Staphylococcal food poisoning results from eating food contaminated with toxins produced by certain types of staphylococci, resulting in diarrhea and vomiting.
The staphylococci bacteria grow in food, in which they produce toxins. Thus, staphylococcal food poisoning does not result from ingesting the bacteria but rather from ingesting the toxins made by the bacteria that are already present in the contaminated food. Typical contaminated foods include custard, cream-filled pastry, milk, processed meats, and fish. The risk of an outbreak is high when food workers with skin infections contaminate foods that are undercooked or left at room temperature. Despite contamination, many foods have a normal taste and odor.
Symptoms usually begin abruptly with severe nausea and vomiting starting about 2 to 8 hours after the contaminated food is eaten. Other symptoms may include abdominal cramping, diarrhea, and sometimes headache and fever. Severe fluid and electrolyte loss may cause weakness and very low blood pressure (shock—see Shock). Symptoms usually last less than 12 hours, and recovery is usually complete.
Occasionally, staphylococcal food poisoning is fatal, especially in the very young, the very old, and people weakened by long-term illness.
The symptoms are usually all a doctor needs to diagnose gastroenteritis. A more specific diagnosis of staphylococcal food poisoning may be suspected when other people who ate the same food are similarly affected and when the disorder can be traced to a single source of contamination. To confirm the diagnosis, a laboratory must identify staphylococci in the suspected food, but this testing is not usually done.
Careful food preparation can prevent staphylococcal food poisoning. Anyone who has a skin infection should not prepare food for others until the infection heals. Food should be consumed immediately or refrigerated and not kept at room temperature.
Treatment usually consists of drinking an adequate amount of fluids. A doctor may give an antinausea drug, either as an injection or as a suppository, to help control severe nausea and vomiting. Sometimes so much fluid is lost that fluids have to be given by vein (intravenously).
Last full review/revision December 2014 by Thomas G. Boyce, MD, MPH