9.5 General management of foodborne diseases
The management approach to patients with foodborne diseases depends on the identification of the specific causative agent, whether microbial, chemical or other. There are many different kinds of foodborne diseases and they may require different treatments, depending on the symptoms they cause. Many episodes of acute diarrhoeal disease are self-limiting and require only fluid replacement and supportive care. If an antibiotic is required, the choice should be based on the clinical symptoms and signs.
You should refer all patients with acute diarrhoea that are not responding to rehydration and supportive care.
Patients with severe diarrhoea and vomiting may need oral rehydration salts (ORS) and antibiotics. In the most severe cases, for example in a cholera epidemic, intravenous fluids containing glucose and normal saline may have to be given to support rehydration. If the disease is due to food poisoning, there may be a need to give an antitoxin, or other antidote to neutralise the effect of the toxin, if such medicines exist or can be accessed in time. These more specialised interventions can only be done at a health facility. However, the limitations of health facilities in rural areas may restrict the choice of the specific management approach.
As a Health Extension Practitioner, you should educate the members of your community on how to recognise the symptoms of foodborne diseases, and to seek advice and supportive treatment from you. If there is a large number of cases, you should document them and report them as soon as possible to the District Health Office.