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This is caused by the consumption of food containing a heat stable enterotoxin which is found in 40% of strains. The enterotoxin stimulates gut receptors which signal the vomiting centre via the vagus nerve. It accounts for 2-5% of all bacterial food poisoning.
Sources include food handlers, cooked meat, unpasteurised milk, cream cakes and fruit salads.
Clinical features include nausea and vomiting, abdominal pain, and dehydration, with or without diarrhoea after a 2 to 6 hour incubation period. Recovery is after six to 24 hours.
The organism may be cultured from vomit, faeces or food.
Fluid and electrolyte balance must be maintained, perhaps with symptomatic treatment of any diarrhoea.
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