.  If some item has to be consumed later it should be refrigerated immediately because warmth promotes bacterial growth. Washing hands before serving or eating food is a useful measure to prevent food poisoning. One should be very vigilant about drinking water to avoid water borne diseases. The water for drinking purposes has to be boiled or purified through water filters before being used to kill any germs present.While eating out, one should ideally demand freshly prepared hot food. In a place where quality of food hygiene is in doubt, hot deep fried items and steaming hot drinks like tea or coffee is preferable as high temperatures kill most of the germs.In case when one has symptoms of food poisoning at home, they can immediately be given oral dehydration solutions if available. If not, one liter of clean water with a small quantity of sugar and a pinch of salt can be given. Bananas also help in reducing diarrhea and hence can be given as first aid. But if symptoms are severe it is better to take the person to the nearest health center for rehydration.Dr. Rachna PandeSpecialist-Internal medicine Ruhengeri Hospital