Food poisoning and gastroenteritis (keracunan makanan, cirit-birit): symptoms, rehydration and when to see a doctor

Food poisoning in Malaysia

Food poisoning is a notifiable disease in Malaysia, so doctors must report cases to the Ministry of Health. The national rate rose from 18.4 per 100,000 people in 2021 to 51 per 100,000 in 2023. Cases then fell: from January to early September 2025 there were 12,821 cases, against 18,034 in the same period of 2024. The ministry aims to keep the rate below 50 per 100,000 by 2030.

Outbreaks are most often linked to food prepared in bulk, such as at schools and hostels, caterers and events:

• In September 2026, about 160 students and staff at a boarding school in Lenggong, Perak fell ill after a school programme. The caterer was ordered to close.
• In July 2025, 427 college students in Kota Bharu fell ill, and an unlicensed home caterer was shut down.

If several people fall ill after the same meal, tell the clinic, so the health office can investigate.

Common causes, and how soon symptoms start

Rice is a common culprit. Bacillus cereus spores survive cooking and multiply in rice left warm. Its toxin isn’t destroyed by reheating, so rice that has been left out for hours isn’t made safe by heating it up.

Gastroenteritis (a “stomach bug” or “stomach flu”) is often caused by viruses such as norovirus, and in young children rotavirus, and spreads easily from person to person. It has nothing to do with influenza. The rotavirus vaccine isn’t part of the National Immunisation Programme but is available at private clinics: see our baby vaccination schedule.

A fever lasting several days after eating out may be typhoid rather than ordinary food poisoning. See our guide to the typhoid injection.

Symptoms and how long they last

• nausea and vomiting
• diarrhoea (cirit-birit)
• tummy cramps
• fever, aches and feeling generally unwell

Vomiting usually stops within 1 to 2 days and diarrhoea within 5 to 7 days. Most people recover within a week. You can pass a stomach bug on for at least 2 days after the diarrhoea and vomiting stop, so stay home from work or school until then.

Severe, constant tummy pain, especially if it moves to the lower right side, may be something else, such as appendicitis. See our guides to stomach pain and appendicitis.

Rehydration: the most important treatment

Diarrhoea and vomiting drain the body of water and salts. Oral rehydration salts (ORS), sold in sachets at pharmacies, contain the right balance of salts and sugar to replace them:

• Mix each sachet with the amount of clean, boiled and cooled water stated on the pack, often 250 ml. Don’t make it stronger or weaker.
• Take small, frequent sips, especially if you are vomiting. Try a sip every few minutes, and keep going even if you vomit.
• Drink extra after each loose stool.
• Avoid fizzy drinks, fruit juice and very sweet drinks, which can make diarrhoea worse. Sports drinks aren’t a substitute for ORS for children.
• Babies: keep breastfeeding or giving formula as usual, with ORS between feeds if advised.

Eating: start eating normally as soon as you feel able, with plain foods such as rice, porridge (bubur), bread, bananas and soup. There is no need to stop eating for long.

Medicines: what helps and what to avoid

• Paracetamol helps with fever and aches.
• Anti-diarrhoea medicine (loperamide) can reduce diarrhoea for a few hours in adults, for example for travel. Don’t use it if you have blood or mucus in your stool or a high fever, and don’t give it to children under 12.
• Antibiotics usually aren’t needed and don’t help viral gastroenteritis. A doctor may prescribe them for some bacterial infections, such as severe or bloody diarrhoea.
• Probiotics probably make little or no difference to how long diarrhoea lasts, according to a Cochrane review.
• Activated charcoal has little evidence for diarrhoea and can stop other medicines from working.

Ask a pharmacist or doctor before giving any medicine to a baby or young child.

When to see a doctor

See a doctor if:

• there is blood in the diarrhoea or vomit
• you have a high fever (38.9°C or above)
• you can’t keep fluids down because of vomiting
• diarrhoea lasts more than 3 days in adults, or vomiting lasts more than 2 days
• you have signs of dehydration: passing very little urine, very dark urine, dry mouth, dizziness when standing
• the person ill is a baby under 1 year, an older person, pregnant, or has diabetes, kidney disease or a weak immune system

Go to an emergency department, or call 999, if:

• a child is very drowsy or floppy, has sunken eyes, is drinking poorly, or has far fewer wet nappies than usual
• there is green or bloody vomit, or severe, sudden tummy pain
• someone is confused, or faints

See our guide on clinic or emergency department. During and after floods, diarrhoea can also come from contaminated water: see our guide to floods and your health.

Preventing food poisoning

The World Health Organization’s Five Keys to Safer Food:

1. Keep clean: wash your hands with soap for at least 20 seconds before handling food and after using the toilet.
2. Separate raw and cooked: use separate boards and knives for raw meat, chicken and seafood.
3. Cook thoroughly: especially chicken, eggs and seafood, until piping hot.
4. Keep food at safe temperatures: don’t leave cooked food at room temperature for more than 2 hours, or 1 hour in very hot weather. Keep hot food hot and cold food cold, and refrigerate leftovers quickly.
5. Use safe water and raw materials: boil or treat drinking water if unsure, and wash fruit and vegetables.

• At kenduri, buffets and events, be wary of rice, curries and kuih that have been sitting out for hours.
• If you have diarrhoea or vomiting, don’t prepare food for others until 48 hours after your symptoms stop.

Where to see a doctor

A GP can check for dehydration, give medicine to stop vomiting, test a stool sample if needed, and issue an MC. Food poisoning often strikes at night or at weekends, so our directory lists clinics open 24 hours and late across Kuala Lumpur, Selangor and other states.

Browse the clinic directory

Frequently asked questions