Foodborne Illness

What's the Problem?

Most people do not think about the safety of their food until they or someone they know becomes ill from a food-related infection. While the food supply in the United States is one of the safest in the world, CDC estimates that 76 million people get sick, more than 300,000 are hospitalized, and 5,000 die each year from illnesses caused by contaminated foods or beverages. As the spectrum of foodborne diseases constantly changes, there are many opportunities for food to become contaminated as it is produced and prepared. More than 250 different foodborne diseases have been described: most are infections caused by various bacteria, viruses, and parasites – e.g. Salmonella, E. coli O157:H7, Campylobacter, Norwalk-like virus, Cryptosporidium and many others. Poisoning may also result from harmful toxins or chemicals that have contaminated food.

Raw foods from animals are most likely to be contaminated – beef, chicken, eggs, unpasteurized milk and cheese, and raw shellfish. Fruits and vegetables eaten raw are also of concern because they may be processed in unsanitary conditions. Most foodborne contamination is only discovered after people have suffered the effects: nausea, vomiting, abdominal cramps, diarrhea or more serious symptoms such as a high fever, blood in the stool, or prolonged vomiting. Fortunately, techniques for tracing outbreaks, quickly finding the source of infection and correcting the cause of the outbreak are constantly improving, which is particularly important in a country as large as the United States and in a world that increasingly shares food products.

Who's at Risk?

In normally healthy people, the symptoms generally last several days without causing other serious problems. No one can be completely protected from foodborne illnesses, but the effects are usually more severe among the very young (infants, especially those who are bottle-fed, and children), pregnant women, older people, people with liver disease, and people whose immune systems are weakened because of disease and/or its treatment. These patients may experience more serious illness, hospitalization may be required, and death can be the final outcome.

Can It Be Prevented?

Not entirely. But you can purchase foods that have been processed for safety, such as pasteurized milk or juice, and irradiated meat; you can also reduce the risk of foodborne illness by following four basic, simple steps:

• Cook foods to the proper temperatures. Use a thermometer to measure the internal temperature of meat to be sure that it is cooked sufficiently to kill bacteria. For example, ground beef should be cooked to an internal temperature of 160o F. Eggs should be cooked until the yolk is firm.
• Separate: Don't cross-contaminate one food with another. To avoid cross-contaminating foods, wash hands, utensils, and cutting boards with soap and warm, running water after they have been in contact with raw meat or poultry and before they touch another food. Put cooked meat on a clean platter rather than one that held the raw meat.
• Chill: Refrigerate foods promptly. Bacteria can grow quickly at room temperature, so refrigerate foods if they are not going to be eaten within two hours. Divide large volumes of food into several shallow containers so they will cool more quickly.
• Clean: Wash surfaces often, and wash hands with soap and water before preparing food; avoid preparing food for others if you have a diarrheal illness. Rinse fresh fruits and vegetables in running tap water to remove visible dirt and grime. Because bacteria can grow well on the cut surface of fruit or vegetables, be careful not to contaminate these foods while slicing them on the cutting board.

Tips for Scripts

• REMIND viewers that no one is completely safe from foodborne illness, but that some people (such as pregnant women, older people, people with weakened immune systems, and people with liver disease) are more susceptible to and more likely to suffer serious consequences from foodborne illness. These people should talk with their doctors about precautions.
• EDUCATE viewers that they can follow basic food safety steps (listed above) in the home to help protect themselves and their families from foodborne illness.
• REMIND consumers that they can also protect themselves from foodborne illness when eating out. When ordering a hamburger, ask for it to be cooked to a temperature of 160º F and send it back if it is still pink in the middle. Before ordering something that is made with many eggs pooled together, such as scrambled eggs, omelets or French toast, ask the waiter whether it is made with pasteurized eggs, and choose something else if it is not. Ask restaurants if juice they serve has been pasteurized.
• ADVISE viewers that it is important to let their local health department know if they think they and others became sick from eating the same food – even if it is days or weeks later. Only in this way can local, state, and national health authorities look for and attempt to correct the problem that caused the outbreak.

Case Examples

1. After a church picnic, a dozen people experience severe and bloody diarrhea and painful abdominal cramps. Two of the younger children become seriously ill and are hospitalized. A week later, one of the children dies from kidney failure, a complication of the foodborne infection. The minister contacts the local health department to report the illnesses. Possible sources of contamination are: potato salad left out in the heat all day was eaten by late-comers; buckets of ice provided to fill water bottles also used by some children to wash their hands and faces; the chef, anxious to please the waiting crowd, didn't check the temperature of burgers to make sure that they were cooked thoroughly. Investigators from the local health department and CDC determine that the cause of the outbreak was the undercooked ground beef.
2. A pregnant woman at a baby shower eats cold cuts and soft cheeses from a party platter. A few weeks later, she experiences mild flu-like symptoms – muscle aches and nausea – but doesn't consider symptoms severe enough to seek medical attention. The infection spreads to her unborn child, resulting in miscarriage. Over the next few weeks, eight other pregnant women and three members of an older adult care center in the same state experience similar symptoms. Three of the pregnant women suffer miscarriages and a 92-year-old man dies. The miscarriages and death are reported to the state health department, which traces the outbreak back to deli meat contaminated with Listeria. The contaminated meat is recalled, and changes are instituted at the meat processing plant to lower the risk of contamination.
3. The Gill family is on the way home from their annual summer vacation. They stop in the airport to buy fruit smoothies and a day later Grandma Gill complains of fever, diarrhea and abdominal cramps. She visits her doctor and he reports the case to the local health department. Their investigation reveals the smoothie was made with unpasteurized orange juice, contaminated with Salmonella. The juice is recalled and the smoothie maker switches to pasteurized juice.