Archive for the 'Medicine' Category

Salmonella, nella, nella…

Remember this? Once again it has come to bother us.

Teen died after Hari Raya food poisoning that hit 13 guests

The Salmonella genus of bacteria is a common cause of food poisoning. The genus also includes Salmonella typhi, which causes Typhoid Fever. It commonly occurs in places with poor sanitation and water supply. In this incident, the culprit was Salmonella enteritidis. It is commonly found in undercooked poultry and unpasteurized milk, undercooked eggs and by contact with rodents and reptiles.

The disease in this case is most probably Salmonellosis. Symptoms include diarrhea, cramps, vomiting and fever. All the victims affected suffered diarrhea and vomiting. Salmonella works by invading the small intestines. The inflammation resulting from the damaged intestinal cells causes water and electrolytes to be lost from the gut, thus causing diarrhea.

Normally this illness is not lethal, if medical attention is sought quickly. The cause of death in the teenager was blood poisoning from Salmonella enteritidis. How did this happen? As mentioned, this is an invasive pathogen. It has the capability to spread to other parts of the body via the bloodstream. Salmonellae, like other gram negative organisms, have a Lipopolysaccharide (LPS) moiety on the cell membrane. This LPS is called an endotoxin, because it is built into the structure of the bacteria and only released when the membrane is disrupted or lysed. Thus when the body’s immune reaction destroys these pathogens, endotoxins are released. They can cause fever, inflammation and shock, and the poor boy’s death as a consequence.

The treatment for this, and most diarrheal illnesses in general, is to rehydrate. Drink lots of water, because you need to replenish the loss of fluids. There is also a need to replenish loss of salts. Drinking the rice water from porridge is a good agent for this. You can take sports drinks, but don’t give them to young kids because the glucose to sodium ratio is not ideal. Get plenty of rest as possible. Other than that, there is little you can do other that to go to the toilet more often than usual.

If you have prolonged diarrhea, it is never a good idea to delay treatment. Go see a doctor! You don’t want to wait till you end up on a gurney in the A&E department, where you will stuck with needles to replenish your lost fluids. IV, is not very pleasant.

We are quite fortunate to have pasteurized milk in Singapore, so my guess is that the poultry was not well cooked or the eggs were contaminated. Prevention is very simple.

1) Make sure the eggs you buy are not cracked.
2) It is always a good idea to clean the exterior of the eggs.
3) Cook the eggs well.
4) If you have to use raw eggs, make sure they are pasteurized. Or use liquid eggs as a substitute.
5) Cook the meat well. Use a meat thermometer if you have to.
6) Keep your kitchen and equipment clean and sanitized.
7) Handwashing. Enough said.

Eat and drink, for tomorrow we die. But please, not from Salmonella!

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Accidents and Medical Emergencies and You

There have been several reports in the local newspapers in the past week, documenting several deaths. One was the death of a 23 year old young man who had cardio-respiratory failure. There was another report of a Malaysian woman choking to death on a biscuit. And who can forget the horrific accident that wiped out four members of a Catholic family, leaving only their 2 month old daughter?

There could have been more ways to help the casualties. For example, if CPR was administered to the young man before the ambulance crew arrived, he might have survived. In the case of the lady, they managed to fish out the debris from the mouth, but the article did not mention if the airway was totally cleared or if artificial ventilation was provided.

Unfortunately, accidents and emergencies occur everyday. What is our response to these? Let’s say one day you are walking along the street, when a man collapses in front of you? What will you do? Some will help, some will not. Some want to help, but are incapable. Some are able to, but do not want to. For most of us it’s not our problem, until one day it hits home. By then it will be too late to regret the loss of our loved ones.

I read another article which is quite heartening (pun intended), there is a First Aid Corps being set up in Marine Parade GRC. The three volunteers are trained in the use of the Automatic External Defibrillator. Some Community Development Councils also conduct CPR courses for residents. I think Mum went for one of those a few months back. I think these are good steps for making people more prepared for emergencies. We should all take some time off to learn some simple first aid, CPR if possible. If we are more prepared, we won’t panic so much when disaster strikes.

By some coincidence, a few days ago we had lessons and tests on CPR, Choking and AED. That means we are trained to assist in such emergencies. I hope my fellow medics and I will have the courage to help in such incidents when we are outside. And we hope like hell that none of us will screw up the rescue! It is clear that there are two requirements in such a situation: Competence and Courage. We must possess the necessary skills to help out, in order to prevent further harm to the patient. We must also have the daring, to help without any hesitation.

But let us not forget about spiritual matters. Death is so untimely and unpredictable. Let us prepare our souls for its arrival.

May the Holy Angels preserve us!

Ala peanut butter Salmonella!!

Salmonella outbreak linked to 2 peanut butter brands

For those of you who enjoy peanut butter, better be careful!

According to the CDC,

The affected jars of Peter Pan and Great Value peanut butter have a product code located on the lid of the jar that begins with the number “2111.”

Incidentally Grandpa bought a can of peanut butter with 2111 on it. We dumped it immediately.

Ala peanut butter Salmonella! Looks like the HACCP guys were slacking off!

Salmonella on XLD agar

Salmonella spp. on XLD agar, courtesy of Todar’s Online Textbook of Bacteriology

Don’t mess with Salmonella, it is a very nasty pathogen!

Let the eater beware!!


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