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Onset, Duration, and Symptoms of

Approximate Predominant symptoms Associated organism or toxin onset time to symptoms

Upper symptoms (, ) occur first or predominate

Less than 1 h Nausea, vomiting, unusual , Metallic burning of mouth.

1-2 h Nausea, vomiting, , Nitrites , , dyspnea, trembling, , loss of consciousness.

1-6 h mean 2-4 h Nausea, vomiting, , and its , abdominal , enterotoxins prostration.

8-16 h (2-4 h Vomiting, abdominal cramps, emesis possible) diarrhea, nausea.

6-24 h Nausea, vomiting, diarrhea, Amanita thirst, dilation of pupils, collapse, coma.

Sore throat and respiratory symptoms occur

12-72 h , , nausea, Streptococcus pyogenes vomiting, , sometimes a .

2-5 days Inflamed throat and nose, Corynebacterium diphtheriae spreading grayish , fever, , sore throat, , difficulty in , of cervical lymph node.

Lower gastrointestinal tract symptoms (abdominal cramps, diarrhea) occur first or predominate 2-36 h, mean 6- Abdominal cramps, diarrhea, Clostridium perfringens, 12 h putrefactive diarrhea associated Bacillus cereus, Streptoco ccus with C. perfringens , sometimes faecalis, S. faecium nausea and vomiting.

12-74 h, mean Abdominal cramps, diarrhea, species (including 18-36 h vomiting, fever, chills, malaise, S. arizonae), , nausea, headache, possible. enteropathogenic Sometimes bloody or mucoid coli, other Enterobacteriacae , diarrhea, cutaneous lesions , associated with V. vulnificus. , Yersinia enterocolitica mimics Aeromonas hydrophila, flu and . Plesiomonas shigelloides , jejuni, (O1 and non-O1) V.vulnificus , V. fluvialis

3-5 days Diarrhea, fever, vomiting Enteric , respiratory symptoms.

1-6 weeks Mucoid diarrhea (fatty stools) lamblia abdominal pain, .

1 to several Abdominal pain, diarrhea, weeks , headache, drowsiness, ulcers, variable -- often asymptomatic.

3-6 months Nervousness, insomnia, hunger , T. solium , , weight loss, abdominal pain, sometimes .

Neurological symptoms (visual disturbances, , tingling, paralysis) occur

Less than 1 h *** SEE Shellfish toxin GASTROINTESTINAL AND/OR NEUROLOGIC SYMPTOMS (Shellfish Toxins) (this )

Gastroenteritis, nervousness, Organic phosphate blurred vision, , cyanosis, twitching, convulsions. Excessive salivation, Muscaria-type mushrooms , gastroenteritis, irregular pulse, pupils constricted, asthmatic breathing.

Tingling and numbness, Tetradon () toxins dizziness, , gastro- hemmorrhage, and of , fixed eyes, loss of reflexes, twitching, paralysis.

1-6 h Tingling and numbness, Ciguatera toxin gastroenteritis, dizziness, dry mouth, muscular aches, dilated pupils, blurred vision, paralysis.

Nausea, vomiting, tingling, Chlorinated hydrocarbons dizziness, weakness, anorexia, weight loss, confusion.

2 h to 6 days, Vertigo, double or blurred vision, Clostridium botulinum and its usually 12-36 h loss of reflex to light, difficulty in swallowing. speaking, and breathing, dry mouth, weakness, respiratory paralysis.

More than 72 h Numbness, weakness of legs, Organic mercury spastic paralysis, impairment of vision, blindness, coma.

Gastroenteritis, leg pain, ungainly Triorthocresyl phosphate high-stepping gait, and wrist drop.

Allergic symptoms (facial , itching) occur

Less than 1 h Headache, dizziness, nausea, (scombroid) vomiting, peppery taste, burning of throat, facial swelling and flushing, pain, itching of skin.

Numbness around mouth, Monosodium glutamate tingling sensation, flushing, dizziness, headache, nausea.

Flushing, sensation of warmth, Nicotinic acid itching, abdominal pain, puffing of and knees.

Generalized symptoms (fever, chills, malaise, prostration, aches, swollen lymph nodes) occur

4-28 days, mean Gastroenteritis, fever, edema Trichinella spiralis 9 days about eyes, perspiration, muscular pain, chills, prostration, labored breathing.

7-28 days, mean Malaise, headache, fever, , Salmonella typhi 14 days nausea, vomiting, constipation, abdominal pain, chills, rose spots, bloody stools.

10-13 days Fever, headache, , rash. Toxoplasma gondii

10-50 days, mean Fever, malaise, lassitude, Etiological agent not yet 25-30 days anorexia, nausea, abdominal isolated -- probably viral pain, .

Varying periods Fever, chills, head- or joint ache, Bacillus anthracis, Brucella (depends on prostration, malaise, swollen melitensis, B. abortus, B. suis, specific illness) lymph nodes, and other specific Coxiella burnetii, Francisella symptoms of in question. tularensis, , Mycobacterium , Mycobacterium species, Pasteurella multocida, Streptobacillus moniliformis, , Leptospira species.

Gastrointestinal and/or Neurologic Symptoms - (Shellfish Toxins)

0.5 to 2 h Tingling, burning, numbness, Paralytic Shellfish Poisoning drowsiness, incoherent speech, (PSP) (saxitoxins) respiratory paralysis

2-5 min to 3-4 h Reversal of hot and cold Neurotoxic Shellfish Poisoning sensation, tingling; numbness of (NSP) (brevetoxins) lips, tongue & throat; muscle aches, dizziness, diarrhea, vomiting

30 min to 2-3 h Nausea, vomiting, diarrhea, Diarrheic Shellfish Poisoning abdominal pain, chills, fever (DSP) (dinophysis toxin, okadaic acid, pectenotoxin, yessotoxin)

24 h Vomiting, diarrhea, abdominal Amnesic Shellfish Poisoning (gastrointestinal) pain, confusion, memory loss, (ASP) (domoic acid) to 48 h disorientation, seizure, coma (neurologic)