Originally published in Heath & Money Magazine
It started off as a wonderful getaway – no kids, rooms at a country inn, a romantic dinner. But by the time Becky and her husband reached their rooms after their seafood dinner, they knew something was wrong. Queasiness and cramps turned into diarrhea and vomiting that lasted for several days.
“We were deathly ill,” she remembers. “We nearly asked if the innkeeper could give us a second room, because we were taking turns pounding on the bathroom door, telling each other to hurry up and get out of there!”
While she laughs about it now, Becky’s bout with fish gone bad sounds familiar to anyone who’s ever endured the effects of food poisoning or “foodborne illness,” as it’s called in the medical field.
Each year, 7-million Americans are laid low with stomach cramps, vomiting, vague aches and weakness after eating tainted foods. For most people, it’s a temporary – if thoroughly unpleasant – experience. But each year, about 2,000 people in this country die from food poisoning.
Most people don’t have to worry about foodborne illnesses. Healthy adults and children can eat mildly-tainted foods without any experiencing even the mildest intestinal grumble. The elderly, pregnant women, and people with weakened immune systems are those at risk.
Many cases of food poisoning come from mishandling foods at home, but over the past few years, highly-publicized recalls of hot dogs, ice cream, hamburgers, and other foods highlight concerns about contaminated meats, vegetables and dairy products sold in stores or eaten in restaurants.
While it’s not hard to follow safe food handling and preparation tips at home, it’s a lot harder to protect yourself in the marketplace. When an outbreak occurs and a recall is announced, consumers can get the impression that food processing safety only worry health officials after the fact. That’s not the case, according to Beth Gaston of the Food Safety and Inspection Service, the government agency that keeps an eye on how our meat, poultry and egg products are prepared.
“There is zero tolerance for pathogens (the bacteria that cause food poisoning) in ready-to-eat products. Inspectors are in slaughterhouses and processing plants every day. Usually, a plant holds an order and doesn’t ship it if there is testing being done. The shipment never leaves the plant if there is a positive result. Recalls are the last line of defense.”
When bad food does manage to escape detection, our mobile, complex food distribution system contributes to the problems of tracking it. Becky’s tainted turbot was an example of an isolated, local case of spoiled food. Most recalls that make headlines involve foods that were once produced and distributed locally or regionally but are now shipped out nationwide and sold under a half-dozen brand names. Even with news releases and lots of media coverage, it’s nearly impossible to reach everyone who has purchased contaminated food.
Last winter’s outbreak of Listeria poisoning from tainted hot dogs is an example. Officials in upstate New York discovered that a Meals on Wheels program was serving the hot dogs more than a week after the recall was announced. No one in the program had paid attention to the news or realized that the hot dogs they were serving was one of the affected brands.
Even when the news reaches consumers, it’s not always heeded. In 1994, Salmonella was found in ice cream delivered by Schwann’s, a company that sells food directly to customers. The company personally contacted and warned all of the customers who’d taken delivery of the ice cream. Despite that, 22 of the 72 households that received the warning still ate the ice cream. “They just didn’t believe it affected them.,” says Gaston.
Are there really more outbreaks of food borne illnesses, or are doctors just finding better ways to diagnose cases of food poisoning and the media giving more coverage when there is an outbreak? According to Tom Skinner of the Center for Disease Control in Atlanta, the answer is: all of the above.
“Our surveillance and detection techniques are better, so that means we are finding more outbreaks.”
Some of those techniques sound like a cross between Star Trek and the X Files. One of them allows scientists to make a ‘fingerprint’ of a bacteria and enter it into a CDC database. Since each bacteria is unique, if a sample from Georgia and another sample from Florida match, scientists know they have a common cause of illness somewhere in the food system. They then interview patients and start tracking down the food source.
That works after the fact, but it doesn’t help prevent outbreaks. Other programs take care of that. By January 2000, all processing plants must initiate a program with the impressive sounding title of “Hazard Analysis and Critical Control Points.” Under this program, food processing plants examine all of the steps of their operation and identify the likely points where contamination could occur, then draw up plans for controlling or eliminating the problem. Inspectors from the FSIS review the plans and physically inspect the plants to see if they can uncover any shortcomings or inadequacies. If they find anything, the plants fix the problem and keep it from happening again.
“The plant’s objective is to produce safe food. The FSIS objective is to insure that’s what happens,” says Gaston.
The CDC and government have yet another approach to the problem, the Food Safety Initiative. Health officials used to wait until cases of suspected food poisoning were reported. Now, they go to the labs and look for suspicious specimens.
“Health departments and academic centers canvass labs and get data on cases that might be caused by foodborne pathogens. We look for case studies that examine what the major risk factors are,” says Skinner of the CDC. Then they are on the alert for cases that fit those patterns.
When there is an outbreak of illness, health officials turn detectives as they trace the source of the outbreak and then try to find the cause. Almost all of the bacteria are found in animals’ intestinal tracts or wastes. They reach the food in both obvious and subtle ways.
“All plants have procedures to follow to prevent contamination during the initial processing and follow-up procedures to prevent recontamination,” explains Gaston. “But there are many ways that those procedures can be accidentally circumvented. Some bacteria can get into the system through condensation from overhead pipes. Some employees don’t clean their hands properly after handling meats. It can be something as simple as someone walking from one area of a plant to another who has unwittingly come into contact with something contaminated.”
Complicating the detection work is the nature of some of the poisons. You don’t always get sick right away. Sometimes the bacteria hangs around in your system and takes its time before making you ill. In the case of Listeria, the incubation period is as much as 70 days. That’s frustrating for those trying to limit the effects of an outbreak, because it’s a particularly hostile bug. Only about 1,800 cases are reported each year, but claims an average of 425 victims, a percentage of deaths than for other, more common, types of food poisoning. In comparison, Salmonella makes about 40,000 people sick each year while killing about 1000 and E. coli checks in with 20,000 victims and 250 deaths.
While the USDA inspectors monitor conditions at processing facilities, the sheer number of plants guarantees that sooner or later, outbreaks of illness will occur. So it’s up to consumers to protect themselves. Proper food preparation is the best way to prevent outbreaks of food poisoning.
“In homes, people should choose to reheat ready-to-eat foods and treat them with special care,” advises Gaston. “That applies to pepperoni and cold cuts as well as to hot dogs. Raw milk and soft cheese are particularly susceptible to contamination.”
When eating out, diners depend heavily on the integrity and efficiency of the local health departments. Those agencies concentrate more on the cleanliness of the restaurant and its kitchen and proper storage of foods than on cooking techniques. The restaurateurs, in turn, rely on their suppliers to deliver fresh produce, meats, and fish. As Becky found out, even the best places sometimes get stuck.
Those who need to pay extra attention to their foods at home should do the same thing when eating out, says Gaston. “It’s probably a good idea for the at-risk community to take the same steps they use at home. Order foods that are thoroughly cooked and perhaps don’t order cold cuts or ready-to-eat foods that won’t be reheated.”
Still feeling queasy after taking all of the precautions? Check in with your doctor, particularly if you are part of the at-risk group. It might just be something that’s going around, but it’s the best way to make sure you won’t be a statistic.