Food Poisoning, Again.

[Forethat]

Most of the time when you sick like that the cause is are noroviruses that give you a gastroenteritis and it's cause by a virus not a bacteria so if you take antibiotic for that you are destroying the good bacteria that will help get you healthy again.

I'm sorry, but you are wrong. Bacteria is by far the most common cause of food borne illness in Thailand. Read my previous posts.

What IS true, is that Noroviruses are the most common cause of all confirmed cases of VIRAL gastroenteritis. However, studies shows that Noroviruses predominantly transmit from person to person, NOT FOOD.

If I provide the source will you stop making things up like the other two "donthaveafreakingclues"?

http://www.chp.gov.hk/files/pdf/StrategiesforNoroviuspreventioncontrol.pdf

If you're going to google, why cant you do it right? It cant be that hard, can it...?

Edited October 24, 2010 by Forethat

[Forethat]

To answer OPs original question, there are a couple of things you can do to minimize the risk.

1. My most important advice is to ignore any type of information from incompetent sources (that’d be Warpspeed and rick75 and maybe a few others).

2. It is imperative that you understand WHY you end up on the shitter every now and then in Thailand. The reason is BACTERIA. Until you’ve established that important fact we can look at how to prevent from being affected by this.

3. The main route of transmission for bacteria in Thailand is FOOD and WATER.

4. Don’t drink water that hasn’t been boiled (or drink bottled water)

5. Avoid the “from farm to table” syndrome, don’t eat vegetable, salad etc. unless you KNOW it’s been cleaned (not easy, trust me on that one…)

6. Make sure the kitchen is clean (have you ever seen a Thai street food stall...?)

7. Make sure the food is properly cooked and thoroughly heated, especially chicken (probably the main reason you can get away with eating street food without getting diarrhea every time).

8. Hygiene. I’m sorry bit this one is just not working out in Thailand. I have NEVER been in a place where so many adult men go to the toilet and return without washing their hands. It’s appalling and disgusting at the same time.

If none of this helps and you end up on the shitter, my advice is as follows:

1. Did you get the diarrhea 4-6 hours after consuming food (lets say you eat at 8pm and get a diarrhea at midnight)

If the answer to this question is YES, and you have no fever, you're not vomiting, your body is not aching and you have no joint pain while at the same time your only problem is that you’re sitting on the shitter spraying like a madman, I’d say it’s a 99.,99% chance that you suffer from acute diarrhea caused by a bacterial infection. My advice in this case, is to start an antibiotic treatment as soon as possible, it is available prescription-free in pharmacies in Thailand for the very reason I’ve been arguing for a while; bacterial gastroenteritis is one of the biggest health issues in Thailand.

If you don’t go for the antibiotics, do the normal rehydration therapy and hope for the best.

[rick75]

Forethat at no time do I say that viruses casuse food poisoning in the majority or minority of cases, what I say is that the over prescription of antibiotics when not needed is a negative thing,

Below I have quoted what I said and I will say it again, you are not qualified to give the advice that people should take antibiotics for treatment of food poisoning, you can not be sure what is causing the problem.

You can not accept you are wrong to give medical advice and make personal insults to people.

I can't believe the crap that goes on here.

"On treatment, ride the horse for a day, dry toast, plenty of fluids and let it pass through your system, the over prescription of antibiotics when not needed is what will kill us all in then end, it just gives the viruses the opportuinty to develop resistance, save antibiotics until you are on deaths door and really need them, do yourself and the worlds population a favour."

[rick75]

Forethat I still see you don't undersatnd what I am saying, which is the over supply of antibiotics is a negative thing.

Edited October 24, 2010 by rick75

[Forethat]

Forethat I still see you don't undersatnd what I am saying, which is the over supply of antibiotics is a negative thing.

Sure I do. What is there to say about this? I'm not arguing this, but I never expected this to become a moral issue, I thought the OP wanted tips and tricks for how to prevent and treat. From a scientific viewpoint I could probably argue that the main reason for this phonomenon is the widespread use within veterinary medicine (you can google that too, check up the meat industry...), but as I said, I dont think this is the right forum or topic.

[Forethat]

Forethat at no time do I say that viruses casuse food poisoning in the majority or minority of cases, what I say is that the over prescription of antibiotics when not needed is a negative thing,

Below I have quoted what I said and I will say it again, you are not qualified to give the advice that people should take antibiotics for treatment of food poisoning, you can not be sure what is causing the problem.

You can not accept you are wrong to give medical advice and make personal insults to people.

First of all, you know nothing regarding my medical education. Secondly, I am fully qualified to give people advice on these issues, thank you.

Thirdly, I guess you forgot about this one, or you're simply so self absorbant you cant see it...? (with regards to claims that you're bing insulted)

this a serious problem that is only perpetuated by silly people that encourage others to take antibiotics when they are not needed

So far, I haven't seen anyone calling you silly for giving people advices that in Thailand could lead (and statisticly DOES) to severe health problems. Edited October 24, 2010 by Forethat

[rick75]

So you understand this yet still encourage people to take antibiotics at the onset.

You say the people who have come on here and advise against antibiotics unless actually needed, are silly, know nothing and to ignore there advice, yet listen to yours.

I have a couple of quotes for you

The first rule of antibiotics is try not to use them, and the second rule is try not to use too many of them.^[53]—Paul L. Marino, The ICU Book

"Inappropriate antibiotic treatment and overuse of antibiotics have been a contributing factor to the emergence of resistant bacteria. The problem is further exacerbated by self-prescribing of antibiotics by individuals without the guidelines of a qualified clinician"

[rick75]

I stand by that, your encouragement to take antibiotics where they may not be needed or may offer no real benefit is silly and irresponsible.

[Forethat]

So you understand this yet still encourage people to take antibiotics at the onset.

OP asked for tips and tricks how to prevent and treat diarrhea. If he wants to know how to prevent a methicillin resistant staphylococci I am qualified to give him that advice as well.

You say the people who have come on here and advise against antibiotics unless actually needed, are silly, know nothing and to ignore their advice, yet listen to yours.

Absolutely rubbish. I have never said anything like that (another chapter in the "rick75 makes up things" book). If you read my posts you'll find that I've said that if you seek medical advice you're likely to be advised an ORT (that's an Oral Rehydration Therapy, in case your google is not working). Look him up in person he is likely to ask you the questions I previously listed and then prescribe antibiotics.

What I DO say is that food borne illness in Thailand is NOT caused by viruses. These have been a major public health problem in Thailand for many years. I have also said that if you want to advice people to drink, not drink, (I even mentioned shoving a vacuum cleaner up their arse) you can do that too. MY advice was the antibiotics, and please spare me the <deleted> regarding the anti-resistance, I'm confident a majority here are grown up people capable of making that decision themselves without getting some moral absolutist beliefs pushed down my throat (there's a perfectly reason for vomiting right there...).

Antibiotics are prescription free in Thailand. By law you have the right to decide when to buy and use them.

Edited October 24, 2010 by Forethat

[Forethat]

I stand by that, your encouragement to take antibiotics where they may not be needed or may offer no real benefit is silly and irresponsible.

Statistically, they ARE needed. You're free to call it irresponsible, I call it I'm excercising my lawful right.

Might I also remind you that the OP asked for advice how to prevent and treat a case of food poisoning, I did exactly that.

Edited October 24, 2010 by Forethat

[Thaddeus]

Let me share a very recent personal episode.

Went to bed last Friday reasonably early and feeling fine. Around 4am broke the land-speed record for bed to toilet bowl dash and vomited quite violently, no bottom squirts. Went back to bed and didn't feel like vomiting again, but didn't sleep very well.

Saturday morning felt a bit queasy but no desire to up chuck again, so drank a cup of coffee on the balcony, no problem, so had another one about an hour later, then I didn't even make it out of the chair and the clean-up crew had to be sent for.

Ok I thought, wait a while and just try some water, nope the water didn't stay down either. I asked my best Thai friend if he would go to the pharmacy for me and get me some electrolyte drink powder and something to settle my stomach. The powder he managed, so tried some of that, it lasted about five minutes and it also went the way of the bucket. Oh dear, Houston we have a problem.

Some TV members will know that I had a problem with severe dehydration several months ago, it is not something I wanted to happen again, having no recollection of what has been happening for four or five days and waking up with tubes all over the place and machines making all sorts of beeping noises is not an experience I care to repeat, and the road to recovery is long and slow.

But as my friend suggested, I needed to be on a drip, I expressed an unwillingness to go to the local slaughter house and he said "no, ploblem" about an hour later a nurse turns up at the house with a stand, bags of liquid and meds. She plumbed me in and gave me an injection of some red stuff that she said would settle my stomach, had quite a peaceful night, occasionally sipped water just to wet my mouth and lips, but spat it out before swallowing.

The nurse stayed the night on a z-bed, checking up on me and changing the bag as needed.

Yesterday morning felt heaps better, a little bit of back pain which I put down to muscles tensing up and retching quite a bit (I really hope it's nothing to do with kidneys) a few stomach cramps, could just be hunger could be something else. I tried an electrolyte drink, it stayed down, so I had another, no problem, so later on in the day I got adventurous and had a bowl of cornflakes, again no problem.... then I just stuck to water, I know those electrolyte things shouldn't be overused.

Watched Liverpool win, a mental vast improvement, and went to bed.

This morning I feel fine, no back pain, an empty stomach, but I will fix that in a minute, slowly.

[Forethat]

Your symptoms all points towards a case of stomach flu (referred to as gastroenteritis if the patient is vomiting), though it could of course have been a bacterial infection. What type of drug did she distribute? Another difficult issue is that you may drink electrolytes but the potassium and sodium which are the most important substances in this drink, will all be lost next time you vomit.

Another important fact that you're pointing out is the duration of the illness; it is likely to last only a day or two when being caused by a virus, but several days when a bacterial agent is involved, therefore increasing the risk for severe dehydration. Most patients who doesn't treat with antibiotics enter a phase where the overall health condition is described as satisfactory, but with liquid stools (I've heard people say "I'm peeing from the ass"). Almost every patient in this stage suffers from different levels of dehydration, in some cases severe. It is not uncommon to experience a weight loss of 10% or more.

I have been trying to figure out why there are people who believe that viral infections are more common than bacterial ones. The only explanation I can come up with is that they "have heard this" or "think this is the case". It can also be that they simply make things up because they want something to say. And it can be that they have googled a little and ended up with a paper which describes this relationship in a European country or why not the USA, where the stats are completely different. In Thailand, and most other countries in SEA, bacterial infections are by far the most common.

[samran]

So you understand this yet still encourage people to take antibiotics at the onset.

You say the people who have come on here and advise against antibiotics unless actually needed, are silly, know nothing and to ignore there advice, yet listen to yours.

I have a couple of quotes for you

The first rule of antibiotics is try not to use them, and the second rule is try not to use too many of them.^[53]—Paul L. Marino, The ICU Book

"Inappropriate antibiotic treatment and overuse of antibiotics have been a contributing factor to the emergence of resistant bacteria. The problem is further exacerbated by self-prescribing of antibiotics by individuals without the guidelines of a qualified clinician"

Been there done that - many times.

Case study one: After 2 days of feeling like I'd spent 10 rounds with Mike Tyson - fever and chills on night three, so bad that I was wearing a polar fleece to bed, under blankets and with the aircon OFF.

Result: Trip to the doctor and a load of antibiotics which fixed the problem.

Case study 2: No no no, no antiboiotics for me (again). No fever this time, but tree days later after feeling very light headed, a massively dehydrated Samran was checked in as a day patient at Samitivej. IV fluids and antibiotics, and 17,000 baht later, was sent home.

[Thaddeus]

Your symptoms all points towards a case of stomach flu (referred to as gastroenteritis if the patient is vomiting), though it could of course have been a bacterial infection. What type of drug did she distribute? Another difficult issue is that you may drink electrolytes but the potassium and sodium which are the most important substances in this drink, will all be lost next time you vomit.

Well, now you are illustrating my basic gripe (no pun) with Thai medical practices.

Gastroenteritis (also known as gastric flu or stomach flu, although unrelated to influenza) is inflammation of the gastrointestinal tract, involving both the stomach and the small intestine and resulting in acute diarrhea. It can be transferred by contact with contaminated food and water. The inflammation is caused most often by an infection from certain viruses or less often by bacteria, their toxins, parasites, or an adverse reaction to something in the diet or medication. Worldwide, inadequate treatment of gastroenteritis kills 5 to 8 thousand people per year,[1] and is a leading cause of death among infants and children under 5.[2]

At least 50% of cases of gastroenteritis due to foodborne illness are caused by norovirus.[3] Another 20% of cases, and the majority of severe cases in children, are due to rotavirus. Other significant viral agents include adenovirus[4] and astrovirus.

I didn't have any diarrhea let alone acute diarrhea, so it is unlikely to be that, possible but unlikely.

And this is my basic premise. Instead of thinking 'what is the simplest thing it could be and just treat that' they think of everything that it could possibly be and try and treat the lot.

Of course doing that most people will get better as one of the meds used will have worked, but the medical practitioner has not learned anything and the patient may now have problems that could occur years later that are very difficult to fix because of an over subscription of some drugs.

I have to compliment the nurse I had over the weekend as she actually listened to me (very non-Thai in my experience, this was probably because it was just me and her in the room and she didn't have a know-it-all in a white coat watching her every move) I explained to her that around 15 years ago I had very severe food poisoning, one of the biggies, and since then I have had a very delicate stomach .... so let's just get me on a drip feed, give me some meds that will stop me projectile vomiting and take it from there. If the situation didn't improve we could then move on to stage two.

If she had had a know-it-all in a white coat, I would have just hidden all the meds subscribed by him until if and when stage two was required.

I cringe when I see people coming away from the local hospital with a bag of medication as big as a space-hopper, and all smiles. They have no idea how much damage they may be doing to their health that may only appear years down the line ..... especially when it comes to broad screen antibiotics.

[tartempion]

Curious, you said she went home and cooked it? In that case highly unlikely it was the fish that got her sick, if it was cooked thoroughly neither bacteria nor viruses can withstand that amount of heat, it must have been something she had along with it? Rice that had been sitting for some time maybe? But highly unlikely it was the fish unless it may have been tainted with a chemical instead possibly?

Will have to wait to this friday when I get home, I take food poisonning very seriously, I want to know all the details, finding it that bad to get transportation to a hospital in the middle of the night is not to be taken lightly.

Cooked rice is always kept in the fridge and re-heathen in the rice cooker, we do so over 10 years now, I will find out what else she has eaten with the fish and how she prepared the food.

Incidentally I went to a Thai restaurant In France this Saturday night and had Kung Phao and something like Chu Chi pla salmon.

I don't think you find much salmon on the menu in Bangkok or elsewhere, found it original.

Sunday morning bypassed my sacred butter croissants and not feeling very well nor hungry at lunch time, very unusual.

Later in the afternoon felt bad in lower regions. Thought about it and can only relate to the food of the Thai restaurant

I have always Motilum at hand but did not take any.

Had dinner appetite almost back to normal.

Edited October 25, 2010 by tartempion

[tartempion]

1. Did you get the diarrhea 4-6 hours after consuming food (lets say you eat at 8pm and get a diarrhea at midnight)

bacterial gastroenteritis is one of the biggest health issues in Thailand.

If you don't go for the antibiotics, do the normal rehydration therapy and hope for the best.

What about running to the loo 15 minutes after eating?

Happened several times after salad bar at Udon Thani's Sizllers and nearby Central Charoensri hotel buffet.

Take 2 pills like Ercefuril replacement (can't get Ercefuril anymore in France, don't have the replacement med name with me here)

Next day I am OK.

Guess it's still gastroenteritis?

I don't do these buffets anymore.

[Forethat]

Gastroenteritis (also known as gastric flu or stomach flu, although unrelated to influenza) is inflammation of the gastrointestinal tract, involving both the stomach and the small intestine and resulting in acute diarrhea. It can be transferred by contact with contaminated food and water. The inflammation is caused most often by an infection from certain viruses or less often by bacteria, their toxins, parasites, or an adverse reaction to something in the diet or medication. Worldwide, inadequate treatment of gastroenteritis kills 5 to 8 thousand people per year,[1] and is a leading cause of death among infants and children under 5.[2]

At least 50% of cases of gastroenteritis due to foodborne illness are caused by norovirus.[3] Another 20% of cases, and the majority of severe cases in children, are due to rotavirus. Other significant viral agents include adenovirus[4] and astrovirus.

Please note that you're referring to an article which describes gastroenteritis, by definition a viral infection, out of which 50% are caused by Noroviruses. I'm not sure you understand the difference, so I'm pointing that out. Out of the food borne illnesses in Thailand, bacterial infections are in huge majority.

I didn't have any diarrhea let alone acute diarrhea, so it is unlikely to be that, possible but unlikely.

Which is exactly why I wouldn't have suspected a bacterial infection - I pointed this out.

I cringe when I see people coming away from the local hospital with a bag of medication as big as a space-hopper, and all smiles. They have no idea how much damage they may be doing to their health that may only appear years down the line ..... especially when it comes to broad screen antibiotics.

You should stop doing that. The most obvious reason is that the drug was prescribed by an educated professional with intent to treat, and in an overpowering majority of cases the treatment works as intended.

As I said, if you want to be morally correct and stay away from medical treatment, be my guest, but for crying out loud; stop pestering people with your moral issues or otherwise utterly rubbish comments like staying away from existing medical treatment. That comment is on the list of the most bizarre comments I've ever read on TV.

You recieved medical treament, didn't you? I ask you again, which drug was distributed?

[Thaddeus]

I ask you again, which drug was distributed?

I've already told you.

Can I ask a couple of questions myself please.

1. Which area of medicine do you specialise in?

2. How many medical institutions have you visited in rural Isaan?

Honest answers are required before I will be bothered reading any more of your pontificating.

[Forethat]

I don't do these buffets anymore.

And if you're concerned with your health you probably shouldn't. I've read a paper some while ago touching on this topic and the amount of bacteria found in a Bangkok buffet was astonishing.

[Forethat]

I ask you again, which drug was distributed?

I've already told you.

You mean "some red stuff"...? lol

She plumbed me in and gave me an injection of some red stuff that she said would settle my stomach

Can I ask a couple of questions myself please.

1. Which area of medicine do you specialise in?

2. How many medical institutions have you visited in rural Isaan?

Honest answers are required before I will be bothered reading any more of your pontificating.

1. rheumatoid arthritis. I also have a degree in microbiology. I dont practice medicine though, I work with regulatory compliance in the research and manufacturing area.

2. Quite a few, I'm afraid. I also represent a medical organisation in Thailand who distributes medical equipment and drugs, predominantly in Isaan on charity basis. Our next trip is 7am tomorrow morning, we're distributing 800 kg of medical equipment and drugs to Korat. If you want to help I can use a hand. I can pick you up if you want to, or perhaps you're not "bothered'?

Now when I've answered honestly, can you please tell me which drug was distributed?

Edited October 25, 2010 by Forethat

[Thaddeus]

Distributed, don't know, administered I don't know either, I was face down while being injected and didn't see the label, it worked anyway.

You appear to be stuck on the word distributed.

As I suspected, you work for a legalised drug pusher who has a vested interest in making the institutions take as many of your products as possible. And you appear to have a special on antibiotics this month.

[bermondburi]

My worst case ever which lasted for four days came from a dodgy fry up from a shitty B+B in Hounslow where I was staying at the time. Absolute nightmare. I couldn't eat anything without projectile vomiting it right up again. Never want to be that sick again.

In Thailand the best thing I have come across is this Chinese medicine called fishing balls ( look dok blah ). Any pharmacy will have it and it only costs twenty baht or so for a small bottle. There are these strange smelling black balls inside and a few of them every few hours is like a plug in the hole. I've never had to take them for more than eight hours. They work brilliantly.

[bermondburi]

My worst case ever which lasted for four days came from a dodgy fry up from a shitty B+B in Hounslow where I was staying at the time. Absolute nightmare. I couldn't eat anything without projectile vomiting it right up again. Never want to be that sick again.

In Thailand the best thing I have come across is this Chinese medicine called fishing balls ( look dok blah ). Any pharmacy will have it and it only costs twenty baht or so for a small bottle. There are these strange smelling black balls inside and a few of them every few hours is like a plug in the hole. I've never had to take them for more than eight hours. They work brilliantly.

Forgot to mention that I've given it to my kids before with one or two balls and it works fine for them too. Stops them shitting for a long time and then booom.

[cdnvic]

Removed some pointless bickering that added nothing to the topic.

[Forethat]

Removed some pointless bickering that added nothing to the topic.

Let me just get this straight, I'm posting and referr only to what has been posted by previous posters; you remove that. But you're allowing the real deal, made up accusations and falsified material that may even qualify for legal retributions?

Edited October 25, 2010 by Forethat

[WarpSpeed]

Forethat I still see you don't undersatnd what I am saying, which is the over supply of antibiotics is a negative thing.

^ From my point of view it's too bad he allowed any of your rubbish posts to stand especially the personally offensive, demeaning and provocative ones which is frankly.......All of them.....

Give it up Rick, I think the point has been made very clearly and some people are just as thick, self involved and self centered as pig poo so they'll never get it, in the end you're just waisting good band width on this individual lost cause..

I'm certain the more intelligent and well informed members will differentiate between the facts we've presented and the fiction that has been spewed forth like the proverbial upchuck the OP is about..

Another poster mentioned washing hands continually, another spot on piece of advice we follow through with continually ...

Edited October 25, 2010 by WarpSpeed

[Forethat]

I'm certain the more intelligent and well informed members will differentiate between the facts we've presented and the fiction that has been spewed forth like the proverbial upchuck we are speaking about..

Yup, especially the incorrect statements you've posted reagrding common cause of food borne illnesses. To be honest I'm surprised you even post again, I cant see how you havent realised that you are dead wrong.

Viruses are NOT the most common cause of food borne illness in Thailand. You'll never admit that you made that up, will you?

lol

[Forethat]

I'm certain the more intelligent and well informed members will differentiate between the facts we've presented

Facts?? You've presented facts?? Were????

If you want to I can referr to the fact Ive presented in this thread.

Have you contributed with FACTS? I'm speachless. Where? I have missed that completely.

Edited October 25, 2010 by Forethat

[Thaddeus]

Boys, Rick, Warp, give it up, it isn't worth it.

Getting back to the OP, there is only one sure fire way of avoiding food poisoning..... don't eat.

For most people that is not an option.

But if you do fall sick, don't automatically blame the food, my last bout was probably not food related. FT, bless, is correct when he says that most food illnesses are bacterial, but not all illnesses are caused by food, and I would just love someone to dig up some figures on how many cases of illness (not causes of illness) are bacterial and how many are viral.

Anyway, still stand by the point that most Doctors, not only Thai, are eager to prescribe antibiotics when the problem may not be bacterial.... and that is very bad.

[WarpSpeed]

Just picked up on this topic. Got my mrs to throw away the wooden block chopping boards, and if we go out have a loooong pee before we go cos the WC's are a mine field of bacteria. It's been a hard struggle to teach my family about bugs that kill and cannot be seen, but l am getting there.

Yep watch those cutting boards, not just wood either, but really no need to throw them out, just bleach them once a week. Put a little bleach on them and spread it around with an old tooth brush, let it soak for a few minutes no need to brush at that point you'll just get bleach splatters all over the place anyway and might ruin good clothes. Rinse and then scrub off with a brush (preferably) or stainless scrubby and all is new..

And whenever I see my food being placed on one it must be very hot or I need to take it home and reheat it..

Edited October 25, 2010 by WarpSpeed