Food poisoning or foodborne illness is a clinical condition that is generally only in the gastrointestinal system and is self-limited. However, some pathogens cause Food poisoning cases to be fatal or death. 

The Deadliest Food Poisoning Causes

This condition causes high morbidity and mortality. Based on data from the World Health Organization (WHO) in 2010, there have been two billion cases and more than one million deaths due to food poisoning from 22 different etiologies. This prevalence varies depending on each country.

Based on data from the Center for Disease Control (CDC) in the United States, around 76 million people experience food poisoning every year. 300,000 of them require hospitalization and 5,000 fatal cases to death. Although most cases of food poisoning can self-limited, not a few of these cases are fatal. In Canada, the deaths caused food poisoning, reach 238 cases each year. Pathogens that cause death are Norovirus, Salmonella spp, Campylobacter spp, and Listeria monocytogenes.

Data from WHO shows that 1 in 10 people experience food poisoning with a mortality rate of around 420,000 per year. Of this number, around 30% of deaths due to food poisoning occur in populations of children under 5 years.

Food poisoning should be suspected in patients with gastrointestinal or neurological symptoms, especially in a group of patients with the same symptoms. When doing anamnesis, the doctor must identify the source of transmission by asking about:
- the last food consumption, 
- history of eating raw meat, 
- consumption of unpasteurized dairy products, 
- and the history of travel. 


Food poisoning is caused by consuming food or drinks that are contaminated by bacteria, viruses, parasites, or chemicals. The etiologies that are often found are Staphylococcus aureus, Bacillus cereus, Escherichia coli, Shigella, Listeria, Vibrio, hepatitis A virus, rotavirus, Giardia lamblia, Entamoeba histolytica, Cyclospora, Cryptosporidium, scombroid, and marine fish poisoning.

The pathogens that cause the most cases of food poisoning are Campylobacter derived from unpasteurized milk, Norovirus from shellfish, Escherichia coli, Salmonella derived from raw or immature eggs, ciguatera toxin from fish such as grouper, tuna, Cyclospora found in raspberries, hepatitis A virus, and Listeria derived from processed meat in packaging.

Most of the clinical manifestations due to food poisoning caused by infectious causes are self-limited, with symptoms generally appearing on the gastrointestinal system. Only a few pathogens cause invasive symptoms or cause manifestations in other organ systems.

The prognosis of food poisoning is worse if the etiology is not self-limited with dangerous complications, such as Clostridium botulinum. Another factor affecting prognosis is susceptibility to dehydration, especially in infants, children, and the elderly. Complications that can arise in poisoning due to botulinum is paralysis that can end in mortality.

The Deadliest Food Poisoning Causes and their Complications

Most food poisoning cases do not cause complications. However, several pathogens cause complications if not properly treated. The following are some examples of pathogens that have further complications.

a. Clostridium perfringens: This pathogen has complications of necrotizing enteritis or pig-bell, which can be fatal.
b. Listeria sp: invasive complications such as bacteremia and meningitis are more common in neonatal patients, the elderly, and immunocompromised patients
c. Salmonella sp: this bacterium can spread hematogenously and cause infectious complications in endovascular such as aortitis and endocarditis, infections of the bones and joints, and visceral abscess.
d. Vibrio parahaemolyticus
Vibrio parahaemolyticus causes bacteremia and sepsis, especially in patients with liver disorders. Eksotosin Vibrio parahaemolyticus causes complications.
e. Yersinia: complications are erythema nodosum in the legs and body (can disappear after 1 month); arthritis in the knee joint, ankle, or wrist (disappears in 1-6 months); and glomerulonephritis.
f. Ciguatera toxin: In some cases, ciguatera toxin can cause cardiovascular disorders that manifest as bradycardia, hypotension, arrhythmias, or atrioventricular block. If not handled properly, this can cause death.
g. Fungal toxin: Food poisoning due to toxins in the fungus, can cause permanent kidney damage due to prolonged dehydration, as well as neurological disorders such as seizures. The risk of complications and mortality will increase in patients with older age and patients who present with gastrointestinal complaints.
h. Arsenic: Prolonged exposure to arsenic or from the womb through contaminated food and drink can increase the risk of cancer, chronic lung disease, myocardial infarction, and kidney failure. 


The doctor must be able to distinguish the etiology of self-limited food poisoning from the etiology that endangers lives. The prognosis of patients with life-threatening etiology is determined by appropriate and quick treatment.

An example is Clostridium botulinum. Cases of botulism that are not handled properly can cause morbidity such as paralysis and mortality in up to 5% of cases. Poisoning due to toxins of fungi can also be fatal, even causes death, if not immediately get the right treatment. The treatment procedure for food poisoning is generally supportive by maintaining the hydration status using an oral rehydration solution and correcting electrolyte imbalance. Antibiotics only for cases with invasive infections or certain bacterial and parasitic infections. Specific management depends on the cause of poisoning.

Source Picture:

1. Petrillo TM, Beck-Sague CM, Songer JG, Abramowsky C, Fortenberry JD, Meacham L, et al. Enteritis necroticans (pigbel) in a diabetic child. N Eng J Med. 2000;342(17):1250-3
2. Allerberger F, Wagner M. Listeriosis: a resurgent foodborne infection. Clin Microbiol Infect. 2010;16(1):16-23
3. Cianflone NF. Salmonellosis and the GI tract: more than just peanut butter. Curr Gastroenterol Rep. 2008;10(4):424-31
4. Shimohata T, Takahashi A. Diarrhea induced by infection of Vibrio parahaemolyticus. J Med Invest. 2010;57(3-4):179-82
5. Gupta V, et al. Detection of Yersinia enterocolitica in food: an overview. J Clin Microbiol Infect Dis. 2015;34(4):641-50
6. Senthilkumaran S, Meenakshisundaram R, Michaels AD, Suresh P, Thirumalaikolundusubramanian P. Cardiovascular Complications in Ciguatera Fish Poisoning: A Wake-up Call. Heart Views. 2011;12(4):166-8
7. Cevik AA, Unluoglu I. Factors affecting mortality and complications in mushroom poisonings over a 20 year period: a report from Central Anatolia. Turk J Emerg Med. 2014;14(3):104-10
8. In utero and early life arsenic exposure in relation to long-term health and disease. Toxicol Appl Pharmacol. Farzan SF, Karagas MR, Chen Y. 2013;272(2):384-90
9. The developmental neurotoxicity of arsenic: cognitive and behavioral consequences of early life exposure. Tolins M, Ruchirawat M, Landrigan P. Ann Glob Health. 2014;80(4):303-14