By: M.D., Rafael Castillo
A FEW weeks ago, heart specialists from all over the country gathered at the Edsa Shangri-La Hotel for its annual convention to discuss common heart problems. Quite out of the scientific program on the last day, discussions turned to dealing with food poisoning as around 30 of the doctors, including my wife and I had repeated bouts of watery diarrhea the day before.
I was seeing patients in the clinic after attending the sessions at the hotel—eating lunch and snacks there earlier during the day, and lunch and dinner the previous day—when I started having nausea and stomach cramps. I had to excuse myself in the middle of examining a patient to rush to the toilet. This happened a few more times.
My wife and I skipped dinner that evening and went straight to bed. My wife’s bum stomach was not as bad as mine; she usually has a stronger resistance to diseases than me. I was feeling chilly and drained. Several other episodes of watery diarrhea followed during the night. It was good though I wasn’t vomiting so I could replace by drinking oral rehydrating solution the fluids I lost through the diarrhea. The bananas I ate also helped preserve my likely dwindling level of electrolytes.
Simple solution
There are convenient effervescent tablets one can just dissolve in plain water, and take the solution after every watery bowel movement. But if one doesn’t have these tablets at home, a simple salt-sugar solution can be easily prepared. Just mix one level teaspoon (5 ml) of salt with eight level teaspoons of sugar in a liter of drinking water. For the potassium lost in the diarrhea, bananas would make a good replacement source. Although the salt is very important in the solution, using too much of it can also be harmful and has even been reported to cause convulsions in extreme cases.
Another important thing to remember about food poisoning is that the diarrhea is actually the body’s compensatory efforts to get rid of the toxins that poisoned one’s gut. So taking anti-diarrheal agents to plug the ooze, as suggested by over-the-counter anti-LBM (loose bowel movement) drugs, is not really medically sound. We should allow the body to eliminate the infected food source, and just replace the fluids and electrolytes we lose in the process. Taking anti-diarrheal agents is only recommended for noninfectious causes of diarrhea.
Going back to our food poisoning, some of our doctor colleagues had worse cases than I had, and had to be brought to the hospital. These included Doctors James Ho, Nikki Jara, Jean Capistrano, and an Indonesian doctor undergoing medical training at UP-PGH. Dr. Nikki even lost consciousness probably due to low blood pressure secondary to dehydration. She related to me what happened to her.
“I awoke at 3 a.m. when I felt like defecating (moving bowels) again. While washing my hands in the toilet, I felt my vision go black. I stood a while to think that it would go back. I groped around the sink to turn off the faucet but since I could not see, I accidentally pushed a mug, making it clatter on the sink and breaking it. My mother asked me if I were ok, and I told her, ‘Mommy, wala akong makita.’”
She was rushed to the Capitol Medical Center, hydrated with intravenous fluids, and was discharged due to improved condition after two days.
Responsibility
Despite best efforts at being careful with what we eat, even doctors have bouts of food poisoning every now and then. But we found it quite hard to believe that it could happen while eating in a 5-star hotel. I talked to Lesley Tan, the hotel’s communications director, and she said that after the incident, they sent all suspected foods and water they had served the doctors to Intertech, a laboratory which does testing for microbes present in food items, and all tests came back negative for any pathogen or bacteria.
She reiterated their hotel’s stringent food safety policies, and raised the possibility that the food poisoning could have come from the snacks—prepared by third parties—which were served in the hospitality suites by some pharmaceutical companies. This is a possibility except that some of those who were downed with vomiting and diarrhea never ate any of these snacks and attributed the poisoning to the foods eaten in the hotel.
The hotel staff may have taken it upon themselves to investigate the source of the poisoning, but since it involved a relatively big number of people which may be considered an outbreak already, they should have reported the incident to the Department of Health, which is generally informed and involved in the investigation of any unresolved disease outbreaks.
For some of the doctors who were downed by the food poisoning, it is a public health issue that has to be looked into by our health authorities. Even if the hotel is not legally mandated to do so, they should be morally mandated, as a good corporate citizen, to make that report. Since they have not done so more than two weeks after the incident, I e-mailed Health Secretary Enrique Ona earlier this week to report the mass food poisoning and leave it to his department whatever needs to be done to make sure that such unfortunate incident does not happen again.
Mistakes happen even with the best people employed to prevent them, and loopholes occur even in the best of systems so the occurrence of incidents like this—though not acceptable—is still understandable even in supposedly clean hotels. It’s quite discomforting though that the source of the problem has not been identified, yet there was no effort to report it to the proper health authorities. As it is now, the pathogen that caused the mass food poisoning is still “at large” and since it has not been identified, it can wreak a more serious mess than it already did during our convention at the Edsa Shangri-La Hotel.
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