December 20, 2007
The CDC estimates that 76 million people get sick, more than 300,000 are hospitalized, and 5,000 Americans die each year from foodborne illness (also called food poisoning).
How does food become contaminated?
Many foodborne microbes are present in healthy animals (usually in their intestines) raised for food. Meat and poultry carcasses can become contaminated during slaughter by contact with small amounts of intestinal contents. Similarly, fresh fruits and vegetables can be contaminated if they are washed or irrigated with water that is contaminated with animal manure or human sewage. Some types of Salmonella can infect a hen’s ovary so that the internal contents of a normal looking egg can be contaminated with Salmonella even before the shell in formed. Oysters and other filter feeding shellfish can concentrate Vibrio bacteria that are naturally present in sea water, or other microbes that are present in human sewage dumped into the sea.
Later in food processing, other foodborne microbes can be introduced from infected humans who handle the food, or by cross contamination from some other raw agricultural product. For example, Shigella bacteria, hepatitis A virus and Norwalk virus can be introduced by the unwashed hands of food handlers who are themselves infected. In the kitchen, microbes can be transferred from one food to another food by using the same knife, cutting board or other utensil to prepare both without washing the surface or utensil in between. A food that is fully cooked can become recontaminated if it touches other raw foods or drippings from raw foods that contain pathogens.
The way that food is handled after it is contaminated can also make a difference in whether or not an outbreak occurs. Many bacterial microbes need to multiply to a larger number before enough are present in food to cause disease. Given warm moist conditions and an ample supply of nutrients, one bacterium that reproduces by dividing itself every half hour can produce 17 million progeny in 12 hours. As a result, lightly contaminated food left out overnight can be highly infectious by the next day. If the food were refrigerated promptly, the bacteria would not multiply at all. In general, refrigeration or freezing prevents virtually all bacteria from growing but generally preserves them in a state of suspended animation. This general rule has a few surprising exceptions. Two foodborne bacteria, Listeria monocytogenes and Yersinia enterocolitica can actually grow at refrigerator temperatures. High salt, high sugar or high acid levels keep bacteria from growing, which is why salted meats, jam, and pickled vegetables are traditional preserved foods.
Microbes are killed by heat. If food is heated to an internal temperature above 160oF, or 78oC, for even a few seconds this sufficient to kill parasites, viruses or bacteria, except for the Clostridium bacteria, which produce a heat-resistant form called a spore. Clostridium spores are killed only at temperatures above boiling. This is why canned foods must be cooked to a high temperature under pressure as part of the canning process.
The toxins produced by bacteria vary in their sensitivity to heat. The staphylococcal toxin which causes vomiting is not inactivated even if it is boiled. Fortunately, the potent toxin that causes botulism is completely inactivated by boiling.
What foods are most associated with foodborne illness?
Raw foods of animal origin are the most likely to be contaminated; that is, raw meat and poultry, raw eggs, unpasteurized milk, and raw shellfish. Because filter-feeding shellfish strain microbes from the sea over many months, they are particularly likely to be contaminated if there are any pathogens in the seawater. Foods that mingle the products of many individual animals, such as bulk raw milk, pooled raw eggs, or ground beef, are particularly hazardous because a pathogen present in any one of the animals may contaminate the whole batch. A single hamburger may contain meat from hundreds of animals. A single restaurant omelet may contain eggs from hundreds of chickens. A glass of raw milk may contain milk from hundreds of cows. A broiler chicken carcass can be exposed to the drippings and juices of many thousands of other birds that went through the same cold water tank after slaughter.
Fruits and vegetables consumed raw are a particular concern. Washing can decrease but not eliminate contamination, so the consumers can do little to protect themselves. Recently, a number of outbreak have been traced to fresh fruits and vegetables that were processed under less than sanitary conditions. These outbreaks show that the quality of the water used for washing and chilling the produce after it is harvested is critical. Using water that is not clean can contaminate many boxes of produce. Fresh manure used to fertilize vegetables can also contaminate them. Alfalfa sprouts and other raw sprouts pose a particular challenge, as the conditions under which they are sprouted are ideal for growing microbes as well as sprouts, and because they are eaten without further cooking. That means that a few bacteria present on the seeds can grow to high numbers of pathogens on the sprouts. Unpasteurized fruit juice can also be contaminated if there are pathogens in or on the fruit that is used to make it.
Follow these general guidelines to avoid contracting a foodborne illness:
- Make sure that food from animal sources (meat, dairy, eggs) is cooked thoroughly or pasteurized.
- Avoid eating raw or undercooked meats and eggs. Check expiration dates on meats before purchasing and again before preparing.
- Carefully select and prepare fish and shellfish to ensure quality and freshness.
- If you are served an undercooked meat or egg product in a restaurant, send it back for further cooking. You should also ask for a new plate.
- Be careful to keep juices or drippings from raw meat, poultry, shellfish or eggs from contaminating other foods.
- Do not leave eggs, meats, poultry, seafood or milk for extended periods of time at room temperature. Promptly refrigerate leftovers and food prepared in advance.
- Wash your hands, cutting boards and knives with antibacterial soap and warm to hot water after handling raw meat, poultry, seafood or eggs.
- Avoid unpasteurized milk or foods made from unpasteurized milk.
- Do not thaw foods at room temperature. Thaw foods in the refrigerator and use them promptly. Do not refreeze foods once they have been completely thawed.
- Wash raw vegetables and fruits thoroughly before eating, especially those that will not be cooked. Avoid eating alfalfa sprouts until their safety can be assured. Methods to decontaminate alfalfa seeds and sprouts are being investigated.
- Drink only pasteurized juice or cider. Commercial juice with an extended shelf life that is sold at room temperature (juice in cardboard boxes, vacuum sealed juice in glass containers) has been pasteurized, although this is generally not indicated on the label. Juice concentrates are also heated sufficiently to kill bacteria.
- Be aware of proper home-canning procedures. Instructions on safe home-canning can be obtained from county extension services or from the U.S. Department of Agriculture
- If you are ill with diarrhea or vomiting, do not prepare food for others, especially infants, the elderly and those with weakened immune systems since they are more vulnerable to infection.
- Wash hands with soap after handling reptiles, birds or after contact with human or pet feces.
- Mother’s milk is the safest food for young infants. Breast-feeding may prevent many foodborne illnesses and other health problems.
- Those at high risk, such as pregnant women, people with weakened immune systems, infants and the elderly should also:
- Avoid soft cheeses such as feta, Brie, Camembert, blue-veined and Mexican-style cheese. (Hard cheeses, processed cheeses, cream cheese, cottage cheese and yogurt are safe.)
- Cook foods until they are steaming hot, especially leftover foods or ready-to-eat foods, such as hot dogs, before eating.
- Although the risk of foodborne disease associated with foods from deli counters is relatively low, pregnant women and people with weakened immune systems may choose to avoid these foods or thoroughly reheat cold cuts before eating.