Foodborne and Airborne Illness

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Foodborne and Airborne Illness

Foodborne illness results from eating food contaminated with bacteria (or

their toxins) or other pathogens such as parasites or viruses. The

illnesses range from upset stomach to more serious symptoms, including

diarrhea, fever, vomiting, abdominal cramps, and dehydration. Although

most foodborne infections are undiagnosed and unreported, the Centers for

Disease Control and Prevention estimates that every year about 76 million

people in the United States become ill from pathogens in food. Of these,

about 5,000 die.

Causes

Harmful bacteria are the most common causes of foodborne illnesses. Some

bacteria may be present on foods when you purchase them. Raw foods are

not sterile. Raw meat and poultry may become contaminated during

slaughter. Seafood may become contaminated during harvest or through

processing. One in 20,000 eggs may be contaminated with Salmonella inside

the egg shell. Produce such as lettuce, tomatoes, sprouts, and melons can

become contaminated with Salmonella, Shigella, or Escherichia coli (E.

coli) O157:H7. Contamination can occur during growing, harvesting,

processing, storing, shipping, or final preparation. Sources of

contamination are varied; however, these items are grown in the soil and

therefore may become contaminated during growth or through processing and

distribution. Contamination may also occur during food preparation in the

restaurant or in the person's kitchen.

When food is cooked and left out for more than 2 hours at room

temperature, bacteria can multiply quickly. Most bacteria grow undetected

because they do not produce an " off " odor or change the color or texture

of the food. Freezing food slows or stops bacteria's growth but does not

destroy the bacteria. The microbes can become reactivated when the food

is thawed. Refrigeration may slow the growth of some bacteria, but

thorough cooking is needed to destroy the bacteria.

Symptoms

In most cases of foodborne illness, symptoms resemble intestinal flu and

may last a few hours or even several days. Symptoms can range from mild

to serious and include:

•abdominal cramps

•nausea

•vomiting

•diarrhea

•fever

•dehydration

Risk Factors

Some people are at greater risk for bacterial infections because of their

age or immune status. Young children, pregnant women and their fetuses,

the elderly, and people with lowered immunity are at greatest risk.

Complications

Some micro-organisms, such as Listeria monocytogenes and Clostridium

botulinum, cause far more serious illness than vomiting or diarrhea. They

can cause spontaneous abortion or death.

In some people, especially children, hemolytic uremic syndrome (HUS) can

result from infection by a particular strain of bacteria, E. coli

O157:H7, and can lead to kidney failure and death. HUS is a rare disorder

that affects primarily young children between the ages of 1 and 10 years

and is the leading cause of acute renal failure in previously healthy

children. The child may become infected after consuming a contaminated

food, such as meat (especially undercooked ground beef), unpasteurized

apple cider or apple juice, or raw sprouts.

The most common symptoms of infection are vomiting, abdominal pain, and

diarrhea, which may be bloody. In 5 to 10 percent of cases, HUS develops

about 2 to 6 days after the onset of illness. This disease may last from

1 to 15 days and is fatal in 3 to 5 percent of cases. Symptoms of HUS

include fever, lethargy, irritability, and pallor. In about half the

cases, the disease progresses until the kidneys are unable to remove

waste products from the blood and excrete them into the urine (acute

renal failure). A decrease in circulating red blood cells and blood

platelets and reduced blood flow to organs may lead to multiple organ

failure. Seizures, heart failure, inflammation of the pancreas, and

diabetes can also result. However, most children recover completely.

You need to see a doctor right away if you have any of the following

symptoms, with or without gastrointestinal symptoms:

•Signs of shock, such as weak or rapid pulse; shallow breathing; cold,

clammy, pale skin; shaking or chills; or chest pain.

•Signs of severe dehydration, such as dry mouth, sticky saliva, decreased

urine output, dizziness, fatigue, sunken eyes, low blood pressure, or

increased heart rate and breathing.

•Confusion or difficulty reasoning.

Diagnosis

Your doctor may be able to diagnose foodborne illness from a list of what

you've recently eaten and results from the proper laboratory tests.

Diagnostic tests for foodborne illness should include examination of the

feces. A sample of the suspected food, if available, can also be tested

for bacteria and their toxins as well as for viruses and parasites.

Treatment

Most cases of foodborne illness are mild and can be treated by increasing

fluid intake, either orally or intravenously, to replace lost fluids and

electrolytes. In cases with gastrointestinal or neurologic symptoms,

people should seek medical attention.

In the most severe situations, such as HUS, the patient may need

hospitalization in order to receive supportive nutritional and medical

therapy. Maintaining adequate fluid and electrolyte balance and

controlling blood pressure are important. Doctors will try to minimize

the impact of reduced kidney function. Early dialysis is crucial until

the kidneys can function normally again, and blood transfusions may be

needed.

Prevention

Most cases of foodborne illness can be prevented through proper cooking

or processing of food, which kills bacteria. In addition, because

bacteria multiply rapidly between 40°F and 140°F, food must be kept out

of this " danger zone. "

To prevent harmful bacteria from growing in food, always:

•Refrigerate foods promptly. If you let prepared food stand at room

temperature for more than 2 hours, it may not be safe to eat. Set your

refrigerator at 40°F or lower and your freezer at 0°F.

•Cook food to the appropriate temperature (145°F for roasts, steaks, and

chops of beef, veal, and lamb; 160°F for pork, ground veal, and ground

beef; 165°F for ground poultry; and 180°F for whole poultry). Use a

thermometer to be sure! Foods are properly cooked only when they are

heated long enough and at a high enough temperature to kill the harmful

bacteria that cause illness.

•Prevent cross-contamination. Bacteria can spread from one food product

to another throughout the kitchen and can get onto cutting boards,

knives, sponges, and countertops. Keep raw meat, poultry, seafood, and

their juices away from other foods that are ready to eat.

•Handle food properly. Always wash your hands before touching food and

after using the bathroom, changing diapers, or handling pets, as well as

after handling raw meat, poultry, fish, shellfish, or eggs. Clean

surfaces well before preparing food on them.

•Keep cold food cold and hot food hot.

•Maintain hot cooked food at 140°F or higher.

•Reheat cooked food to at least 165°F.

•Refrigerate or freeze perishables, prepared food, and leftovers within 2

hours.

•Never defrost food on the kitchen counter. Use the refrigerator, cold

running water, or the microwave oven.

•Never let food marinate at room temperature; refrigerate it.

•Divide large amounts of leftovers into small, shallow containers for

quick cooling in the refrigerator.

•Remove the stuffing from poultry and other meats immediately and

refrigerate it in a separate container.

•Do not pack the refrigerator. Cool air must circulate to keep food safe.

Food Irradiation

Food irradiation is the treatment of food with high energy such as gamma

rays, electron beams, or x rays as a means of cold pasteurization, which

destroys living bacteria, to control foodborne disease. The United States

relies exclusively on the use of gamma rays, which are similar to

ultraviolet light and microwaves and pass through the food leaving no

residue or " radioactivity. " Food irradiation is currently approved for

wheat, potatoes, spices, seasonings, pork, poultry, red meats, whole

fresh fruits, and dry or dehydrated products. Although irradiation

destroys many bacteria, it does not sterilize food. Even if you're using

food that has been irradiated by the manufacturer, you must continue to

take precautions against foodborne illness, through proper refrigeration

and handling, to safeguard against any surviving organisms.

Links to Other Disorders

Scientists suspect that foodborne pathogens are linked to chronic

disorders and can even cause permanent tissue or organ destruction.

Research suggests that when some people are infected by foodborne

pathogens, the activation of their immune system can trigger an

inappropriate autoimmune response, which means the immune system attacks

the body's own cells. In some people, an autoimmune response leads to a

chronic health condition.

Chronic disorders that may be triggered by foodborne pathogens are:

•arthritis

•inflammatory bowel disease

•kidney failure

•Guillain-Barré syndrome

•autoimmune disorders

Further research is needed to explain the link.

Common Sources of Foodborne Illness

Source of illness: Raw and undercooked meat and poultry

Symptoms: Abdominal pain, diarrhea, nausea, and vomiting

Bacteria: Campylobacter jejuni, E. coli O157:H7, L. monocytogenes,

Salmonella

Source of illness: Raw (unpasteurized) milk and dairy products, such as

soft cheeses

Symptoms: Nausea and vomiting, fever, abdominal cramps, and diarrhea

Bacteria: L. monocytogenes, Salmonella, Shigella, Staphylococcus aureus,

C. jejuni

Source of illness: Raw or undercooked eggs. Raw eggs may not be

recognized in some foods such as homemade hollandaise sauce, caesar and

other salad dressings, tiramisu, homemade ice cream, homemade mayonnaise,

cookie dough, and frostings.

Symptoms: Nausea and vomiting, fever, abdominal cramps, and diarrhea

Bacteria: Salmonella enteriditis

Source of illness: Raw or undercooked shellfish

Symptoms: Chills, fever, and collapse

Bacteria: Vibrio vulnificus, Vibrio parahaemolyticus

Source of illness: Improperly canned goods, and smoked or salted fish

Symptoms: Double vision, inability to swallow, difficulty speaking, and

inability to breathe (seek medical help right away!)

Bacteria: C. botulinum

Source of illness: Fresh or minimally processed produce

Symptoms: Diarrhea, nausea, and vomiting

Bacteria: E. coli O157:H7, L. monocytogenes, Salmonella, Shigella,

Yersinia enterocolitica, viruses, and parasites

Points to Remember

Foodborne illness results from eating food that is contaminated with

bacteria, viruses, or parasites.

People at greater risk for foodborne illness include young children,

pregnant women and their fetuses, the elderly, and people with lowered

immunity.

Symptoms usually resemble intestinal flu. See a doctor immediately if you

have more serious problems, or if you do not seem to be improving as

you'd expect.

Treatment may range from replacement of lost fluids and electrolytes for

mild cases of foodborne illness, to hospitalization for severe conditions

such as hemolytic uremic syndrome.

You can prevent foodborne illness by taking the following precautions:

•Wash your hands with hot, soapy water before preparing food and after

using the bathroom or changing diapers.

•Keep raw meat, poultry, or seafood and their juices away from

ready-to-eat foods.

•Cook foods properly and at a high enough temperature to kill harmful

bacteria.

•Refrigerate foods within 2 hours or less after cooking because cold

temperatures will help keep harmful bacteria from growing and

multiplying.

•Clean surfaces well before using them to prepare foods.

For More Information

American Dietetic Association

120 South Riverside Plaza, Suite 2000

Chicago, IL 60606-6995

Consumer Nutrition Hotline: 1- or 1-

Internet: www.eatright.org

U.S. Department of Agriculture

14th & Independence Avenue SW.

Washington, DC 20250

Meat and Poultry Hotline: 1-

Internet: www.usda.gov

U.S. Department of Health and Human Services

200 Independence Avenue SW.

Washington, DC 20201

Phone: 1- or

Internet: www.os.dhhs.gov

U.S. Environmental Protection Agency (EPA)

Ariel Rios Building

1200 Pennsylvania Avenue NW.

Washington, DC 20460

Phone:

Internet: www.epa.gov

U.S. Food and Drug Administration

FDA (HFE-88)

5600 Fishers Lane

Rockville, MD 20857-0001

Phone: 1-888-INFO-FDA (463-6332)

Internet: www.fda.gov

Center for Food Safety & Applied Nutrition

5100 Paint Branch Parkway

College Park, MD 20740-3835

Food Information Line: 1-888-SAFEFOOD (723-3366)

Internet: http://vm.cfsan.fda.gov/list.html

Centers for Disease Control and Prevention

1600 Clifton Road

Atlanta, GA 30333

Phone: 1- or

Internet: www.cdc.gov

Gateway to Government Food Safety Information

Internet: www.FoodSafety.gov

Partnership for Food Safety Education

Internet: www.fightbac.org

Marilyn

Moderator for

Diabetic_Recipes

dnevessr@...

Opinions expressed are solely

my own and should not be

mistaken for

Professional advice.