Six simple steps to avoid food-borne illness: with some simple precautions, there's no reason mealtime should lead to sick time

Vibrant Life, March-April, 2002 by Debra Fulghum Bruce

If you are a vegetarian, the thought of having a food-borne illness probably never crosses your mind. After all, everyone knows that E. coli makes its home in raw beef, and Salmonella breeds rapidly in undercooked chicken or pork.

Well, it's time to rethink your past beliefs about food-borne illness, as fresh fruits, vegetables, eggs, lentils, and dairy products can also play host to a variety of deleterious bacteria, including E. coli and Salmonella. In fact, some of the most common carriers of food-borne germs include basil, cantaloupe, lettuce, potatoes, raspberries, scallions, strawberries, and tomatoes.

According to the Centers for Disease Control and Prevention (CDC), food-borne diseases cause an estimated 76 million illnesses, 325,000 hospitalizations, and 5,200 deaths in the United States each year. Not only are the symptoms uncomfortable; food-borne illnesses can lead to secondary long-term illnesses. For example, there are some strains of E. coli that can cause kidney failure in young children, while Salmonella can lead to reactive arthritis and serious infections. For pregnant women, the Listeria bacteria (commonly found in soft cheeses such as brie and feta) can cause meningitis and stillbirths.

What Causes It?

You encounter thousands of types of bacteria in your everyday environment; most of them cause you no harm. For instance, the bacteria in yogurt is "good" bacteria and benefits your body. But when harmful bacteria (also called pathogens), such as Listeria, Salmonella, and E. coli 0157:67 enter our food or water supply, they can cause problems ranging from flulike symptoms to incurable illness to death (see "Signs and Symptoms of Food-borned Infection" on page 13 for a list of common symptoms). Sometimes even the bacterial poisons or toxins produced by germs such as Staphylococcus aureus or Clostridium botulinum can result in food-borne illness. Three of the most common types of food-borne bacteria that affect vegetarians include the following:

* Campylobacter, the most common cause of diarrhea and abdominal cramps from food-borne illness. While most raw poultry meat has Campylobacter on it, vegetarians should be concerned if food becomes contaminated with juices dripping from raw chicken, such as a salad or vegetable dish cooked while someone prepared a chicken dish. Unpasteurized milk or contaminated water may also cause this infection.

* Escherichia coli 0157:H7, which causes an estimated 73,000 cases of infection and 61 deaths in the United States each year. While most strains of E. coli live in the intestines of healthy humans and animals, the 0157:H7 strain can be deadly, leading to bloody diarrhea and even kidney failure.

* Salmonella enteritidis, a bacterium that can cause illness if raw or undercooked eggs are eaten. Salmonella infection can lead to fever, abdominal cramps, and diarrhea within 12 hours to three days after eating the contaminated food. In some high-risk people (the elderly, pregnant women, infants, and those with compromised immune systems), Salmonella bacteria can lead to hospitalization and even death.

If you suspect a food-borne infection, you need to seek medical care. Your doctor will culture a stool sample to identify the particular bacteria; then treatment will follow, depending on the pathogen and your symptoms. Experts believe that many people who have diarrhea or vomiting assume this is a "virus," and let it run its course instead of getting an accurate diagnosis. For this reason, the CDC estimates that 38 cases of salmonellosis actually occur for every case that is diagnosed and reported to public health authorities.

Who's at Risk?

If you eat food, you are at risk for food-borne illness. Yet those at highest risk include infants, pregnant women, the elderly, the chronically ill, and those with compromised immune systems. While there are more than 250 different types of food-borne diseases causing such symptoms such as diarrhea, vomiting, and body aches, this is one common illness you can avoid--if you understand the rules. Consider the following six steps as you protect yourself and your family from unnecessary illness.

Step 1: Watch what you buy.

Make sure the food you buy at the grocery store is the freshest available. Check the package for expiration or "use by" dates, and make sure you will have time to eat the food before it needs to be thrown out. When this date expires, throw the food away to be safe.

When buying eggs, open the carton and inspect each egg for cleanliness. Make sure the eggs have no cracks or thinness in the shells. Select cheese that is fresh and has no unusual mold or discolored spots. Dairy products should be dated and pasteurized.

Avoid buying fruits or vegetables that are slippery, moldy, or have a funny odor. And never eat fresh fruits or vegetables in the store, as you have no idea what types of germs or pesticides may be on them.

Step 2: Always wash fresh fruits and vegetables (even if they come in prewashed packages).

Fruits and vegetables can harbor some of the most deadly food-borne pathogens, particularly if they are washed or irrigated with water that is contaminated with animal or human feces. These germs can get into fruits and vegetables during processing or packaging. And if the workers who packed the fruits and vegetables into crates are ill, these germs go right onto the foods they are touching.