Foodborne Illness


INTERNATIONAL FOOD SAFETY CONSULTANCY
DR WILLEM MARSMAN

 

*     What can I do to protect myself from food poisoning?

*     What should you do if you have a problem with a food product?

*     What food and drugs can cause severe side effects when taken during the same time period?

*     Why should older people be especially concerned about food safety?

*     What food safety advice is there for persons with AIDS?

*     What are the food safety concerns with sprouts

 

 

What can I do to protect myself from food poisoning?

 


Follow the food safety rules listed below:

 

 

*  Buy only pasteurised dairy products, as indicated on the label, and hard cheeses marked "aged 60 days" (or longer) if unpasteurised milk is used to make them.

 

*  After you've handled or cut raw meat, poultry or seafood, wash your hands, the cutting board, counter, knives, and any other utensils you've used with hot soapy water before you use them again to prepare any other food.

*  Thoroughly cook all meat, poultry and seafood, especially shellfish.

*  Cover and store leftover cooked food in the refrigerator as soon as possible.

*  Reheat all leftovers until they are steaming hot.

*  Thoroughly wash raw fruits and vegetables with tap water.

*  Follow label instructions on products that must be refrigerated or that have a "use by" date.

*  Keep the inside of the refrigerator and the counter tops clean.

 

What to do if you have a problem with Food Products

 

Problems:

 

  1. Your hot dog has a strip of plastic inside.
  2. The canned chilli contains a metal washer
  3. You think a restaurant dinner made you ill.
  4. D sugar-coated roach was in your box of cereal.

 

What can you do?

 

FOR HELP WITH MEAT, POULTRY AND EGG PRODUCTS (examples A and B): Call the toll free:

 

FOR HELP WITH RESTAURANT FOOD PROBLEMS (example C):  Call the Health Department in your city, country or state.

 

FOR HELP WITH NON-MEAT FOOD PRODUCTS (example D): For complaints about food products which do not contain meat or poultry – such as cereal – call:

 

In order for the officials to investigate a problem with meat, poultry or egg products, you must have:

 

  1. The original container or packaging:
  2. The foreign object (the plastic strip, or metal washer, for example) and
  3. Any uneaten portion of the food (refrigerate or freeze it).

 

Information you should be ready to tell the Hotline on the phone includes:

 

  1. Your name, address and phone number:
  2. The brand name, product name and manufacturer of the product;
  3. The size and package type;
  4. Can or package codes (not UPC bar codes) and dates;
  5. Establishment number (EST) usually found in the circle or shield near the “passed and inspected” phrase;
  6. Name and location of store and date you purchased the product.
  7. You can complain to the store or the product’s manufacturer if you don’t choose to make a formal complaint.

 

IF YOU THINK YOU ARE ILL, SEE A PHYSICIAN.

 

  1. If an injury or illness allegedly resulted from use of a meat or poultry product, you will also need to tell the Hotline staff about the type, symptoms, time of occurrence and name of attending health professionals (if applicable).
  2. If you can’t reach the Hotline staff, or if an injury or illness allegedly resulted from restaurant food, call your local Health Department.
  3. If an injury or illness allegedly resulted form non-meat food products, call or write to……………

 

THE BOTTOM LINE: If you sense there is a problem with any food product, don’t consume it.

“When in doubt, throw it out”.

 

 

 

What food and drugs can cause severe side effects when taken during the same time period?

 

 

Medicines can treat and cure many health problems.  However they must be taken properly to ensure that they are safe and effective.  Many medicines have powerful ingredients that interact with the human body in different ways, and diet and lifestyle can sometimes have a significant impact on a drug’s ability to work in the body.  Certain foods, beverages, alcohol, caffeine, and even cigarettes can interact with medicines.  This may make them less effective or may cause dangerous side effects or other problems.

 

When you take medicine, be sure to follow your doctor’s instructions carefully to obtain the maximum benefit with the least risk.  Changes in a medicine’s effect due to an interaction with food, alcohol or caffeine can be significant; however, there are many individual factors that influence the potential for such variations, like dose, age, weight, sex and overall health.

 

This article has information about possible interactions between many common prescriptions and non-prescription (over the counter) medications with food, alcohol and caffeine.  But this article should not replace the advice from your physician, pharmacist, or other health care professional.  If you have any questions or concerns about possible drug interactions, consult your health care professional.

 

Make sure your doctor and pharmacist know about every drug you are taking, including non-prescription drugs and any dietary supplements such as vitamins, minerals and herbals.  If you have problems or experience side effects related to medication, call your health care provider right away.  It is also important to remember that many drugs interact with other drugs and may cause serious medical conditions.

 

*       Allergies

*       Arthritis and Pain

*       Asthma

*       Cardiovascular Disorders

*       Infections

*       Mood Disorders

*       Stomach Conditions

 

Not only can drugs interact with food and alcohol, they can also interact with each other.  Some drugs are given together on purpose for an added effect, like codeine and acetaminophen for pain relief.  But other drug-to-drug interactions may be unintended and harmful.  Prescription drugs can interact with each other or with over-the-counter (OTC) drugs, such as acetaminophen, aspirin, and cold medicine. Likewise, OTC drugs can interact with each other.

 

Sometimes the effect of one drug may be increased or decreased.  For example, tricyclic antidepressants such as amitriptyline (ELAVIL), or nortriptyline (PAMELOR) can decrease the ability of clonidine (CATAPRES) to lower blood pressure.  In other cases, the effects of a drug can increase the risk of serious side effects.  For example, some antifungal medications such as itraconazole (SPORANOX) and ketoconazole (NIZORAL) can interfere with the way some cholesterol lowering medications are broken down by the body.  This can increase the risk of a serious side effect.

 

Doctors can often prescribe other medications to reduce the risk of drug-drug interactions.  For example, two cholesterol lowering drugs – pravastatin (PRAVACHOL) and fluvastatin (LESCOL), are less likely to interact with antifungal medications.  Be sure to tell your doctor about all medications – prescriptions and OTC – that you are taking.

 

 

Seniors need wisdom on Food Safety

 

An old adage states, “With age, comes wisdom.”  Hopefully that wisdom includes lots of good food safety information.  Why?  As we mature, our bodies change.  Seniors become more at-risk for illness and, once ill, it can take them longer to recover.

 

Knowledge of safe food handling is needed to help seniors stay healthy.  It’s important to understand the effect of pathogens and other micro-organisms on elderly bodies.  The best preventative is understanding the safeguards necessary to remain free from foodborne illness.

 

Some of the changes seniors undergo lessen the body’s ability to combat bacteria.  For example, there is a decrease in stomach acid secretion, which is a natural defence against ingested bacteria.  And over time, the immune system may become less adept in ridding the body of bacteria.

 

Too, the sense of taste or smell – sometimes affected by medication or illness – may not always sound an alert when meat is spoiled or milk may be sour.  By knowing how the body changes and using safe food handling techniques, seniors can easily protect themselves and reduce the risk of foodborne illness.

 

Some seniors are homebound and must rely on delivered food.  Others are new widowers with little cooking experience.  Whether seniors are part of these groups or experienced cooks, adhering to the following up-to-date food safety guidelines is just plain good wisdom.

 

GUILDELINES FOR SAFE FOOD HANDLING

 

1.           Keep it safe, refrigerate or freeze.  Refrigerate or freeze all perishable foods.  Refrigerator temperature should be 40° F or less (4.4° C); freezer temperature should be 0°F or less (-17.78°C) .  Use a refrigerator/freezer thermometer to check the temperatures.

2.           Never thaw food at room temperature.  Always thaw food in the refrigerator, or in cold water or in a microwave.  When thawing in the microwave, you must cook the food immediately.

3.           Wash hands with warm soapy water before preparing food.  Wash hands, utensils, cutting boards and other work surfaces after contact with raw meat and poultry.  This helps prevent cross contamination.

4.           Never leave perishable food out of refrigeration over two hours.  If room temperature is 90°F (32.22°C) or above food should not be left out over 1 hour.  This would include items such as take-out foods, leftovers from a restaurant meal and meals-on-wheels deliveries.

5.           Thoroughly cook raw meat, poultry and fish (see chart of internal temperatures).  Do not partially cook food.  Have a constant heat source, and always set the oven at 325°F (162.78°C) or higher when cooking.  There is no need to bring food to room temperature before cooking.

 

 

FOODS PURCHASED OR DELIVERED HOT

 

Eating Within Two Hours?

 

Pick up or receive the food HOT …….and enjoy eating within two hours.

 

Not Eating Within Two Hours?

 

Keeping food warm is not enough.  Harmful bacteria can multiply between 40°F (4.4°C) and 140°F (60°C).

 

Set oven temperature high enough to keep the hot food at 140°F (60°C) or above.  Check internal temperature of food with a meat thermometer.  Covering with foil with help keep the food moist.

 

Eating Much Later?

 

It’s not a good idea to try and keep the food hot longer than two hours.  Food will taste better and be safely stored if you:

 

*  Place in shallow containers.

*  Divide large quantities into smaller portions.

*  Cover loosely and refrigerate immediately.

*  Reheat thoroughly when ready to eat.

 

 

Reheating?

 

Reheat thoroughly to temperature of 165°F (73.89°C) or until hot and steaming.  In the microwave oven, cover food and rotate so it heats evenly.  Allow stand time for more even heating.

 

Consult your microwave owner’s manual for recommended cooking time, power level and stand time.  Inadequate heating can contribute to illness.

 

FOODS PURCHASED OR DELIVERED COLD

 

Keep Cold Food Cold

 

Eat or refrigerate immediately.  Cold food should be held at 40°F (4.4°C) or colder.

 

The Two Hour Rule

 

Perishable food should not be at room temperature longer than two hours.  Discard food which has been left at room temperature longer than two hours.  For room temperatures over 90°F (32.2°C),discard food after one hour.

 

MINIMUM INTERNAL COOKING TEMPERATURES

 

We recommend the following:

 

Fresh ground beef, veal, lamb and pork

160°F (71.11°C)

Beef, veal, lamb – roasts, steaks and chops

 

Medium

160°F

Well done

170°F (76.67°C)

Fresh pork – roasts, steaks, chops

 

Medium

160°F

Well done

170°F

Ham

 

Cook before eating

160°F

Fully cooked, to reheat

140°F (60°C)

Poultry

 

Ground chicken, turkey

165°F (73.89°C)

Whole chicken, turkey

180°F (82.22°C)

Breasts, roasts

170°F

Thighs and wings

Cook until juices run clear

Egg dishes, casseroles

160°F

Leftovers

165°F

 

COLD STORAGE

 

PRODUCT

REFRIGERATOR (40°F) (4.4°C)

FREEZER (0°F)

Eggs

 

 

Fresh, in shell

3 weeks

Don’t freeze

Hardcooked

1 week

Don’t freeze well

TV Dinners

Keep frozen until ready to use

 

 

3-4 months

Deli prepared convenience foods such as egg, chicken, ham and macaroni salads

 

3-5 days

 

Don’t freeze well

Hotdogs and Lunch Meats

 

 

Hotdogs, opened package

1 week

1-2 months

Hotdogs, unopened package

2 weeks, but not more than one week after the “sell-by” date

 

1-2 months

Lunch meats, opened

3-5 days

1-2 months

Lunch meats, unopened

2 weeks

1-2 months

Deli sliced luncheon meats

3-5 days

Don’t freeze well

Soups and Stews

Vegetable or meat added

 

3-4 days

 

2-3 months

Ground Meat and Poultry

1-2 days

3-4 months

Bacon

7 days

1 month

Sausage

1-2 days

1-2 months

Ham

 

 

Ham, fully cooked - whole

7 days

1-2 months

Ham, fully cooked - half

3-5 days

1-2 months

Ham, fully cooked - slices

3-4 days

1-2 months

Fresh Meat

 

 

Beef, steaks and roasts

3-5 days

6-12 months

Pork, chops and roasts

3-5 days

4-6 months

Lamb, chops and roasts

3-5 days

6-9 months

Veal

3-5 days

4-8 months

Meat leftovers

3-4 days

2-3 months

Fresh Poultry

 

 

Chicken or turkey, whole

1-2 days

1 year

Chicken or turkey pieces

1-2 days

9 months

Poultry Leftovers

3-4 days

4 months

 

 

Eating Defensively:

Food Safety Advice for Persons with AIDS

 

Bacteria and Food Poisoning

 

“It must have been something I ate!”  How many times do people say this following about of nausea, upset stomach, cramps, diarrhea, or vomiting?

 

Indeed, these can be the symptoms of food poisoning – illness caused by eating food on which harmful bacteria have grown.  The bacteria that cause food poisoning are difficult to detect by food’s appearance, taste or smell. But they can cause illness ranging from mild to very severe and even life-threatening.  The human body ordinarily is well-equipped to deal with these bacteria, but individuals with weakened immune systems – such as those with acquired immune deficiency syndrome (AIDS) and those infected with the human immunodefiency virus (HIV) – can be at far greater risk of serious illness.  Because of their weakened immune systems, these individuals are more susceptible to contacting a food borne illness.  Once contracted, these infections, with their severe vomiting and diarrhea, can be difficult to treat and they can come back again and again.  This can further weaken the immune system and hasten the progression of HIV infection and be fatal for persons with AIDS.

 

Since most foodborne illnesses result from improper handling of food, persons with AIDS or HIV infection can help themselves by following basic food safety guidelines.  Applying these guidelines when buying, preparing and storing food, along with having a basic knowledge of the most common harmful bacteria and the foods on which they are found or can grow, call allow persons with AIDS to eat defensively while choosing a nutritious diet.

 

People cannot get AIDS from food.  The food safety advice in this article is intended to help persons with HIV infection to reduce the risk of food poisoning, thereby avoiding an illness that could worsen their condition or even cause death.  While many kinds of bacteria can cause food poisoning, three are the most prevalent threat to persons with AIDS and HIV infections.  These are:  Campylobacter, Listeria and Salmonella.

 

The symptoms of Campylobacter infection (campylobacteriosis) include acute abdominal pain, diarrhea (which can be watery and contain blood), nausea, headache, muscle pain, and fever.  Symptoms can begin 2 to 5 days after eating contaminated food and generally lasts 7 to 10 days.  Campylobacter bacteria are most commonly found in raw or undercooked poultry, unpasteurised milk and non-chlorianted water.

 

Listeriosis, the disease caused by Listeria, is characterised by flu-like symptoms of chills, fever and headache, sometimes accompanied by nausea and vomiting.  These early symptoms can appear 2 to 30 days after exposure and can be followed by bacteremia (a bloodstream infection) meningitis (an inflammation of the membranes covering the spinal cord  and brain) or encephalitis (an inflammation of the membranes of the brain itself).  Foods found to contain Listeria are unpasteurised milk and cheeses, raw or undercooked meat, poultry and fish.

 

Salmonellosis is the illness that can develop from eating foods containing Salmonella bacteria.  It is characterised by flu-like symptoms, possible accompanied by nausea, vomiting, abdominal cramps, and diarrhea.  Symptoms can develop 6 to 48 hours after exposure and last up to a week.  Foods most often associated with salmonellosis include raw or undercooked meat, poultry, fish and eggs.

 

 

 

Shopping for Food

 

For persons with AIDS, it is especially important to read food labels to select foods that pose the lest risk of food poisoning.  For example, all milk and cheese products should have the word “pasteurised” on the label.  Products that contain any raw or undercooked meat or dairy product should be avoided, as well as products with a “sell by” or “best used by” date that has passed.

 

It is a good idea to put packaged meat, poultry or fish into a plastic bag before placing it in the shopping cart.  This prevents drippings from coming into contact with other foods and thus reduces the risks of cross contamination – bacteria from one food contaminating another food.

 

The sale of food products with damaged packaging, the unsafe displaying of products (such as cooked shrimp on the same bed of ice as raw seafood), workers with poor personal hygiene, and unsanitary store conditions can add to the risk of foodborne illness.  Not only should consumers avoid purchasing food products sold under such conditions, but the conditions should be reported to local health authorities.

 

After shopping, get chilled and frozen foods into refrigerator or freezer as soon as possible.  Storing them in a warm car or office or even just carrying them around for a couple of hours can raise the foods’ temperature enough to allow bacteria to grow.

 

At Home

 

Most cases of food poisoning are caused by improper food handling or preparation in the home.  Keeping shelves, counter tops, refrigerators, freezers, utensils, sponges and towels clean is one of the best ways to prevent bacterial contamination of food at home.  It is especially important to wash all utensils and your hands with soap and hot water after handling one food and before handling another.  This helps prevent cross contamination in which, for example bacteria in raw meat could be transferred to other foods, such as salads or vegetables.  For the same reason, wooden cutting boards should not be used for cutting raw meat, poultry or fish.  Plastic boards are easier to clean and sanitize.  Fresh fruits and vegetable should be thoroughly washed with water and refrigerated to reduce spoilage, the temperature should be maintained at or below 40°F and food should be stored in covered containers.

 

Properly cooking food is another important guard against food poisoning.  Heat kills bacteria.  Most cookbooks give appropriate cooking times and temperature for different foods.  A meat thermometer should be used to ensure complete cooking.  Cook red meat until it is well done and poultry until the juices run clear.  Thoroughly reheat leftovers (165°F).

 

Never eat raw eggs or foods that contain them.  Pasteurised eggs should be used in place of shell eggs when making homemade ice cream, eggnog and mayonnaise.  If you can’t obtain pasteurised eggs, then you must omit the egg ingredient when making homemade ice cream.  When cooking eggs, make sure that the yolk and white are firm, not runny.  Here are cooking times and temperatures:

 

*  Scrambled – 1 minute at medium stove top setting (250°F for electric frying pans)

*  Sunnyside – 7 minutes at medium setting (250°F) or cook covered 4 minutes at 250°F

*  Fried, over easy – 3 minutes at medium setting (250°F) on one side, then turn and fry for another minute on the other side

*  Poached, - 5 minutes in boiling water

*  Boiled – 7 minutes in boiling water

 

Microwave cooking requires special precautions.  Most microwave recipes include a “standing time” after the cooking period to ensure that a proper temperature is reached throughout the food.  Also, many microwave dishes must be removed from the oven and stirred from time to time-again, ensuring thorough cooking.  It is particularly important to heat pre-cooked foods or leftovers thoroughly, whether in a microwave or conventional oven.

 

Eating Out

 

Restaurants, like grocery stores, are required to follow sanitation guidelines established by state and local health departments to ensure cleanliness and good hygiene.  Persons with AIDS need to avoid the same foods in restaurants that they would at home.  Always order food well-done; if it is served medium to rare, send it back.  A good way to determine doneness is to cut into the corner of a steak, hamburger, or other piece of meat.  If it is the least bit pink or bloody, it needs more cooking.  Fish should be flaky, not rubbery, when cut.

 

Order  fried eggs cooked on both sides instead of sunny side up, and avoid scrambled eggs that look runny.  Caesar salad should also be avoided since it contains raw eggs.  If unsure about the ingredients in a particular dish, ask before ordering.

 

Raw seafood poses a serious risk of food poisoning for persons with AIDS.  Raw shellfish, like raw meat and poultry, should be assumed to harbour harmful bacteria.  Oysters on the half shell, raw clams, sushi and sashimi should not be eaten.  Lightly steamed seafood, such as mussels and snails, should be avoided.

 

Travelling Abroad

Not all countries have the same high standard of hygiene and sanitation, so persons with AIDS should take additional precautions before travelling abroad.

 

Boil all water before drinking.  Drink only beverages made with boiled water or canned or carbonated bottled drinks.  Ice, too, should be made only from boiled water.  Avoid uncooked vegetables and salads.  Eat cooked foods while they are still hot.

 

A good rule of thumb is “Boil it, cook it, peel it or forget it”.

 

While food poisoning can usually be treated with rest and plenty fluids until solid food can be eaten again, persons with AIDS or HIV infection may experience prolonged and more serious symptoms requiring a doctor’s care.

 

If a consumer or doctor believes that an attack of food poisoning was related to a particular food, or restaurant, the local health department should be contacted.  Reporting the incident to health officials can help others avoid serious illness.

 

These food safety guidelines for persons with AIDS or HIV infection are no different than those recommended for anyone.  But, in the case of persons with AIDS or HIV infection, contaminated food can have more serious consequences.

 

There are other high-risk groups – such as cancer patients, diabetics, transplant recipients, infants, pregnant women, and the elderly – who should also give special attention to those guidelines.  For individuals in these high-risk groups, maintaining a nutritious diet is of great importance.  Cooing and eating defensively need not interfere with a nutritious diet.  But not being aware of the hazards and not taking appropriate steps to reduce the risk food poisoning can be life-threatening.

 

 

 

 

CONSUMERS ADVISED OF RISKS ASSOCIATED

 WITH RAW SPROUTS

 

Because of reports of increasing numbers of illnesses associated with consumption of raw sprouts, the health officials  are advising all persons to be aware of the risks associated with eating raw sprouts, (e.g. alfalfa, clover, radish).  Outbreaks have included persons of both genders and all age categories.  Those persons who wish to reduce the risk of foodborne illness from sprouts are advised not to eat raw sprouts.

 

This advise is particularly important for children, the elderly, and persons with weakened immune systems, all of whom are at high risk of developing serious illness due to foodborne  disease.  People in high risk categories should not eat raw sprouts.

 

This advisory is updated from a previous health advisory used August 31, 1998 (U.S.), and is based on additional information from clover and alfalfa sprout-associated salmonellosis outbreaks from January through May 1999.  Two outbreaks were associated with clover sprouts: one occurred in California in May and involved approximately 30 cases; a second outbreak in Colorado from March through May involved approximately 70 cases.  In addition, from January through March an outbreak of salmonellosis affecting approximately 85 people occurred in Oregon, Washington, and California and was associated with the consumption of alfalfa sprouts.

 

Since 1995, raw sprouts have emerged as a recognised source of foodborne illness in the United States.  These illnesses have involved the pathogenic bacteria Salmonella and E.coil O157.  Alfalfa and clover sprouts have been involved most often, but all raw sprouts may pose a risk.

 

The sprout industry has been working in cooperation with government, academia, and other industry segments to enhance the safety of its product.  These efforts have focused primarily on seed treatment strategies, good manufacturing practices, and sanitation.

 

“Despite all these efforts to make raw sprouts safer, we continue to receive reports of illnesses associated with raw sprouts.  Consumers need to understand that, at this time, the best way to control this risk is not to eat raw sprouts”.

 

Although infections with Salmonella and E.coli 0157 can cause serious illness, the illness is generally self-limiting in most health adults.  However, an E.coli O157 infection can lead to haemolytic uremic syndrome with resultant kidney failure or death in children, and equally serious complication in elderly. Salmonella infections can cause serious illness in children, the elderly and the immune compromised.  Healthy persons infected with these bacteria experience diarrhea, nausea, abdominal cramping and fever for several days.

 

The following advice to all consumers concerning sprouts:

 

*  Cook sprouts.  This significantly reduces the risk of illness.

*  Check sandwiches and salads purchased at restaurants and delicatessens.  These entrees often contain raw sprouts.  Consumers who wish to reduce their risk of foodborne illness should specifically request that raw sprouts not be added to their food.

*  Sprouts grown in the home also present a risk if eaten raw.  Many outbreaks have been attributed to contaminated seed.  If pathogenic bacteria are present in or on seed, they can grow to high levels during sprouting even under clean conditions.

 

Consumers who have eaten raw sprouts and are experiencing diarrhea or other symptoms of foodborne infections are advised to consult health care providers.