September 2006
When bad food happens
By Marvin M. Lipman, M.D.
What do the following hospitalized patients have in common?
About 76 million Americans get sick from food poisoning every year. About 325,000 require hospitalization and more than 5,000 die. But since most cases of food poisoning come from food that is cooked at home, you can sharply reduce your risk by carefully observing a few commonsense precautions.
THE USUAL SUSPECTS
A number of microorganisms are culprits in food poisoning. Viruses of the so-called Norwalk group can be involved, as can Campylobacter, Listeria, Salmonella bacteria, and one rather mean strain of E. Coli (related to the bacterium that is a normal and benign intestinal inhabitant) called E. Coli O157:H7. All cause similar symptoms: fever, diarrhea, and sometimes nausea and vomiting.
All three of our victims started out with those symptoms but then developed serious complications. The toddler, who contracted E. Coli O157:H7 from undercooked hamburger prepared at home, had a devastating complication known as hemolytic uremic syndrome. Despite excellent care, he died.
The butcher had Listeria meningitis, which he acquired by failing to wash up after handling raw meat. Antibiotics saved his life.
The chef had a complication of Campylobacter infection known as the Guillain-Barre syndrome. The source of the infection was never established but raw poultry was suspected. She survived but is unable to walk.
Not all food-poisoning symptoms are caused by the bacterium or virus itself. Sometimes those organisms produce a toxin, which then does the dirty work. The most infamous of those is botulism.
SYMPTOMS OF CONCERN
The "symptom triad" of fever, vomiting, and diarrhea should always raise a suspicion of food poisoning. Any diarrheal illness that lasts three days or more should be reported to your physician. For the very young or very old, who are more vulnerable to complications, call your doctor after 24 hours.
During the acute illness, try to replace the fluids and electrolytes lost through diarrhea. Your pharmacy sells special solutions, such as Pedialyte or Rehydralyte, for this purpose and they're preferable for children. For older children and adults, I often recommend drinking citrus-fruit juice and eating canned soup, which together contain plenty of two electrolytes, potassium and sodium.
HOME CLEAN HOME
Contamination can take place anywhere from the farm to the retail outlet. Until the government enacts better food-safety laws and consolidates food-safety responsibility under one agency (a measure strongly supported by Consumers Union), there is little the consumer can do to control contamination from those sources. But taking some fairly simple precautions at home offers excellent protection:
This article first appeared in the December 2001 issue of Consumer Reports on Health.
- A 4-year-old toddler with severe anemia, bleeding gums, and failing kidneys.
- A 53-year-old butcher with high fever, headache, and a stiff neck.
- A 38-year-old chef with double vision, paralysis of her legs and arms, and difficulty breathing.
About 76 million Americans get sick from food poisoning every year. About 325,000 require hospitalization and more than 5,000 die. But since most cases of food poisoning come from food that is cooked at home, you can sharply reduce your risk by carefully observing a few commonsense precautions.
THE USUAL SUSPECTS
A number of microorganisms are culprits in food poisoning. Viruses of the so-called Norwalk group can be involved, as can Campylobacter, Listeria, Salmonella bacteria, and one rather mean strain of E. Coli (related to the bacterium that is a normal and benign intestinal inhabitant) called E. Coli O157:H7. All cause similar symptoms: fever, diarrhea, and sometimes nausea and vomiting.
All three of our victims started out with those symptoms but then developed serious complications. The toddler, who contracted E. Coli O157:H7 from undercooked hamburger prepared at home, had a devastating complication known as hemolytic uremic syndrome. Despite excellent care, he died.
The butcher had Listeria meningitis, which he acquired by failing to wash up after handling raw meat. Antibiotics saved his life.
The chef had a complication of Campylobacter infection known as the Guillain-Barre syndrome. The source of the infection was never established but raw poultry was suspected. She survived but is unable to walk.
Not all food-poisoning symptoms are caused by the bacterium or virus itself. Sometimes those organisms produce a toxin, which then does the dirty work. The most infamous of those is botulism.
SYMPTOMS OF CONCERN
The "symptom triad" of fever, vomiting, and diarrhea should always raise a suspicion of food poisoning. Any diarrheal illness that lasts three days or more should be reported to your physician. For the very young or very old, who are more vulnerable to complications, call your doctor after 24 hours.
During the acute illness, try to replace the fluids and electrolytes lost through diarrhea. Your pharmacy sells special solutions, such as Pedialyte or Rehydralyte, for this purpose and they're preferable for children. For older children and adults, I often recommend drinking citrus-fruit juice and eating canned soup, which together contain plenty of two electrolytes, potassium and sodium.
HOME CLEAN HOME
Contamination can take place anywhere from the farm to the retail outlet. Until the government enacts better food-safety laws and consolidates food-safety responsibility under one agency (a measure strongly supported by Consumers Union), there is little the consumer can do to control contamination from those sources. But taking some fairly simple precautions at home offers excellent protection:
- Consider all raw meat and fish contaminated. The same goes for everything with which they come in contact: countertops, cutting boards, sinks, sponges, colanders, and platters.
- After use, wash all food-contact surfaces with soap and hot water and dry with paper towels.
- Prevent cross-contamination by washing your hands frequently with soap and warm water while preparing food. Never allow cooked foods to touch surfaces they touched when raw.
- Cook all food thoroughly to kill pathogenic microorganisms. Beef, pork, and lamb should reach an internal temperature of at least 160° F; poultry, 165° F; eggs, until the yolk is firm and the white not runny; fish, until opaque all the way through and easily flaked.
- Wash fresh produce with cold running water and use a scrubbing brush if necessary. Be especially thorough with produce you're planning to eat raw.
- Thaw frozen foods in the refrigerator. If time is a factor, use the microwave rather than let food defrost at room temperature.
- Refrigerate leftovers promptly in containers small enough to permit rapid cooling.
This article first appeared in the December 2001 issue of Consumer Reports on Health.
