Important Health Topics
Unwelcome Dinner Guest:
Preventing Foodborne Illness
It must be something I ate," is often the explanation people
give for a bout of home-grown "Montezuma's Revenge" (acute diarrhea)
or some other unwelcome gastrointestinal upset.
Despite the fact that America's food supply is the safest in
the world, the unappetizing truth is that what we eat can very
well be the vehicle for foodborne illnesses that can cause a variety
of unpleasant symptoms and may be life-threatening to the less
healthy among us. Seventy-six million cases of foodborne illness
occur in the United States every year.
The Food and Drug Administration has given high priority to
combating microbial contamination of the food supply. But the
agency can't do the job alone.
Consumers have a part to play, especially when it comes to following
safe food-handling practices in the home.
The prime causes of foodborne illness are bacteria, viruses
and parasites. Bacteria causing foodborne illness include Escherichia
coli O157:H7, Campylobacter jejuni, Salmonella, Staphylococcus
aureus, Listeria monocytogenes, Clostridium botulinum, Clostridium
perfringens, Vibrio parahaemolyticus, Vibrio vulnificus, and
Shigella. Viruses, such as hepatitis A virus and noroviruses,
can also cause foodborne illness. Parasites are another origin
of this type of illness and include Giardia lamblia, Cyclospora
cayetanensis, and Cryptosporidium parvum.
These organisms can become unwelcome guests at the dinner table.
They can be in a wide range of foods, including meat, milk and
other dairy products, spices, chocolate, seafood, and even water.
Specific foods that have been implicated in foodborne illnesses
are unpasteurized fruit and vegetable juices and ciders; raw or
undercooked eggs or foods containing undercooked eggs; chicken,
tuna, potato and macaroni salads; cream-filled pastries; and fresh
Bacteria such as Listeria monocytogenes, Vibrio vulnificus,
Vibrio parahaemolyticus, and Salmonella have been found
in raw seafood. Oysters, clams, mussels, scallops, and cockles
may be contaminated with hepatitis A virus.
Careless food handling sets the stage for the growth of disease-causing
"bugs." For example, hot or cold foods left standing too long
at room temperature provide an ideal climate for bacteria to grow.
Improper cooking also plays a role in foodborne illness.
Foods may be cross-contaminated when cutting boards and kitchen
tools that have been used to prepare a contaminated food, such
as raw chicken, are not cleaned before being used for another
food, such as vegetables that will not be cooked.
Common symptoms of foodborne illness include diarrhea, abdominal
cramping, fever, headache, vomiting, severe exhaustion, and sometimes
blood or pus in the stools. However, symptoms will vary according
to the type of organism and the amount of contaminants eaten.
In rare instances, symptoms may come on as early as a half hour
after eating the contaminated food, but they typically do not
develop for several days or weeks. Symptoms of viral or parasitic
illnesses may not appear for several weeks after exposure. Symptoms
usually last only a day or two, but in some cases can persist
a week to 10 days. For most healthy people, foodborne illnesses
are neither long-lasting nor life-threatening. However, they can
be severe in the very young, the very old, and people with certain
diseases and conditions.
These conditions include:
- liver disease, either from excessive alcohol use, viral hepatitis,
or other causes
- hemochromatosis, an iron disorder
- stomach problems, including previous stomach surgery and
low stomach acid (for example, from antacid use)
- immune disorders, including HIV infection
- long-term steroid use, as for asthma and arthritis.
When symptoms are severe, the victim should see a doctor or
get emergency help. This is especially important for those who
are most vulnerable. For mild cases of foodborne illness, the
individual should drink plenty of liquids to replace fluids lost
through vomiting and diarrhea.
The idea that the food on the dinner table can make someone
sick may be disturbing, but there are many steps you can take
to protect your families and dinner guests. It's just a matter
of following basic rules of food safety.
Prevention of foodborne illness starts with your trip to the
- Pick up your packaged and canned foods first.
- Don't buy food in cans that are bulging or dented or in jars
that are cracked or have loose or bulging lids.
- Don't eat raw shellfish and use only pasteurized milk and
cheese and pasteurized or otherwise treated ciders and juices
if you have a health problem, especially one that may have impaired
your immune system.
- Choose eggs that are refrigerated in the store. Before putting
them in your cart, open the carton and make sure that the eggs
are clean and none are cracked.
- Select frozen foods and perishables such as meat, poultry
or fish last. Always put these products in separate plastic
bags so that drippings don't contaminate other foods in your
- Don't buy frozen seafood if the packages are open, torn or
crushed on the edges. Avoid packages that are above the frost
line in the store's freezer. If the package cover is transparent,
look for signs of frost or ice crystals. This could mean that
the fish has either been stored for a long time or thawed and
- Check for cleanliness at the meat or fish counter and the
salad bar. For instance, cooked shrimp lying on the same bed
of ice as raw fish could become contaminated.
- When shopping for shellfish, buy from markets that get their
supplies from state-approved sources; stay clear of vendors
who sell shellfish from roadside stands or the back of a truck.
And if you're planning to harvest your own shellfish, heed posted
warnings about the safety of the water.
- Take an ice chest along to keep frozen and perishable foods
cold if it will take more than an hour to get your groceries
- The first rule of food storage in the home is to refrigerate
or freeze perishables right away. The refrigerator temperature
should be 40 degrees Fahrenheit (5 degrees Celsius), and the
freezer should be zero F (minus 18 C). Check both "fridge" and
freezer periodically with a refrigerator/freezer thermometer.
- Poultry and meat heading for the refrigerator may be stored
as purchased in the plastic wrap for a day or two. If only part
of the meat or poultry is going to be used right away, it can
be wrapped loosely for refrigerator storage. Just make sure
juices can't escape to contaminate other foods.
- Wrap tightly foods destined for the freezer. Leftovers should
be stored in tight containers.
- Store eggs in their carton in the refrigerator itself rather
than on the door, where the temperature is warmer.
- Seafood should always be kept in the refrigerator or freezer
until preparation time.
- Don't crowd the refrigerator or freezer so tightly that air
can't circulate. Check the leftovers in covered dishes and storage
bags daily for spoilage. Anything that looks or smells suspicious
should be thrown out.
- A sure sign of spoilage is the presence of mold, which can
grow even under refrigeration. While not a major health threat,
mold can make food unappetizing. Most moldy foods should be
thrown out. But you might be able to save molding hard cheeses,
salami, and firm fruits and vegetables if you cut out not only
the mold but a large area around it. Cutting the larger area
around the mold is important because much of the mold growth
is below the surface of the food.
- Always check the labels on cans or jars to determine how the
contents should be stored. Many items besides fresh meats, vegetables,
and dairy products need to be kept cold. For instance, mayonnaise
and ketchup should go in the refrigerator after opening. If
you've neglected to refrigerate items, it's usually best to
throw them out.
- Some precautions will help make sure that foods that can be
stored at room temperature remain safe. Potatoes and onions
should not be stored under the sink because leakage from the
pipes can damage the food. Potatoes don't belong in the refrigerator,
either. Store them in a cool, dry place. Don't store foods near
household cleaning products and chemicals.
- Check canned goods to see whether any are sticky on the outside.
This may indicate a leak. Newly purchased cans that appear to
be leaking should be returned to the store, which should notify
Keep It Clean
The first cardinal rule of safe food preparation in the home
is: Keep everything clean.
The cleanliness rule applies to the areas where food is prepared
and, most importantly, to the cook.
- Wash hands with warm water and soap for at least 20 seconds
before starting to prepare a meal and after handling raw meat
- Cover long hair with a net or scarf, and be sure that any
open sores or cuts on the hands are completely covered. If the
sore or cut is infected, stay out of the kitchen.
- Keep the work area clean and uncluttered. Wash countertops
with a solution of 1 teaspoon of chlorine bleach to 1 quart
of water or with a commercial kitchen cleaning agent diluted
according to product directions. They're the most effective
at getting rid of bacteria.
- Also, be sure to keep dishcloths clean because, when wet,
they can harbor bacteria and may promote their growth. Wash
dishcloths weekly in hot water in the washing machine.
- Sanitize the kitchen sink drain periodically by pouring down
the sink a solution of 1 teaspoon of bleach to 1 quart of water
or a commercial kitchen cleaning agent. Food particles get trapped
in the drain and disposal and, along with the moistness, create
an ideal environment for bacterial growth.
- Use smooth cutting boards made of hard maple or a non-porous
material such as plastic and free of cracks and crevices. Avoid
boards made of soft, porous materials. Wash cutting boards with
hot water and soap, using a scrub brush. Then, sanitize them
by washing in an automatic dishwasher or by rinsing with a solution
of 1 teaspoon of chlorine bleach to 1 quart of water.
- Always wash and sanitize cutting boards after using them for
raw foods, such as seafood or chicken, and before using them
for ready-to-eat foods. Consider using one cutting board only
for foods that will be cooked, such as raw fish, and another
only for ready-to-eat foods, such as bread, fresh fruit, and
- Always use clean utensils and wash them between cutting different
- Wash the lids of canned foods before opening to keep dirt
from getting into the food. Also, clean the blade of the can
opener after each use. Food processors and meat grinders should
be taken apart and cleaned as soon as possible after they are
- Do not put cooked meat on an unwashed plate or platter that
has held raw meat.
- Wash fresh fruits and vegetables thoroughly, rinsing under
running water. Don't use soap or other detergents. If necessary--and
appropriate--use a small scrub brush to remove surface dirt.
Keep Temperature Right
The second cardinal rule of safe home food preparation is: Keep
hot foods hot and cold foods cold.
- Use a digital or dial food thermometer to ensure that meats
are completely cooked. Insert the thermometer into the center
of the food and wait 30 seconds for accurate measurement. Beef,
lamb, and veal should be cooked to at least 145 F (63 C); pork
and ground beef to 160 F (71 C); whole poultry and thighs to
180 F (82 C); poultry breasts to 170 F (77 C); and ground chicken
or turkey to 165 F (74 C).
- Eggs should be cooked until the white and the yolk are firm.
Avoid foods containing raw eggs, such as homemade ice cream,
mayonnaise, eggnog, cookie dough and cake batter, because they
carry a Salmonella risk. Their commercial counterparts
usually don't because they're made with pasteurized eggs. Cooking
the egg-containing product to an internal temperature of at
least 160 F (71 C) will kill the bacteria.
- Seafood should be thoroughly cooked to an internal temperature
of at least 145 F (63 C). Fish that's ground or flaked, such
as a fish cake, should be cooked to at least 155 F (68 C), and
stuffed fish to at least 165 F (74 C).
If you don't have a food thermometer, look for other signs of
doneness. For example:
- Fish is done when the thickest part becomes opaque and the
fish flakes easily when poked with a fork.
- Shrimp can be simmered three to five minutes or until the
shells turn red.
- Clams and mussels are steamed over boiling water until the
shells open (five to 10 minutes). Then boil three to five minutes
- Oysters should be sautéed, baked or boiled until plump,
about five minutes.
Protect food from cross-contamination after cooking, and eat
- Cooked foods should not be left standing on the table or kitchen
counter for more than two hours. Disease-causing bacteria grow
in temperatures between 40 and 140 F (4 and 60 C). Cooked foods
that have been in this temperature range for more than two hours
should not be eaten.
- If a dish is to be served hot, get it from the stove to the
table as quickly as possible. Reheated foods should be brought
to a temperature of at least 165 F (74 C). Keep cold foods in
the refrigerator or on a bed of ice until serving. This rule
is particularly important to remember in the summer months.
- After the meal, leftovers should be refrigerated as soon as
possible. (Never mind that scintillating dinner table conversation!)
Meats should be cut in slices of three inches or less and all
foods should be stored in shallow containers to hasten cooling.
Be sure to remove all the stuffing from roast turkey or chicken
and store it separately. Giblets should also be stored separately.
Leftovers should be used within three days.
And here are just a few more parting tips to keep your favorite
- Don't thaw meat and other frozen foods at room temperature.
Instead, move them from the freezer to the refrigerator for
a day or two; or defrost submerged in cold water. You can also
defrost in the microwave oven or during the cooking process.
Cook foods immediately after defrosting in the microwave or
- Never taste any food that looks or smells "off" or comes out
of leaking, bulging or severely damaged cans or jars with leaky
Though all these dos and don'ts may seem overwhelming, remember,
if you want to stay healthy, when it comes to food safety, the
old saying "rules are made to be broken" does not apply!
Keep Your Food Safe
Always be sure to practice these four simple steps to food safety:
CLEAN: Wash hands and surfaces often
Wash your hands, cutting boards, dishes, utensils, and counter
tops with hot, soapy water before, during, and after preparing
SEPARATE: Don't cross-contaminate
Always keep raw meat, poultry, seafood and their juices away from
COOK: Cook to proper temperatures
Use a food thermometer to make sure foods are cooked to a safe
CHILL: Refrigerate promptly
Be sure to refrigerate foods within two hours. Set your refrigerator
no higher than 40 F and the freezer at 0 F