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Page Title:
Table 1-10. Guidelines for confirmation of foodborne-disease outbreaks (Cont) |
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|  MANUAL OF NAVAL PREVENTIVE MEDICINE
Etiologic agent
Incubation
Clinical syndrome
Confirmation
period
4. Mushroom toxins
Clinical syndrome among
<2 hrs
a. Shorter-acting
Usually vomiting and
persons who have eaten
toxins:
diarrhea, other
mushroom identified as toxic
symptoms differ with
type
toxin:
OR
Confusion, visual
Muscimol
Demonstration of toxin in
disturbance
epidemiologically implicated
Salivation,
Muscarine
mushroom or mushroom-
diaphoresis
containing food
Hallucinations
Psilocybin
Disulfiram-like
Coprinus artre-
reaction
mentaria
Confusion, visual
Ibotenic acid
disturbance
b. Longer-acting
6-24 hrs
Diarrhea and abdominal
Clinical syndrome among
toxin (e.g.,
cramps for 24 hrs
persons who have eaten
followed by hepatic
mushroom identified as toxic
Amanita spp.)
and renal failure
type
OR
Demonstration of toxin in
epidemiologically implicated
mushroom or mushroom-
containing food
Parasitic
2-28 days,
Diarrhea, nausea,
Demonstration of organism or
1. Cryptosporidium
median: 7
vomiting, fever
antigen in stool or in small-
parvum
days
bowel biopsy of two or more
ill persons
OR
Demonstration of organism in
epidemiologically implicated
food
1-11 days,
Fatigue, protracted
Demonstration of organism in
2. Cyclospora
median: 7
diarrhea, often
stool of two or more ill
cayetanensus
days
relapsing
persons
3-25 days,
Diarrhea, gas, cramps,
Two or more ill persons and
3. Giardia lamblia
median: 7
nausea, fatigue
detection of antigen in
days
stool; or demonstration of
organism in stool, duodenal
contents, or small-bowel
biopsy specimen
1-2 days
Fever, myalgia,
Two or more ill persons and
4. Trichinella spp.
for
periorbital edema,
positive serologic test or
intestinal
high eosinophil count
demonstration of larvae in
phase; 2-4
muscle biopsy
wks for
OR
systemic
Demonstration of larvae in
phase
epidemiologically implicated
meat
140
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