Each year food poisoning causes about 76 million Americans to get sick, over 300,000 to be hospitalized, and 5,000 people to die. It’s estimated that only five pathogens account for more than 90 percent of food-related deaths: Salmonella (31%), Listeria (28%), Toxoplasma (21%), Norwalk-like viruses (7%), Campylobacter (5%) and E. coli O157:H7 (3%). (Food Poisoning Information Center) The typical fatality involves a child, an elderly person, a chronically ill person, or a person with an impaired immune system.
One problem people have is determining whether they have food poisoning or if they have the flue. Food poisoning tends to start and end much more quickly than the flu, and usually lasts from 12 to 24 hours. Flu symptoms generally develop slowly over a day or so and a person typically develops a headache, fever, weakness, and a sore throat. In addition to the speed of onset the three main clues suggesting you don’t have the flu and do have food poisoning are frequent vomiting, repeated diarrhea, and (sometimes) if others who ate the same food are sick in the same way.
If someone is poisoned the advice varies depending on how severe it is and how vulnerable the patient is. If the victim is a member of an especially vulnerable population, such as an infant, you should go to a doctor. If you are a healthy adult, and any of the following symptoms occur, the advice also is to get to a doctor:
See medical attention if you have a fever over 101 F, you have been vomiting for more than 12 hours, you haven’t been able to keep fluids down for at least 12 hours, you have serious muscle cramping, you have bloody diarrhea, or suspect you have botulism.
The big concern with food poisoning, except if you have botulism, is dehydration. Dehydration is indicated by any of the following symptoms: having a dry mouth or sticky saliva, have little urine or dark urine, being dizzy, lightheaded, confused, having an increased heart rate, having problems with breathing, having a fast rate of breathing, having no tears, or having sunken eyes.
In very serious cases of food poisoning medications may be prescribed to stop the cramping and vomiting, and a doctor might also prescribe antibiotics. However, you should never stop diarrhea because its purpose is to clear the toxins from the body.
Botulism is a much more serious matter, and you should get to a hospital if you think you have it. Its symptoms include a headache, double vision, dizziness, weakness, droopy eyelids, constipation, dry mouth, paralysis, or the loss of reflex to light. The antitoxin for it must be given in the first 72 hours after symptoms first appear, and cannot be used on infants.
If you choose not to go to a doctor you should rest in bed, avoid activity (especially after eating), take plenty of fluids (ideally containing electrolytes - but not lots of sugars), and have someone monitor you. You can get electrolyte drinks sold in drugstores. Unless the condition is extreme (and if it is you should be in the hospital) you shouldn’t take medicines to prevent the vomiting and diarrhea because, as mentioned above, these are the mechanisms by which your body gets rid of food toxins. If you can, temporarily discontinue all oral medications. Avoid dairy products (because of temporary lactose intolerance), and caffeinated drinks. Don’t eat solid foods until you stop vomiting, when you began to do this limit them, and only eat light, soft, bland foods (such as saltine crackers or plain bread). One option is to try the BRAT diet, which gets its name from the four foods it includes: banana, rice, applesauce, and toast. Eat and drink slowly, and don’t mix hot and cold foods. Avoid brushing your teeth after eating since this can make you nauseous.
Alternative medicine sites sometimes recommend taking charcoal tablets that soak up toxins. Others recommend treatments with two bacteria found in milk products, Lactobacillus acidophilus, Lactobacillus bulgaricus, along with citrus seed extract. A fluid to replace water and electrolytes can be made by adding one teaspoon of salt and four teaspoons of sugar to one quart of water. Two herbs that are sometimes recommended for treating forms of food poisoning other than botulism are Arsenicum album and Nux vomica. You might consider calling your doctor and asking about any other foods or liquids, and off the shelf medicines, you should take.
From my prior posts regarding symbiotes (We Need Our Symbiotes – Lost Wanderer , We Need Our Symbiotes II – Lost Wanderer, and Umami Hypothesis – Lost Wanderer) readers will know that I have mixed feelings about going all out to avoid germs, (For a lighthearted spoof of this issue see: Germs – Weird Al Yankovic) but with that in mind here’s the advice I’ve been able to find on-line regarding trying to prevent food poisoning:
Prevention:
Foods from animal sources (FFAS) include such things as meat, milk, poultry, seafood (such as fish and shellfish), and eggs. Check the expiration dates on FFAS before buying or preparing them. Keep FFAS cold, and do not allow them to sit at room temperature. Cover and refrigerate these foods within a few hours. Be careful to keep juices from animal sources from contaminating other foods, such as by dripping down in the refrigerator. Don’t thaw FFAS at room temperature. Thaw meat in the refrigerator allowing 1 day for every 5lbs. Alternatively immerse FFAS in a cold water bath and change the water every 30 minutes (a 20 lb turkey will take 12 hours to thaw in cold water.) Don’t refreeze foods that have been thawed (especially poultry), and don’t partially cook a FFAS one day and then finish cooking it the next. FFAS should be cooked thoroughly to the appropriate internal temperature for the type of meat it is, (See the chart at: Safe Food Handling – USDA) and you should be sure of the temperature by using a good instant-read, digital, probe meat thermometer that is sensitive at the tip. (Of course, some FFAS are safe because they have been pasteurized.) Don’t cook stuffing inside the turkey, and remove it from the turkey before refrigerating leftover meat. Gravy and broth should be stored separately, too. The general rule is keep hot foods hot and cold foods cold.
Don’t drink unpasteurized milk (or foods made from it), juice, or cider. (Commercial juices sold at room temperature are safe because they have been pasteurized.) (Buying food that has been sterilized by using gamma radiation is another option. (Food irradiation – Wikipedia)) Breast-feeding is safest for infants and might prevent many food borne illnesses as well as other health problems. Don’t eat shellfish that has been exposed to red tides or are from contaminated waters. Don’t give honey to children under 1 year of age. Don’t store food in containers that previously held poisons or are made of metals. Don’t eat wild mushrooms unless you are certain they are safe.
Wash your hands, cutting boards, work surfaces, and utensils with soap and hot water both before and after handling raw FFAS. Wash raw fruits and vegetables thoroughly before eating them, out of concern for E.coli, Salmonella, and pesticides. (Some people recommend avoiding alfalfa, bean, clover, or radish sprouts altogether since they are difficult to clean.) Wash your hands with soap after handling reptiles, birds, or feces. If you are ill (especially with diarrhea or vomiting) do not prepare food for others. Cover any sore on your hands before preparing food
If you do home-caning, of course, use the proper procedures, while remembering that undercooking is the main problem in home canning. Rotate dry and canned food products. Put a “Use by” date on your canned products, and if a store bought product does not have a “Use by” date take a black ink marker and write the purchase date somewhere on the label. High-acid canned food such as grapefruit, tomatoes, and pineapple can be stored for 12 to 18 months. Low-acid canned foods such as poultry, fish, meat, and most vegetables will keep from two to five years if stored in a cool dry place. Avoid containers that are swollen with bulging lids, are rusted or leaking, are dented, have an unusual odor, or have an odd color. The rule is when in doubt, throw it out. (See: Safe Home Canning of Fruits, Vegetables and Meats - University of Minnesota Extension and USDA Complete Guide to Home Canning, 2009 revision)
Those at high risk, such as people with weakened immune systems, infants, the elderly, and pregnant women should avoid soft cheeses (such as feta, Brie, Camerbert, blue, Mexican style) and foods from deli counters. (Hard cheeses, processed cheeses, cottage cheese, cream cheese, and yogurt are considered safe.)
If you need to move anything from its original package to a new container, take a marking pen and write on the new container in large letters the common name of the product. This is especially important for products that are not easily identifiable, because while what it is might be obvious to you it might not be obvious to someone else. To help prevent cross contamination have separate color-coded plastic cutting boards or cutting plastic surfaces for different foods. An example would be red for red meats, yellow for poultry, tan for seafoods, green for fruits and vegetables, blue for ready-to-eat foods, and white for dairy. Store baking utensils together and keep them separate from cooking utensils. The same goes for the pots and pans and so forth.
Things you should have in your kitchen include:
You should have a liquid soap in a dispenser for hand-washing at your kitchen sink. (Antibacterial soaps aren’t an improvement, but what is important is to thoroughly scrub under running water for at least 20 seconds.)
You should also have an easily readable thermometer for your refrigerator placed in front for easy reading. (This is also the warmest part of the refrigerator.) Keep your refrigerator set so it reads 40° F, and your freezer at or below 0 F.
You should have a paper towel dispenser instead of using kitchen sponges or cloth towels, since they are excellent breeding grounds for bacteria.
You need shallow pans or containers to store foods in the refrigerator. Shallow pans allow more surface area for more rapid cooling.
Restaurant Eating:
You should order foods or dishes that are mostly made-to-order. This means most of the cooking of the main part of the dish (the meat, chicken or seafood part) is done after it is ordered. If this is not clear from the menu then ask. Temperature abuses are more likely to occur with foods that the cook is keeping warm with a steam table or a warmer rather than keeping cold in a refrigerator.
Stick with ordering foods that you are familiar with, either because you have had it before or you know how it’s prepared. You will be more likely to notice if something is wrong.
Know the minimum cooking temperatures of the meat and seafood products you order and make a request that the food be cooked to this temperature. For example, when ordering a hamburger, ask for it to be cooked to an internal temperature of at least 160 F.
If you are served an undercooked meat or egg product in a restaurant, send it back for further cooking. You should also ask for a new plate. If the problem is more than it simply being undercooked, but the sight, smell, or taste suggests some other concern don’t eat it and don’t re-order the same food again. The server might possibly re-serve you what you just returned, or perhaps all the servings of that food might be unsafe. This is especially likely to be the case if it came from a batch processed food. Avoid raw or rarely cooked meats, eggs, and seafoods; this includes such dishes as sushi, sashimi, raw oysters, rare hamburgers, or raw egg sauces (such as hollandaise, béarnaise, etc.).
If you are going all out you should regularly review a restaurant’s inspection and violation history. This is part of the public record. Familiarize yourself with the structure of the food inspection report used by your local program. Look at previous inspections for temperature violations and food-borne illness investigations. Investigate the training that your restaurant chef received by looking for food safety certificates, degrees, etc. Many local public health programs now publicize the inspection results on the Internet as well as require food facilities to post inspection grades, and will make them available for review by the public upon request. (For more information regarding preventing restaurant food poisoning see: Food Poisoning Information Center)
(Food Poisoning – Medline Plus, What medicine is there to treat food poisoning? – Go ask Alice!, Food Poisoning – Treatment, Food poisoning prevention – University of Iowa, Food Safety – Prevention – NOAH, Food Poisoning, Food Poisoning Prevention, Food poisoning prevention – MedlinePlus)
