Maintaining Your Health on Mackinac
Prevention and Treatment Are Keys To Combating Food Poisoning
By Yvan Silva, M.D.

Food poisoning is common. It is more common in the summer, when raw and cooked foods are left exposed and subjected to higher temperatures. Bacteria grow exponentially into the millions, and the degree of the attack of food poisoning relates to the type of ingested food and the number of bacteria present. A decade ago, there was a national concern regarding millions of pounds of ground beef that were believed to have been contaminated with E. coli; there have also been sporadic reports of infected strawberries and other fruits and vegetables imported from other countries. Just recently there have been widespread media reports of fatal food poisoning from contaminated fruits and vegetables. Public health authorities remain concerned that thousands of Americans die every year from food containing abnormal amounts of bacteria, viruses, and parasites; millions get sick, and the symptoms and signs may be subclinical so that less than 5% of cases are recognized and treated.

It is difficult to identify contamination because of the variance of the food products themselves, and the types of microbes they harbor. Raw vegetables taken from the farm to the grocer could have been tainted with animal feces. Cross contamination is known to occur during shipping and handling. Further mishandling in the kitchen can magnify the problem. It is important to know that contaminated food, in most situations, may taste and smell perfectly normal. Most of the time, the individual dismisses the problem as a stomach or flu bug, and the symptoms are resolved within 24 to 48 hours. There are hundreds of food recalls per year, but unfortunately, they occur after the recognition of a local epidemic. The U.S. Department of Agriculture recalled 25 million pounds of hamburger patties a decade ago, the largest recall ever. This took place about two months after the initial contamination actually occurred.

The most important line of prevention begins with the selection, handling, and preparation of food. Studies have shown that 50% of the public eats raw or undercooked eggs, 23% consume undercooked hamburgers, and 17% eat raw clams and oysters; 26% do not wash cutting boards properly after using them for raw meat and poultry. We know all too well that a large proportion of people do not wash their hands regularly, and more importantly, after personal physiological functions.

At restaurants and fast food outlets, it is important to check the food before you eat it. A gritty salad could be contaminated with dirt; the burger or chicken still pink on the inside should be returned. Lack of cleanliness of the facilities, clutter, and poor organization are often tip-offs for trouble. In the home kitchen, meats should be kept separately away from other foods. Cutting boards, plates, and utensils and all used surfaces should be cleansed with hot soapy water or a diluted bleach solution.

Cooking temperatures are most important. Beef, veal, and lamb must be cooked at least to 140 degrees Fahrenheit; ground meat and all pork products to 160 degrees. Cooked poultry should reach at least 180 degrees. A meat thermometer will help. Eggs should be cooked so that the yolk is firm and the whites not runny. Produce should be thoroughly washed, including fruit, because of the risk of introducing bacteria into the pulp when cutting. Dairy products should be carefully refrigerated and properly used before expiration dates. Seafood should be cooked thoroughly, although it takes less time. Salads should be kept cold before serving.

The onset of vomiting and diarrhea following a contaminated meal may not equally affect all who ate the food. Depending on the severity of symptoms, they can go from mild to moderate to severe within hours, it is best to see a physician. Even with mild symptoms, there is no telling how rapid the progression might be. Symptoms can escalate to fever, chills, dehydration, bloody stools, and a debilitated state. You will help yourself, and more importantly you will help others, if an outbreak can be diagnosed early. Severe attacks can be fatal, especially in young children, the elderly and infirm, and patients with weak immune systems. Physicians treating these patients must obtain stool samples to be cultured to identify the infection, and also report the results to public health authorities who will monitor the outbreak, if there is one.

A well-known list of pathogens - infectious agents - are food borne. Salmonella strains in a wide variety of foods cause up to 2,000 deaths per year, and an estimated two million infections. Symptoms ensue within six to 24 hours, and can continue for three to four weeks. A new drug-resistant strain has been recently identified and is of concern. E. coli can be found in undercooked and raw meats and in several other items. It is believed to infect about 25,000 people per year; the death rate is about 200. Treatment can range from supportive regimens at home until the infection has run its course, to hospitalization and treatment for a host of possible complications. Listeria species, campylobacter, and the Hepatitis A virus are also known to be involved in large numbers of infections per year, ranging from 1,500 to more than 100,000.

Seeking treatment early is well advised. Procrastination can be harmful for the victim, as well as others in the environment. Public health officials are rightly concerned that the incidence of food poisoning and deaths from this condition can possibly increase by 10% to 15% in the next 10 years or so. The food industry is shaping up - large meat and poultry companies will be required to test and monitor their products regularly and at particular points of production, including cutting, grinding, and cooking. There is the hope that food retailers will have to bear scrutiny for their sales.

The mixing of meats is adulteration, according to Michigan law, and yet in a recent exposé, regulators found that 19% of ground poultry, 38% of ground pork, and 84% of ground lamb were mixed with other meats, and less than 3% of ground meat and 6% of hamburgers were similarly adulterated. Several stores have been cited more than once for violations. Clearly, consumers cook meats differently, and admixture can have serious health consequences, not to mention the important considerations for religious compliance.

Vigilance is vital for prevention. Persistent symptoms should receive prompt medical attention.

Dr. Silva is a professor of surgery at Wayne State University and a resident of Woodbluff on Mackinac Island.