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FOODBORNE ILLNESSES - PART II: A Survival GuideApr 1, 2004 In last month’s Newsletter, we gave our readers the latest information about the alarming number of critical violations found in the major fast-food restaurant chains and the effect that media attention has had in getting those chains to clean up their act. This month, we will be providing you with critical information about the most serious and widespread foodborne illnesses.
The types of critical violations discussed in Part I included conditions that are most commonly known to cause outbreaks of foodborne illnesses. Hopefully, both sections of this two-part Newsletter will serve as a “survival guide” to the general public and educate people as to what to expect when eating out and what to do when faced with the onset of a suspected foodborne illness.
Foodborne illnesses are among the most debilitating and potentially deadly sicknesses the public is exposed to on a regular basis. In fact, contracting a foodborne illness is relatively easy given the “right” circumstances. These include dirty restaurants, food that is contaminated or improperly cooked or stored, the presence of vermin or bacteria, or sick food handlers. The Centers for Disease Control estimates that there are about 76 million cases of foodborne illness reported in the United States each year. According to this statistic, one in four Americans contracts a foodborne illness from something they eat at a restaurant or buy from a food store every year.
Out of the millions of people who have symptoms of foodborne illnesses ranging from mild to severe, approximately 350,000 people are hospitalized and 5,000 die. In the last few years there have been massive food recalls and consumer advocate groups have made people increasingly aware of the risks to America’s food supply. (See our Newsletters of February and September 2002). Still, too many Americans are not fully aware of the impact a foodborne illness could have on themselves or their families (especially children) and most see it as something that could never happen to them.
Below, we have provided comprehensive and tangible information about seven major foodborne illnesses: E. coli; Norwalk Virus; Salmonella; Listeria; Shigella; Hepatitis; and Campylobacter. For each one of these illnesses we will list some general information and background, all known symptoms and how to detect them, what to do if you have contracted the illness, and a few key news items regarding the illness. It is extremely important that people take the time to learn about foodborne illnesses as most can be treated and cured if diagnosed quickly. When left untreated, however, many of these illnesses may have serious, or even deadly, consequences.
The E. coli bacteria, short for Escherichia coli, were first discovered in the human colon in 1885 by German bacteriologist Theodor Escherich. E. coli can grow in air using oxygen as a terminal electron acceptor (aerobically) or by fermentative metabolism (anaerobically). This means that there are several conditions which can lead to E. coli development. Interestingly, the majority of E. coli strains are harmless. Yet in certain circumstances, the bacteria can become extremely dangerous and once it appears, it will spread rather quickly. Because there are so many different types of E. coli, they are classified and split into groups. E. coli O157: H7, the harmful form of the bacteria, was identified for the first time at the U. S. Centers for Disease Control in 1975.
E. coli O157: H7 usually takes about 3-9 days to incubate. It affects the body by traveling through the stomach and small intestine, and then attaching itself to the inside surface of the large intestine, causing inflammation of the intestinal wall. This inflammatory reaction is caused by toxins secreted by the bacteria, which then causes hemorrhagic colitis. Hemorrhagic colitis is characterized by the sudden onset of abdominal pain and severe cramps, followed within 24 hours by diarrhea as well as vomiting in some cases. As the disease progresses, the diarrhea becomes watery and then bloody.
In most cases, the illness lasts about a week and is cured without any long term problems. There is still no known “cure” for E. coli and antibiotics which are usually prescribed may not always help. It is thought now, however, that the bacteria initially speed up blood coagulation that may then lead to serious future medical consequences.
While most people, however, fully recover within two weeks, a small percentage of infected individuals, primarily children, go on to develop a severe, life-threatening complication known as hemolytic uremic syndrome (HUS). E. coli O157: H7 is responsible for over 90% of the cases of HUS that develop in North America and is the most common cause of kidney failure in children. HUS is believed to develop when E. coli enters into circulation through the inflamed bowel wall, releasing a specific chemical system known as shiga-like toxin (SLT) which attaches to receptors on the inside surface of blood vessel cells. Some organs that are more susceptible to HUS are the kidney, pancreas, and brain.
Currently, there is nothing that will halt the progression of HUS. The active stage of the disease usually lasts one to two weeks, during which a variety of complications are possible. About 5% of individuals affected with HUS die while other consequences include dialysis due to kidney failure, pancreatitis, seizures, and diabetes mellitus.
Another severe condition that can be caused by E. coli bacteria is thrombotic thrombocytopenic purpura (TTP), otherwise described as “adult HUS.” TTP affects most of the major body organs, including the heart, brain, kidneys, pancreas and adrenals. Other organs are involved to a lesser degree. Symptoms and warning signs of TTP include vomiting, diarrhea, malaise, weakness, hypertension, headache, confusion, stupor, coma, and seizures.
E. coli, while curable and certainly not always life threatening can be quite unpleasant. Therefore, it is important to be aware of the various ways in which it is possible to contract this foodborne illness. People have reported obtaining the virus from several different foods and situations; however, eating undercooked ground beef remains the number one risk factor for acquiring the E. coli virus. Whether eating out or cooking at home, always make sure that ground beef and hamburgers are cooked thoroughly as they can turn brown and appear ready to eat long before disease causing bacteria are actually killed. Never eat ground beef patties that are still pink in the middle.
While the meat itself can be harmful, anything that touches E. coli bacteria can become a hazard as well. To avoid spreading dangerous bacteria in the kitchen; always keep raw meat separate from ready-to-eat foods; wash hands, counters, and utensils with hot soapy water after they touch raw meat; and never place cooked hamburgers or ground beef back on the plate that held raw patties unless it has been thoroughly washed.
Be aware of the food you buy for yourself and your family. Milk, juice, or cider that is not pasteurized can also be quite problematic and may contain harmful pathogens. Check the label and ask a supermarket employee if you are still unsure. Fruits and vegetables bought at the store or the market should always be washed thoroughly, especially those that will not be cooked.
Food-related situations are not the only time E. coli can be a risk. Public places can be a veritable breeding ground for harmful germs or bacteria. Places like pools or lakes, which are constantly filled with people, and even animals, are just two examples. You should never drink or swallow pool or lake water while swimming.
As in the aforementioned situation, people themselves, not food, can sometimes be the problem. People with diarrhea, especially children, spread bacteria like E. coli if they do not wash their hands carefully with soap after bowel movements. If you have diarrhea, you should avoid swimming in public pools or lakes, sharing baths with others, and preparing food without proper protection. Likewise, you should avoid these situations if a friend or family member has diarrhea.
Over the years there have been many serious outbreaks of E. coli. In most cases, it is not an illness that affects isolated people. The following is a brief summary of a few serious outbreaks of E. coli.
• In 1998, 10 elementary school children in Yakima, Washington, were sickened after eating undercooked taco meat from their school cafeteria. Another child, of preschool age, contracted the virus from coming into contact with one of the other children. This child now has permanent kidney damage and will require several kidney transplants throughout her life. Nine of the families sued the school as they believed it was the school’s responsibility to serve uncontaminated meat to the children. The meat was distributed to the school district by the USDA commodity program which buys meat from the lowest bidder. The beef in question had 171 food safety violations and was classified as critical yet it was still served in the cafeteria. The meat, which was not safe to begin with, was not cooked properly, leading the state to conclude that the problem was indeed the hamburger meat and not something else in the cafeteria.
* In June of 2002, 18 children in Rockland County, New York, contracted the E. coli virus. The source was never really found but it was concluded to be a person-to-person transmission. Kids are especially susceptible to bacterial infections such as E. coli.
* In July of 2002, ConAgra, a major Colorado-based meat company, recalled 19 million pounds of ground beef after an E. coli outbreak was linked to their meat. About 30 people contracted the foodborne illness and sued for a total of $50 million for compensatory damages. At the time of the outbreak, the plant was shut down, in part, due to feces found on beef carcasses.
* E. coli found in unpasturized apple juice/cider was responsible for a number of outbreaks across the country between 1991 and 1999. In at least one case, a young child died from the effects of the bacteria.
* Between 1988 and 2002, there were 34 major outbreaks of E. coli in the United States.
The Norwalk Virus is extremely common in the United States and again, while not always deadly, it can make for an extremely uncomfortable situation. In fact, the common cold is the only virus reported more frequently than Norwalk Virus, otherwise referred to as viral gastroenteritis. Norwalk and Norwalk-like viruses are increasingly being recognized as leading causes of food borne disease in the United States.
Norwalk Virus is a product of Norwalk, a virus contained in a round blue protein ball that attaches to the outside of cells lining your intestine. Norwalk transfers its genetic material into intestinal cells then reproduces, finally killing the human cell to release new copies of itself that attach to more cells. Norwalk causes more outbreaks of food borne illness than bacteria and parasites - approximately 181,000 cases occur annually, with no known associated deaths.
The Norwalk Virus is generally transmitted via contaminated food either from the source or an infected food preparer. The virus is transmitted though the vomit and stool of infected individuals, most commonly while they are ill and sometimes even after. Norwalk virus may also be spread from person to person. In fact, one sick person has been known to spread the illness to hundreds, or even thousands, of other individuals.
Common symptoms of Norwalk include nausea, vomiting, diarrhea, abdominal pain, headache, and sometimes low-grade fever. It will usually develop 24 to 48 hours after consuming contaminated food or water and can lasts for up to 60 hours. People usually recover in 2 to 3 days without any serious or long-term health effects.
Outbreaks of Norwalk Virus in the United States have been linked to raw shellfish, especially oysters and clams. Even steaming does not kill the virus or prevent its transmission. Contaminated water, ice, eggs, salad ingredients, and ready-to-eat foods have also been known to cause outbreaks of Norwalk Virus. In 2002 alone, there were 9 major Norwalk outbreaks in the United States.
Surprisingly, even though it is extremely common, Norwalk is actually easy to avoid. It does not multiply in foods as other bacteria do and thorough cooking can destroy the virus completely. In order to remain on the safe side, avoid shellfish unless you are cooking it yourself or dining in a restaurant where you know it will be cooked properly and thoroughly.
Other precautions should be taken with vegetables and water. Raw vegetables should be washed thoroughly before eating or preparing salads. If you are traveling in an area with polluted water, try to drink only boiled drinks or carbonated bottled beverages without ice.
If you or someone you know is unable to avoid contracting Norwalk Virus, there are a few key hygienic precautions you should take to make sure it does not spread. Always wash your hands with soap and warm water after using the bathroom, before preparing or eating food, and after taking care of someone infected by the virus. Do not let someone with Norwalk Virus in the kitchen either while food is being prepared, eaten, or handled.
Many people might remember that there was a highly-publicized outbreak of the Norwalk Virus at the 2002 Academy of Motion Pictures Arts and Sciences, Scientific and Technical Awards. The virus spread through the guests staying at the Regent Beverly Wilshire Hotel and came from food that was delivered to the hotel, not prepared on the premises. The menu for that night featured lobster bisque, the likely cause of the virus (although no one was really sure). It demonstrates that even at the rich and famous can be affected by this common foodborne illness.
Salmonella is a type of bacteria that causes typhoid fever and many other intestinal infections. There are actually over 2300 different strains of these bacteria. A few of the more common strains have recently become resistant to several of the antibiotics traditionally used to treat it. This development has caused concern on the part of medical experts.
Salmonellosis can be detected by examining stool or blood samples. However, blood cultures are often not performed and, in most cases, it is the stool and not the blood stream that is infected. In addition, many persons submit cultures after they have started antibiotics, therefore the diagnosis of salmonellosis may be problematic and many mild cases are never detected at all.
Salmonella is rather common, although not always widely publicized. In order to stop the increase in Salmonella, consumers and producers must be educated in the proper handling and cooking of eggs and other high-risk foods. One specific problem is cross-contamination of foods. Contaminated meat, poultry, and uncooked eggs will cross-contaminate other ready-to-eat foods or anything else with which they come into contact. Washing hands, cutting boards, counters, knives, and other utensils after handling uncooked foods is also essential for the prevention of cross-contamination.
Poultry, ground beef, and eggs need to be cooked thoroughly and properly at all times. Eggs are one of the biggest sources of Salmonella poisoning. In order to ensure that eggs do not contain viable Salmonella they must be cooked at least until the yoke is solid. Eating or drinking raw eggs, such as while baking, is never a good idea. Other sources of raw eggs are homemade eggnog, hollandaise sauce, undercooked French toast, and freshly prepared Caesar salad dressing. Raw, unpasteurized milk can also be dangerous. If you are ever served undercooked meat, poultry or eggs in a restaurant, do not hesitate to send it back to the kitchen for further cooking. When the food is returned to the table, you should make sure that the other items on the plate have been replaced as well in order to avoid possible cross-contamination.
Salmonella can actually be a rather painful illness. In August of 2002, approximately 100 people got sick after eating at a country club in Gates, New York. One of the affected individuals lost 12 pounds and missed three weeks of work and a 9-year-old girl was taken to the hospital. The country club guests who became sick complained of severe abdominal pain and most said they could not move at all. The severity of Salmonella poisoning can vary widely. The same is true with respect to the difficulties encountered during recovery. Between 1974 and 2002, there have been 46 major outbreaks of Salmonella.
If anyone you know is suffering from Salmonella poisoning, you should make sure to take careful sanitary precautions around them, such as washing your hands thoroughly and constantly. If symptoms persist after initial medical care, you should contact your physician for further treatment.
Listeria monocytogenes is a disease-causing bacterium that is food-borne and causes an illness called listeriosis. There are approximately 2,500 cases of Listeriosis in the United States annually leading to about 500 deaths. Major outbreaks of Listeria have occurred in numerous states between 1985 and 2002. Unlike other bacteria, Listeria survives in temperatures from below freezing (20°F) to body temperature. It grows best in the temperature range that is used for refrigeration. This creates an added danger as Listeria may be transmitted in ready-to-eat foods that have actually been properly refrigerated.
Certain groups of individuals, such as pregnant women and their unborn fetuses, are at higher risk for listeriosis. Among infants, listeriosis occurs when the infection is transmitted from the mother through the placenta or during the actual birthing process. Some of the more serious outcomes of listeriosis in infants are spontaneous abortion, stillbirths, or sepsis in infancy.
Listeria bacteria enter the body through a normal and intact gastrointestinal tract. Once in the body, Listeria can travel through the blood stream and are often found inside cells. Listeria can manipulate the host cell genes, produce a toxin that damages cells, and move directly from cell-to-cell, thereby avoiding the body’s natural defense mechanisms.
Listeria is found in soil and vegetation and easily contracted and transmitted by herd animals. It can live in the intestines of humans, animals, and birds for long periods of time without causing infection. It can be passed to humans from eating infected cattle and fowl, as well as dairy products, fruits, and vegetables.
After eating contaminated food, the incubation period ranges from 1 to 8 weeks, averaging about 31 days. Symptoms of listeriosis include fever, muscle aches, and gastrointestinal symptoms such as nausea or diarrhea. If the nervous system is affected, which is a possibility with listeriosis, other symptoms can include headache, stiff neck, loss of balance, confusion, or convulsions. In these cases, listeriosis may mimic a stroke.
Although Listeria is generally treatable, it remains a serious public health threat, especially to pregnant women, people with AIDS, or those who are immuno-compromised. Moreover, doctors often fail to consider a diagnosis of Listeria food poisoning because they are not aware that Listeria can survive and grow in refrigerated foods. In fact, a recent nationwide outbreak of Listeria poisoning was eventually determined to have been caused by contaminated hot dogs and lunch meat; foods that had not previously been considered dangerous.
Although major outbreaks of Listeria have been infrequent, the illness is one of the more serious foodborne illnesses and can be fatal. In 2002, a Listeria outbreak in Vancouver, British Columbia, caused two pregnant women to lose their babies. The outbreak was a result of bad cheese served at a hotel. Listeria should be taken very seriously by the public and medical professionals.
The Shigella bacteria can cause the sudden onset of gastroenteritis with accompanying diarrhea. It lives in the human intestine and can be spread through food and by person to person contact. About 25,000 cases of shigellosis are reported each year in the United States, however, it is estimated that another 425,000 cases either go undiagnosed or unreported. Individuals who are at increased risk are small children and persons infected with HIV. Antibiotics are used to treat Shigellosis and, in the most serious cases, may even be life saving.
Symptoms of Shigellosis include diarrhea, fever, abdominal cramps, and rectal spasms. The diarrhea can sometimes contain blood or mucus. The illness can begin anywhere from 12 hours to 6 days after initial exposure. Shigellosis usually lasts for 5 to 7 days, although bowel problems can persist for several months. Hospitalization can be necessary for young children, the elderly, and immune-compromised persons. Complications associated with shigellosis include severe dehydration, seizures in small children, rectal bleeding, and invasion of the blood stream by the bacterium.
Shigellosis is more severe than other forms of gastroenteritis, because when Shigella bacteria multiply in the human digestive system they invade cells, causing serious tissue destruction. While some 700 shigellosis-related deaths occur annually in the United States, more than one million such deaths occur yearly worldwide. Most of those deaths involve children in underdeveloped nations.
A small percentage of persons who are infected with Shigella may later develop a syndrome called reactive arthritis, or Reiter’s Syndrome, that includes joint pain and swelling, irritation of the eyes, and sometimes painful urination as well. Reiter's syndrome can last for months or years and may be difficult to treat.
The primary source of Shigella bacteria is the excrement of an infected individual. That infectious material then spreads by person-to-person contact such as caring for a sick child, sexual contact, and even ordinary household contact. Contaminated food or water can also spread the disease. Food can be contaminated by handlers or preparers or even during processing. Contaminated drinking water is particularly problematic in under-developed countries. Basic food safety precautions help to prevent shigellosis. This includes thorough cooking which kills Shigella bacteria.
The spread of Shigella can be stopped by frequent and thorough hand washing with soap and water. Anyone caring for a baby with shigellosis should dispose of diapers properly and carefully wash his or her hands with soap and warm water. People with shigellosis or diarrhea should not prepare food for others until they are bacteria free.
Shigella is a serious worldwide problem. In fact, there have been 11 serious outbreaks in the United States since 1986. In 2000, many families filed lawsuits against Senor Felix Gourmet Mexican Foods in California as a result of contaminated dip. More than 335 people in Washington, California, Oregon, Idaho, New Mexico, Arizona and Alaska were affected by the bacterial illness with symptoms such as severe diarrhea, nausea, fever and stomach cramps. Such widespread outbreaks are troublesome since the contamination often goes undetected until after the affected products are distributed nationwide.
Hepatitis viruses A through E primarily infect the human liver. Although Hepatitis A is usually not a serious problem in developed countries with adequate sanitation systems, there are still approximately 30,000 to 50,000 cases and 100 deaths (from acute liver failure) annually in the United States due to Hepatitis A. Hepatitis A is now completely preventable and, for that reason, outbreaks and even individual cases should not occur.
An unsettling situation connected with Hepatitis A is that there are often no immediate symptoms. Typically, however, Hepatitis A is associated with the sudden onset of flu-like symptoms starting about 30 days after the virus is contracted. This is followed by muscle aches, headache, loss of appetite, abdominal discomfort, fever and malaise, and jaundice. The recovery time is about 2 months, but some people will can experience relapses lasting up to 6 months. Most people who contract Hepatitis A fully recover and it does not lead to chronic Hepatitis. Unfortunately, about .2% (2/1000) of those with symptomatic acute Hepatitis A will die. Those most at risk for fatal consequences are people with chronic liver disease, Hepatitis B, Hepatitis C, and cirrhosis of the liver.
Hepatitis A is contagious and may be spread from person to person. The virus is usually ingested with contaminated food. An infected food preparer is very likely to spread the illness to anyone eating the food that is handled by that person. The problem is that the infected person may be spreading Hepatitis A while not exhibiting any signs of infection since the illness is most communicable during the 2 weeks before the onset of symptoms. In that time period an infected food handler may spread the illness to hundreds, or even thousands, of customers and fellow employees.
Hepatitis A may also be contracted from close contact with family members and roommates, sexual activity, contaminated drinking water, eating raw or undercooked shellfish, or persons sharing illicit intravenous drugs. Children often do not display the pronounced symptoms found in adults and frequently transmit the virus to playmates and their own parents.
There are several precautions which help stop the spread of this highly preventable illness. For instance, many restaurants prohibit infected food-handlers from working while they are ill. However, to ensure compliance with this policy these restaurants will continue to pay the employee. This discourages the sick person from showing up for work simply because they are worried about getting fired or losing money. Strict enforcement of hand washing rules is another effective preventative measure. Vaccinating food handlers would also dramatically decrease the risk of outbreaks.
Immediately after diagnosis, Immune Globulin should be administered. If this done within 2 weeks of exposure to the virus, it will often prevent the disease or at least reduce its effect. There are certain individuals who should be vaccinated as a precautionary measure including children living in or those traveling to areas with increased rates of Hepatitis A, gay men, any type of illicit drug user, hemophiliacs, and those with chronic liver disease. Any individual age 3 or older can be vaccinated.
There have been many major outbreaks of Hepatitis A (26 between 1986 and 2003) and, generally, when a public facility is involved, one or more law suits are brought. In August of 2000, 29 people in Seattle won $1.06 million as a result of contracting Hepatitis A after eating at a Subway franchise.
Although most cases of Hepatitis A in the United States are not caused by contaminated food or water, worldwide, such contamination is the primary cause of the disease. Still, it should be taken seriously as a foodborne illness as it can be quite dangerous if left untreated or contracted by a person suffering from any of the complicating factors. Prompt medical attention is the best way to treat Hepatitis A.
Campylobacter was first recognized as a serious foodborne illness in 1975. Since then, it has become the most common foodborne illness in the United States, followed by Salmonella. Over 10,000 cases of Campylobacteriosis are reported to the CDC each year with outbreaks occurring more frequently in the summer than the winter. Unreported but diagnosed cases number about 46,000 annually. While major outbreaks have occurred, the illness usually occurs in isolated or sporadic events. Campylobacteriosis is not usually fatal but some 500 people do die each year from the illness.
Contaminated chicken is associated with about 70% of the annual cases of the illness. Amazingly, a recent Consumer Reports study identified Campylobacter in 63% of more than 1000 chickens obtained in grocery stores. Other foods that may carry the bacteria include unpasteurized milk, undercooked meats, mushrooms, hamburger, cheese, pork, shellfish, and eggs. Food becomes contaminated from the intestinal material of animals during processing, but Campylobacter can survive on properly refrigerated foods. Thereafter, it will grow if the contaminated food is left out at room temperature. Pasteurization of milk, adequate cooking of meat and poultry, and chlorination of water will adequately destroy these bacteria.
Most cases of Campylobacteriosis are sporadic and can be contained within the household, but larger outbreaks (at least 15 between 1985 and 2002) have occurred due to contaminated water, chicken, fruit, or milk and milk products. Campylobacteriosis can also be spread by contact with an animal carrier such as cattle, pigs, chickens, turkeys, ducks, and geese, birds, cats, dogs, hamsters, and turtles. The bacterial organism is also occasionally isolated from streams, lakes and ponds.
Children under the age of five and young adults aged 15-29 are the age groups most frequently affected. The incubation period is typically two to five days but may be as long as 10 days after initial exposure. Campylobacteriosis usually lasts no more than one week but symptoms may continue for up to three weeks. Symptoms include diarrhea, blood in the stool, fever, nausea, vomiting, abdominal pain, headache, and muscle pain. Although the majority of cases are mild and do not require hospitalization, the bacterial infection can be severe and even life-threatening in certain cases. Death is more likely to occur where other diseases, such as cancer, liver disease, and immuno-deficiency diseases are present.
Long-term consequences, although rare, may occur as a result of Campylobacter infection. A small percentage of victims people develop Guillain-Barré syndrome, which affects the nervous system and may cause acute generalized paralysis. This complication may occur several weeks after the diarrheal illness. Guillain-Barré syndrome begins in the feet and spreads up the body and is detectable by prickling sensations that give way to weakness that may lead to paralysis. Most people fully recover but some people sustain severe neurological damage. It is estimated that approximately .1% (1/1000) of the reported Campylobacteriosis cases lead to Guillain-Barré syndrome.
Miller Fisher Syndrome is another neurological syndrome that can be precipitated by Campylobacteriosis. It affects the nerves of the head more than those of the body. Reiter's syndrome, or reactive arthritis, is yet another illness associated with Campylobacter. The bacterial infection may also cause appendicitis or infect the abdominal cavity, the heart, the central nervous system, the gallbladder, the urinary tract, and the blood stream.
There are several treatments available for Campylobacteriosis. Affected individuals can take anti-diarrheal medications, such as loperamide, to alleviate symptoms and drink plenty of fluids in order to maintain hydration. In more severe cases of gastroenteritis, antibiotics such as erythromycin, clarithromycin, azithromycin ciprofloxacin, levofloxacin, gatifloxacin, or moxifloxacin may shorten the course of the illness.
To prevent Campylobacter infection the following precautions should be taken:
* Cook all poultry completely using a cooking thermometer to ensure thoroughness.
* Transport meats home quickly and in the coolest part of your vehicle, especially in warm weather.
* Meat and poultry should be defrosted in the refrigerator, taking precautions to prevent the drippings from reaching other foods. If there is not enough time to defrost in the refrigerator, then use the microwave. Do not leave meat and poultry out in order to defrost it.
* Cook stuffing before placing it inside the bird.
* Never leave food out at room temperature, either during preparation or after cooking, for more than 2 hours.
* Do not place cooked meats and chicken back onto a platter or pan that contained the raw food unless it has been thoroughly washed.
* Do not cut or prepare other food on cutting boards, trays, or plates that have held raw meat or poultry.
* Wash knives thoroughly after cutting raw meat or poultry and before cutting other food.
* Avoid cutting or preparing raw meat or poultry on porous surfaces like wooden cutting boards. If such surfaces are used they must be thoroughly cleaned (in a dishwasher or hot soapy tub if possible).
* Avoid raw milk and products made from raw milk. Drink only pasteurized milk products.
* Avoid food sold by street vendors. It is often undercooked, improperly stored, cross-contaminated, or improperly prepared.
* Avoid eating poultry at a restaurant if it appears to be pink inside or undercooked.
* Wash hands thoroughly using soap and water, especially after contact with pets, before and after preparing food, especially poultry, and after changing diapers or having contact with an individual with an intestinal infection.
* Wash fruits and vegetables carefully, especially if they are to be eaten raw.
Outbreaks, while rare, have been triggered by contaminated foods such as lettuce, lasagna, tuna salad, fruit salad, chicken, and raw milk. However, non-food objects may also be a problem. One outbreak in a Washington State penitentiary was traced to a contaminated stainless steel food preparation table. 38 inmates and 4 staff members fell ill. After the outbreak, the penitentiary changed food preparation practices to include stressing hand-washing among inmates, requiring food handlers to wear gloves during preparation and serving, and thoroughly sanitizing food preparation surfaces. These kinds of practices are standard at any other food service facilities and should be mandatory at institutions such as penitentiaries as well.
Being aware of what you are eating and where you are eating it will help you to avoid Campylobacter. Although it is what you can not see that often causes the problem, you can still prevent potential problems by being vigilant. Campylobacter can be kept an isolated problem if the above guidelines are followed.
Foodborne illnesses may be lurking anywhere: at home, in the workplace, restaurants, supermarkets, cafeterias, hospitals, playgrounds, street vendors, and schools. While ingestion of contaminated substances is certainly the quickest way to contract a foodborne illness, contraction from person-to-person contact can be an unexpected and unwelcome surprise. Of course there is only so much that you can do to avoid a foodborne illness without completely abandoning a normal way of life. Foodborne illnesses are common but are still rare enough that you should feel safe eating at respectable establishments and shopping at well maintained supermarkets. When you are preparing your own food, take the necessary precautions to ensure that you are cooking everything correctly and using fresh produce and milk products. When dining out, choose your restaurants based on ratings of both quality of food and cleanliness of venue.
Most people can go their whole lives without ever experiencing the severe symptoms of a foodborne illness but almost everyone knows what it is like to get a little sick from food from time to time. Individuals with other serious health issues should always take extra precaution when eating out or eating in as they are more susceptible to contracting foodborne illnesses.
To find out more about foodborne illnesses and information relating to reported outbreaks of the illnesses discussed above log onto the CDC Foodborne Disease Outbreak Surveillance System at http://www.cdc.gov/ncidod/dbmd/outbreak/us_out.htm.
However, if you or a family member is experiencing, or has experienced, health problems associated with food that may have been contaminated as a result of improper food storage or preparation or contact with an infected person or animal, contact your physician immediately. Most foodborne illnesses respond well to prompt medical treatment. If you believe you or a loved one has suffered an injury as a result of a foodborne illness attributable to the negligence of a third party, contact Parker and Waichman for a free case assessment. You may be entitled to compensation for your medical expenses, lost earnings, and pain and suffering.