UNIT 14 FOOD INFECTIONS AND INTOXICATIONS

Structure 14.1 Introduction 14.2 Food Infections and Intoxications 14.3 Food of bacterial origin 14.3.1 Salmonella food poisoning 14.3.2 Staphylococcal food poisoning 14.3.3. Botulism 14.3.4 Clostridiwn perfigens food poisoning 14.3.5 Bacillus cereus food poisoning . 14.4 How to prevent/control food infections and intoxications? 14.5 Food poisoning of non-bacterial origin 14.5.1 14.5.2 Aflatoxicosis 14.5.3 14.5.4 Argemone 14.6 Let Us Sum Up 14.7 Glossary 14.8 Answer to Check Your Progress Exercises

14.1 INTRODUCTION

Yo11 would have read in newspapers many instances of food poisoning reported from several places sometimes resulting in many deaths. These instances occur due to food infection or food intoxications due to the contamination of food with certain bacteria or their , inorganic chemicals, of animal origin or poisonous substances derived from plant sources. Food infections and intoxications will cause acute symptoms of either or diarrhoea or both. The characteristic features of this sort of episode will include (a) sudden onset of illness (b) common source of food (c) simultaneous involvements of many persons, and (d) manifestation of same type of complaints by all affected. In this unit, you will learn about food borne diseases which occur due to the consumption of toxic materials in foods (food toxins) and intoxications due to intake of food which contains toxins formed by bacteria. Food infections occurring due to intake of food containing large numbers of microorganisms causing intestinal diseases like salmonella is the second focal point of the unit. i \ Objectives I \ After studying this unit, you will be able lo: list the common food toxins, food infections and intoxications prevalent in our community.

0 identify their causes, symptoms and complications, and desc6be the management, prevention and control of these conditions.

\ 14.2 FOOD INFECTIONS AND INTOXICATIONS

Food infections and food intoxications are the two categories of food poisoning. What do we mean by food poisoning? Food poisoning refers to the harmful effects of consumirp food contaminated by microorganisms (bacteria, viruses, moulds ). You may recall reading about these microorganisms in unit 16, block 4 of course 1. \ Let us now understand how food infection is different from food intoxications? Food Borne Diseases, Food When we consume contaminated food (i.e. microorganisms are already present in the Infeetloas .ad IatoxlcsLloa food), the microorganisms enter the body, begins to grow and produces the disease. This is food infection. Common diseases infections caused as a result of eating contaminated food include dysentery, cholera, typhoid, infectious hepatitis (Viral infection). On the othcr hand, consuming foods which contains toxic substances produced by the microorganism (in the food) leads to food intoxication. Botulism (an illness) is one example of fmd intoxication. The produced by clostridium botulinum (a bacteria) in food, can cause death. Moulds, fungus also produce toxins in foods. fungus causes ergotism. Food poisoning i.e. food infections and intoxications is therefore of two types : a) Bacterial origin, and b) Non-bacterial origin. The following section presents a detail discussion on the two types.

14.3 FOOD POISONING OF BACTERIAL ORIGIN

You have already leamt that food poisoning can occurs due to the contamination of food by living bacteria or by toxins liberated by them. Different bacteria are known to cause the poisoning. Let us now leam what these different bacteria are which can cause food poisoning and how these organisms get into the food. 14.3.1 Salmonella food poisoning Salmonella food poisoning is a very common form of food poisoning. Its increase in incidence in recent years is attributed to increase in communal feeding activities like in marriages and large parties, increased popularity of ready-to-eat foods, especially tinned foods and certain household practices. What is the causative organism? The common organisms (bacterias) belonging to salmonella specie involved in food poisoning are Salmonella typhimurim, Salmonella Cholera-suis and Salmonella- enteritidis. mat is the source of infection? Food gets infected through contaminated meat, milk and milk products, poultry, egg and egg products. Food also can get infected by rats and mice when the food gets contaminated by their urine and faeces. How does the poisoning occur? Contamination of food may occur at the source or by cross-contamination (due to excess of organisms from surroundings or their foods) during processing of food. It can also occur due to contamination by a carrier or fecal contamination by food handler. The conraminant organisms on ingestion multiply in the intestine and give rise to sudden . onset of diarrhoea or vomiting or both. What are the of salmonellosis? The onset of the episode is usually sudden. accompanied by chills, fever, , vomiting and a profuse watery diarrhoea lasting for 2 to 3 days. Death is reported to occur in about one per cent of cases.

Who are susceptible? Generally all are susceptible. Debilitating conditions increase the susceptibility. What is the incubation period? The incubation period varies from 12-24 hours. What is the period of communicability? The period of communicability extends throughout the course of the disease. Undetected c~enare also known. 14.3.2 Staphylococcal food poisoning Food Infections and Intoxlurtlom Staphylococcus is another common form of food poisoning due to bacterial origin. Staphylococcus toxin is the developed by the bacteria when it grows in food.

Whet is the causative organism? Staphylococcus aureus are the causative organisms for staphylococcal fc~$poisoning. When the enterotoxin liberated by these strains contaminates the food items, the toxicity occurs. Optimal temperature for th~formation of the enterotoxin by the bacteria is observed to be between 35 to 37 C. The toxins formed are relatively heat stable and resist boiling upto 30 minutes.

What is the source of infection? Staphylococci are plentiful in nature. They are found on the skin, in the nose and throat of humans and animals. These are the common organisms causing boils and common skin infections. Udder infection by Staphylococci in milch cattle leads to contamination of milk and milk products causing episodes of food poisoning. Cooked ham, or other meat, chopped or ground food, warmed-over food are the other source of infection. \ What is the reservoir of infection? You will find that the most common source of the organism is a food handler who might be suffering from a nose, throat or skin infection (boils, pimples etc.). Another source is milk of a cow with udder infection. If you store food preparations which are thus infected for several hours at room temperature, the bacteria (disease causing organisms) multiply and produce toxins which cause the poisoning.

What is the mode of transmission? Consumption of contaminated food products like pastries, custard, salads, sandwiches, sliced meats and meat products. Contamination occurs from the purulent discharges from infected fingers, infected eyes, abscesses, nasal secretions and apparently normal skin of food handlers coming in contact with food items, where the bacteria multiply when allowed to stand for several hours before serving. These bacteria liberate toxins and cause outbreaks of food poisoning.

How does the poisoning occur? Food poisoning occurs because of the toxins liberated by the organisms growing in the contaminated food. As you have already learnt that the toxin is heat resistant, it can remain in the food and cause harm even after the actual organisms have died. The effect of poisoning is due to the action of toxin on the gut and .

What are the signs and symptoms? The illness in staphylococcus poisoning is sudden and usually manifests by onset of vomiting, abdominal cramps and loose motions. When the disease is severe, blood and mucus may appear in the stools. One does not get fever and can recover in one to three

What is the incubation period? The incubation period in staphylococcal food poisoning is short and is between 1-6

14.3.3 Botulism Botulism is a very serious form of food poisoning but fortunately its occurrence is rare. If it occurs, it can kill upto the extent of two thirds of its victims. What is the causative organism? The organism responsible is Clostridium botulinum and it is the toxin liberated by the organism that causes the food poisoning. 55 Food Borne Diseases, Food What is the source of contamination? lnfectlons and Intoslcatlon The organism that causes poisoning is widely distributed in soil and dust. Toxin produced by Clostridium botulinum is the toxic agent. Toxins are produced in improperly processed foods and umefrigerated foods of low acidity. It is also observed to be present in the intestinal tracts of domestic animals. The organism enters the food as spores. The foods that are commonly affected by botulism poisoning are home preserved foods (pickles, vegetables), home made cheese etc.

What is the incubation period? Incubation period for botulism is reported to be from 12 to 36 hours. How does the poisoning occur? Once spores of the organisms enter the food, under favorable anaerobic conditions they grow and liberate the toxin. The toxin thus liberated acts on the nervous system. The effects of the toxin on the gastrointestinal system are minimal.

What is the mode of transmission? Consumption of contaminated food usually consisting of inadequately processed canned items used as it is, without adequate cooking, is responsible for the msmission of the disease. Incidence of botulism, as a result, of contamination from the infected wounds also is known.

What are the signs and symptoms? The prominent symptoms in botulism include: difficulty in swallowing, blurring of . vision, double vision, closing of the eyelids, painful joints, weakness of the muscles and sometimes even the paralysis of both hands and legs. Subject is conscious and usually there is no fever. The condition is usually fatal and death results in 4 to 8 days due to failure of functioning of respiration or heart or both.

Check Your Progress Exercise 1 1) State whether the following statements are true or false. Correct the false statements. a) Salmonella food poisoning occurs because of contaminated meat, milk, and milk products...... b) Reservoir of infection for staphylacoccal food poisoning are utensils. (TrueFalse) ...... c) Inadequately processed canned items are responsible for staphylococcal food poisoning...... 2) Give the causative agent, mode of transmission and symptom of the following food poisoning.

- Food Causative Mode of Sympton poisoning agent transmissioh

Botulism

Salmonellosis

56 14.3.4 Clostridium perfringens food poisoning Food Ltectlone md htoxlcatiom Food poisoning due to Clostridium perfringens is a mild disease of short duration and rarely it is fatal. In very serious conditions deaths are known to occur.

What is the causative organism? Some swains of clostridium perfringens (also known as Evelenii) are the causative

What is the source of infection? t As in the case of botulism, in this case also, soil and gastrointestinal tracts of man and animals form the reservoir of infection. Meat which has been boiled. steamed or partially roasted, allowed to cool several hours and subsequently either reheated is

L another source of infection.

How does the poisoning occur? It is the spores which cause the poisoning. It is a natural contaminant of meat. The spores are able to survive the cooking. The favourable temperature for the organism to multiply is between 30 C to 50 C.

What are the signs and symptoms? Sudden onset of colicky abdominal pain followed by diarrhoea 8 to 24 hours after consuming contaminated food are the common symptoms. There will be little or no fever. Nausea and vomiting are rare. Illness last usually for a short duration of a day and recovery is rapid. Generally all are susceptible.

What is the incubation period? Incubation pedod is between 6 to 24 hours with a peak from 10 to 14 hours. 14.3.5 Bacillus cereus food poisoning Bacillus cereus food poisoning is a gastrointestinal disorder occurring due to the contamination of food by a bacillus known as Bacillus cereus.

What is the causative organism? The causative organism is Bacillus cereus. It is an aerobic spore bearing, motile rod like bacillus. The organism (spores) can survive cooking procedures. It produces an enterotoxin which is responsible for causing the food poisoning. The toxin liberated is quite stable. What is the source of infection? Bacillus cereus is the source of infection which is found plentiful in the soil and in raw, dried and processed food. How does the poisoning occur? Consumption of contaminated food in conditions favourable for the multiplication of the bacillus leads to the episode of poisoning. What are the signs and symptoms?

cc&c followed by diarrhoea occurs. ~everusu&l~is not associated w;& the disease.

Period of communicability and the nature of susceptibility are not yet known. What is the incubation period? Incubation period extends from 1-24 hours and usually around 6 hours. FOO~Borne Diseases, Food How to differentiate food poisoning from other gastrointestinal diseases? Infections and Intorrication Food poisoning must be differentiated from morbidities like cholera, diarrhoea and dysentery or chemical poisoning of the food. The characteristics of the episode are involvement of a group of people at the same time with a history of sharing a common meal and a sudden onset. These suggest the possibility of food poisoning. In addition if any laboratory investigations are undertaken they will indicate the organism or the agent involved, which kill confirm the occurrence of poisoning.

14.4 HOW TO PREVENTICONTROL FOOD INFECTIONS AND INTOXICATIONS

Prevention and control of infections from food depend on clean and safe food, free of contamination handled by clean people in clean premises with clean utensils and thorough protection from flies and other insects. As you know, most of these infections spread by contamination or transfer of the disease causing organism by human hands or insects like flies, rodents etc.. to food or utensils. Food hygiene and hygiene of the food handlers is a must in preventing or controlling food infections. In fact, scrupulous auention to hygiene and cleanliness along with whole food chain-right from the stage of production, harvesting, marketing, storage, retailing, processing, serving and eating is essential. In places where large population groups are provided food and in institutions adequate facilities must be provided to promote scrupulous hygiene habits like provision of clean lavatories and opportunities for frequent washing of hand. Food handlers, should be subjected to frequent and regular health checks for detection of any infection or carrier state. Almost all disease causing organisms are destroyed by heat. Therefore, proper cooking and handling makes the food safe. Here you may remember the age old practice of cooking meals every day and eating it hot is the safest measure. Food should not be left in warm places so that multiplication of disease causing organisms occur and toxin production is prevented. Food not eaten immediately should be kept in cold storage so that bacteria do not multiple and produce toxins. One of the favourable conditions for bacterial multiplication and toxin production is temperature between 10 C and 49 C. The temperature below 4 C is bacteriostatic, i.e., bacteria do not grow at this temperature. Public health laboratories and personnel in the departments of public health and municipalities are provided with certain powers to prevent and control food borne diseases. These public health personnel can inspect the places of public eating for hygiene; examine slaughter house and meat stalls for cleanliness and enforce food handlers hygiene. As you are aware of the causes of contamination in most of the instances, you should help to prevent food dysentery, throat infection and carriers of any infection handling foods. Due to the urbanisation phenomenon and time constraints in the life of the public, ready to-eat-foods are becoming popular. Handling of these food with bare hands should be reduced to a minimum and proper care should be taken in their packing and storage. Food premises should be kept free from rats, mice, flies and dust Milk and milk products should be pasteurised. A system of continuing surveillance is necessary to avoid outbreaks of foodborne diseases. Health education of the community regarding the dangers of foodborne diseases, the causes for such outbreaks and methods to prevent the food contamination are very important in preventionlcontrol of foodborne diseases and also in prevention of recurrences of such outbreaks. Information given in Highlight 6 "How to get the better of bacteria and moulds", in unit 16, block 4 of Course 1 will be very useful in preventionlcontrol of food poisoning. Read this highlight carefully. A few words about the management of food poisoning. Management: The management of the cases of food infections and intoxications depends on the identification of the exact cause of the outbreak. Hence, you should take care to alert the public, health authorities about the outbreak. In severe cases, immediately shift the patients to a nearby hospital. Till the time the patients are shifted to hospital. you may take care of the dehydration arising due to diarrhoea and vomiting by advocating Food Infections and oral fluids (ORS). Intoxlcatlom

Check Your Progress Exercise 2 1) Plan out on education programme to be delivered to the community on prevention of food infections...... 2) List any three preventive measures that you will adopt to prevent food poisoning. a) ...... b) ...... c) ...... !......

14.5 FOOD POISONING OF NON-BACTERIAL ORIGIN

You may recall reading earlier that moulds, fungus can also cause food poisoning. In addition there might be certain toxins present naturally in foods which may also cause food poisoning. It this section. you will be learning about four important conditions which occur due to toxic contamination of food items. These are of the non-bacterial origin. Among the four conditions described here, Ergotism and Ajlatoxicosis are due to fungal and mould contamination of foodgrains respectively. Lathyrjsm, the third condition is due to toxic princples present in the food item while is due to contamination of edible oils with argemone oil. Let us dicuss each of these food poisoning seperately. 14.5.1 Ergotism Ergotism, is a condition arising due to a field fungus affecting food grains like bajra. , sorghum and wheat. The growth of the ergot fungus occurs during the flowering stage. Consumption of such ergot infested foodgrains leads to the toxic condition known as ergotism. Sporadic outbreaks of ergot poisoning in human beings have been observed from time to time where bajra and rye are consumed as staple food. High yielding varieties of bajra are known to be more prone for ergot infestation. What' is the fungus causing ergotism? The fungus that causes ergotism is identified as Clavicepsfusifonnis. The fungus grows as a blackish mass and the seeds become black and irregular which are harvested along with the foodgrains. The ergot produces toxins which result in ergotism. What are the signs and symptoms? The symptoms of ergotism are acute but rarely they are fatal. The symptoms include nausea, repeated vomiting, giddiness and (Irowsiness lasting over extended periods of 'upto two years after ingestion of ergot affected grain. When the condition becomes chronic the patient will complain of painful cramps in limbs, depression, weakeness and . Sometimes blood supply to limbs is affected due to the toxic effect on capillary blood vessels which may result in . Gangrene is a condition, where body parts begin to get destroyed due to infection. Such parts often have to be cut off otherwise it will spread to other parts of the body. Food Born Dl-, Food How to controllprevent ergotism? Infections d IntoxlepUon The safe limit of ergot (toxin) in food material is found to be 0.05 mg,100 g of the food material. You may undertake the health education of the communities by making them aware of the ergotism and its toxic effects. You may also teach them the methods of removal of ergot seeds from the foodgrains. Ergot infested grains can be easily removed by floating them in 20 per cent salt water. This can also be done by hand picking or air floatation. 14.5.2 Aflatoxicosis A~xicosisis a condition brought about by Aflatoxins (a toxin) which are a group of produced by moulds known as Aspergillus flavus and Aspergillus parusitious. These moulds usually contaminate the groundnut seedlings. Aflatoxins are toxic to liver. Aflatoxicosis has been implicated as a cause of human hepatic carcinoma (cancer of the liver). Its role in cirrhosis in humans is still under investigation. These toxins can cause outbreaks of fatal diseases characterised by acute enteritis and hepatitis. In addition to groundnut seedlings, it is now known that the mould can affect other foodgrains like maize, sorghum and many other human foods like parboiled rice, tapioca, wheat etc. Some samples of milk from dairy farms were found to contain aflatoxins. The mould, Aspergillus fravus grows and contaminates the foodgrains under favourable conditions like harvesting, storing and processing in high humidity. Mositure above 16 per cent and temperature between 11 and 37 C favour toxin formation.

What are the control/prevention measures? You have learnt that the important factors leading to contamination are moisture and improper storage. The crucial measure in the prevention of aflatoxicosis will be thorough drying of foodgrains after harvest followed by proper storage. If any food item is suspected to be contaminated, it must not be allowed for consumption. You should undertake health education of the community on the health hazards of mould contamination of foodgrains. Control/preventive measures listed in Highlight 6, of unit 16. block 4 of course 1 are applicable here as well. 14.5.3 Lathyrism Luthyrisrn, is a condition occuring due to the consumption of excessive amounts of a pulekesari dal-for a long period. The generic name of the is Luthyrus sativus. Lathyrism is manifested by spastic paralysis of lower limbs. It is due to the toxin Beta oxalyl amino alanine present in the kesari dal. Kasari dal is a hardy crop and drought resistant. This is mostly grown in Madhya Pradesh and Rajasthan and, hence, the disease is more common in these parts of the country where sometimes the kesari dal is consumed as a staple. The disease usually occurs in young and active people crippling them for life thus making them a social burden on the community. Noting the advantages in the crop and realising the difficulty in banning the crop. methods have been evolved to leach out the poison from the dal. A simple procedure of soaking the dal and then boiling it and steeping for a period of one hour leaches out the toxin. The water can then be discarded, the pulse dried and then pounded to consumable form. This praceedure will leave the dal free of the toxin. You can safely eat the dal, thus treated. Research efforts to identify low toxin varieties and possible genetic manipulation for reducing the toxin content in the crop are underway. Preventive measures for the control of lathyrism have already been dealt in course 1, block 5. unit 19 (section 19.6). Do your recall these preventive measure. Read this section once again and be equipped to deal with lathyrism. 14.5.4 Argemone toxicity You might have heard about the outbreaks of Epidemic dropsy occurring in parts of the country now and then. What is this condition? Epidemic dropy is a condition characterised by changes in the heart and blood vessels. The cause of this dropsy was identified in 1926 to be due to contamination of mustard oil with argemone oil. What is the toxin? ~ood~oreetlons .ad Io~catlom A toxic , sanguinarine present in the argemone oil, causes epidemic dropsy.

How does the toxicity occur? This toxic present in argemone oil is known to interfere in the carbohydrate metabolism. What are the signs and symptoms? The person affected with argemone toxicity complains of sudden onset of swelling on.both legs associated with diarrhoea. Some people complain of pain in the eyes caused by a condition known as which occurs due to raised tension in the eyeballs. Sometimes death may follow which occurs due to heart failure and difficulty in breathing.

Who are susceptible for the toxicity? All the persons who consume the contaminated mustard oil are susceptible for the toxicity. It is not found in breastfed infants as they do not consume oil.

How does the contamination occur? You might have seen or heard about the plant prickly poppy. The plant grows wild in India The botanical name of this plant is Argemone mexicana. The seeds of this plant closely resemble mustard seeds. Crops of mustard are harvested during early summer and during the same period the seeds of argemone also mature and are likely to be gathered along with mustard seeds. Thus contamination of mustard seeds with those of argemone may be accidental. But the contamination can be deliberate also when some dealers who want to become rich overnight mix the argemone oil with mustard or other oils.

How to manage epidemic dropsy? As you have seen that this is an acute condition and fatal, once the argemone toxicity is suspected, consumption of contaminated oil should be immediately stopped and the affected cases should be immediately shifted to a nearby hospital where treatment should be undertaken on an emergency bases.

Is there any method available to detect argemone contamination in edible oils? The physical characteristics of argemone oil are its orange colour and an acrid odour. There is a chemical test available to detect the contamination. It is called 'Nitric acid test'. It is a simple test which you can also undertake. The test involves addition of niaic acid to the suspected sample of oil in a test tube. On shaking the tube. development of a brown colour or orange red colour, indicates the presence of argemone oil. Only disadvantage with this test is that the test will be positive only when the contamination is to the extent of 0.25 per cent or more. There is a more sensitive test available but it requires sophisticated equimpment usually available in big laboratories. This is known as paper chromatography test. This test can detect argemone oil contamination upto 0.00001 per cent in all edible oils.

How to prevent contamination? The accidental contamination of mustard seeds with other oil seeds can be prevented at the field level itself by removal of the argemone weeds growing among oilseed crops. The deliberate contamination by argemone oil by unscrupulous oil dealers should be . ~oodBorne Diseases, Food Chech Your Progress Exercise 3 Intectioas and IntoalcnUon 1) Depict the causative agent, sign symptom, preventive measure of the four food toxins in a tabular form.

Food - Causative Sign! Preventive toxins agent Symptom measure

a) Ergotism b) Aflatoxins c) Lathyrism d) Argemone toxicity

14.6 LET US SUM UP

In this unit, you learnt about the common food infections and intoxications like salmonella and staphylococcal food poisoning, botulism, clostridium perfringens and bacillus cereus food poisoning. Common food toxins causing ergotism, aflatoxicosis. lathyrism, argemone toxicity and epidemic dropsy were enumerated. Prevention/control and management of these food poisoning was dicussed.

14.7 GLOSSARY

Anaerobic Describing a type of cellular respiration in which foodstuffs (usually carbohydrates) are never completely oxidized because molecular oxygen is not used. Fermentation is an example of anaerobic respiration. Cirrhosis A condition in which the liver responds to injury or death of some of its cells by producing interlacing strands of fibrous tissue between which are nodules of regenerating cells. Spores A small reproductive body produced by plants and microorganisms. Enterotoxin A poisonous substance which has a particularly marked effect upon the gastrointestinal tract, causing vomiting. diarrhoea and abdominal pain. Moulds Moulds are minute plants that grow on all kinds of foods and prefer warm, damp and dark place. They produce harmful toxic material. Pasteurized When milk is heated to a high temperature for a short period of time to destroy the bacteria. it is pasteurized. Staple Food used frequenlty or daily, for example rice is the staple in south or wheat is the staple in the north. Toxin Toxin means poison. But it is frequently used to refer specifically to a protein produced by some higher plants, certain animals and pathogenic bacteria, which is highly toxic for other living organisms. The characteristic of these poisons is their antogenicity. 14.8 ANSWERS TO CHECK YOUR PROGRESS EXERCISES

Check Your Progress Exercises 1 1) a) True b) False; Food Handlers c) False; Inadequate processed canned items cause botulism food poisoning

Food Causative Mode of Symptom poisoning agent transmission

Botulism Clostridium Consumption of Difficulty botulisum contaminated food in swallowing like pmkssed canned food Blurring of Infected food vision handlers Double vision (wounds/cuts) Painful joints Weakness of joints Paralysis of limbs

Salmonellosis Salmonella Contaminated Chill fever typhirnurium meat, milk and nausea and milk products, vomitting poultry. egg. Contamination by Watery diarrhoea carrier Contamination of food by the urine and faeces of &mice

Check Your Progress Exercise 2 1) Open ended answer 2) a) Observe rules of food hygiene at every stage of food handling. b) People having infections (cold, cough, boils, etc) should not be allowed to handle foodstuff. c) Cook food for a sufficient length of time and at the right temperature to destroy bacterialspores. Food Borne Diseases, Food Check Your Progress Exercise 3 Infections Md Inbrdcatlon 1) Food Toxins Causative SignlSymptom Preventive agent measures

a) Ergotism Claviceps Nausea Remove ergot fusiformis Repeated seeds from vomiuing food grains Painful cramps Educate in the limbs community Gangrene about toxic effect

b) Aflatoxicosis Aspergillus Acute Drying food fivisl hepatitis grains after parasiticus (liver disease) harvest enteritis Proper storage of food grain Health education of the community

c) Lathyrism Toxin present Paralysis of Ban consumption limbs of kesari dal Leaching out the toxin from the dal

d) Argemone Sanguinarine Swelling of Remove argem toxicity legs one seed from mustard seed. Diarrhoea Ban consumption of contaminated oil ' Strict enforcement of food adulte- ration act