Foodborne Illnesses

Ingestion of food contaminated with disease producing organisms or their toxins may result in illness.  76 million cases of food-borne illness occur, each year, in the United States,  5000 of which result in death.  

Causes

Food-borne illness is usually caused by bacteria or its toxins, but may be related to parasites (trichinosis), viruses (hepatitis), and chemicals (mushrooms). Contamination of foods may occur during cultivation, harvesting, handling, storage, transportation, or preparation.

Bacteria account for 79% of food-borne outbreaks in the United States. Salmonella constitutes over half of these confirmed cases. Campylobacter causes four million cases each year in the U.S. but these are usually sporadic and not associated with an outbreak.  Campylobacter is spread through milk, chicken, beef and pet animals, whereas Salmonella may be contracted through eggs, meat and poultry. One in 20,000 eggs carries Salmonella inside the eggshell.  

Risk factors

Pregnant women, small children, and persons with chronic problems such as diabetes, liver cirrhosis, chronic kidney failure, AIDS and cancer are at an increased risk for food-borne illnesses.  

Senior citizens

The elderly are especially vulnerable to food-borne illnesses because of weakened immune systems. In addition, stomach acid, which helps in destroying the ingested bacteria, is reduced in the elderly.

Seniors should avoid raw fish, oysters, mussels, raw meat or poultry, non-pasteurized milk or cheese, lightly cooked eggs or egg-products such as Caesar salad, custard, cake batter and beverages such as egg nog. They should also stay away from  non-pasteurized fruit or vegetable juices (they have a warning label). Foods made from pasteurized eggs are okay.  

Diagnosis 

The symptoms of food-borne illness are nonspecific and resemble stomach flu. Patients complain of stomach cramps, nausea, vomiting and diarrhea. Diarrhea may by bloody. Some patients may have fever, headache and body aches.  Dehydration may occur.

          Diagnosis is based on the history of ingestion of particular foods and laboratory tests including stool tests. Examination of the suspected food, if available, is helpful.  

Treatment

Most food-borne illnesses are mild and require only increased fluid intake to replenish the losses.

Patients with bleeding, fever, neurological symptoms, shallow breathing, cold and clammy skin, dizziness, dry mouth, decreased urination, dizziness, double vision, difficulty speaking or any unusual symptoms should consult their physician. Some patients may need hospitalization for hydration or other medical treatment.  

Long term consequences

Chronic disorders like arthritis, inflammatory bowel disease (ulcerative colitis and Crohn’s disease), irritable bowel syndrome, kidney failure, and other autoimmune diseases may occur as a result of food-borne illness.    

PREVENTION

          The four basic rules of prevention are Clean, Separate, Cook and Chill.   

Clean hands and surfaces

          Wash hands with hot soapy water frequently for at least 20 seconds, especially after handling raw meat or produce, after playing with pets, after using restroom and after handling diapers.

Rinse raw foods in water and use a vegetable brush to remove dirt. Additional protection can be accomplished by using kitchen-sanitizing agents, i.e. .a solution containing one teaspoon of chlorine bleach in one quart of water.       

Wash kitchen counter tops and cutting boards often, especially after using them for raw foods. Replace worn out cutting boards. Paper towels are better than cloth towels for cleaning.  

Prevent cross-contamination

          Keep raw foods away from cooked foods. Do not put the cooked food back onto a plate that held the raw food.

When thawing products in the refrigerator, keep the food on bottom shelf so that fluids from the thawing food do not drip on to other foods.  

Food preparation

Defrost meat in the refrigerator, cool water or microwave oven and not on the kitchen table. Remember, thawing 4-5 pounds of meat in the refrigerator takes about 24 hours.

Do not marinate food at room temperature.  

Cooking

          Use a clean food thermometer. This will ensure that food is cooked to the desired temperature and will also avoid overcooking. Cook steak, veal, lamb roasts to at least 145^oF, chicken (whole bird or thigh) to 180^oF, chicken breast to 170^oF, and ground beef, pork or lamb  to 160^oF. Fish should be cooked such that it flakes with a fork. Cook eggs till the yolk and egg-white are firm.

     When using a microwave for cooking, cover the food and stir it a couple times during cooking.

     Reheat precooked foods. Leftovers should be reheated to at least 165^oF. Sauces, soups and gravy should be boiled.  

Refrigeration

Prompt refrigeration of food is important. Bacteria in food at room temperature double every 20 minutes. Food left at room temperature for two hours or more is not safe for ingestion even though there may not be any change in its color or odor.

Set the refrigerator temperature at least 40^oF and the freezer at zero degrees. Freezing slows down the growth but does not kill the organisms.

Do not jam pack the refrigerator. Divide large portions of food into small containers for rapid cooling. Cool air needs to circulate to keep foods cool.  

Personal responsibility

Never assume that just because the food was purchased in the supermarket, it is clean and safe. The United States relies upon food irradiation (gamma rays) to destroy bacteria in foods. These rays pass through foods without leaving any remaining radioactivity.

Irradiation is undertaken for wheat, potatoes, spices, seasonings, pork, poultry, red meat, whole fresh fruit and dry or dehydrogenated foods. The irradiated food is not completely sterile.    

This is meant to be an informational exercise and NOT a medical consultation. Your doctor is the only one who can best assess your situation and offer you medical advice.

Helpful websites

Center for Food Safety & Applied Nutrition:  http://vm.cfsan.fda.gov/list.html

Food Safety and Inspection Service www.fsis.usda.gov

Senior food safety page www.cfsan.fda.gov/~dms/seniors.html

Partnership for Food Safety Education www.fightbac.org

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