Food-borne Disease

By Dr. David Lipschitz

November 30, 2011 5 min read

The Centers for Disease Control and Prevention recently reported that more than 1,000 food-borne disease outbreaks occurred in 2008, the latest year information is available.

This led to more than 23,000 illnesses; nearly 1,300 were reported hospitalized, and 22 people died. The actual number of food-borne illnesses is almost certainly higher, as the vast majority of them go unreported. The CDC believes that more than 48 million infections occur annually.

Salmonella is the most common type of bacteria that contaminate beef, poultry and fish; it also can be found in fruits, vegetables and nuts. Salmonella infections cause abdominal pain, fever, nausea and diarrhea. This usually occurs 12 to 72 hours after contamination and resolves within four days to a week. On rare occasions, salmonella can spread to the bloodstream, leading to a life-threatening illness.

Recently, the deadliest food-borne outbreak in the past decade occurred because of contamination of cantaloupes with listeria. According to the CDC, at least 139 illnesses and 29 deaths have been reported in 18 states in the West and Midwest.

Listeria is the deadliest type of bacteria contaminating food. The current outbreak is the worst on record. In 1985, cheese contaminated by listeria led to 28 deaths, and in 1998, listeria-contaminated hot dogs caused 21 deaths. This organism is particularly dangerous, as it can survive in the refrigerator for prolonged periods and remain viable in many heated foods. Unless you are assured that recently bought melons are not from a contaminated source, the Food and Drug Administration recommends that they be discarded.

Listeria is most serious in those older than 70 and in those with underlying illnesses impairing the immune system. The first evidence of illness may occur within a few days to as long as two months after the initial infection. In most cases, the illness is mild -- abdominal pain and diarrhea that spontaneously resolve. In susceptible people, listeria can enter the bloodstream, causing flu-like illness with fever, headache and muscle pain. The organism may then invade the nervous system, resulting in meningitis or encephalitis, which can cause a severe headache, confusion and disorientation, gait and balance problems, and convulsions.

For reasons that are not well-understood, listeria infections are more common in pregnant women. Though listeria causes only mild symptoms in the mother, the bacteria frequently infect the fetus, leading to miscarriage, premature delivery, permanent brain damage and death.

In those with a serious illness, identifying the organism in the stool, blood and cerebrospinal fluid and treating with antibiotics may prevent serious adverse effects. Patients always require hospitalization. Antibiotic treatment is given for two weeks or, if the brain is involved, for four weeks.

Clearly, contaminated foods are a serious health threat. There is, however, much that can be done to reduce the risk of food poisoning. The way food is handled is particularly important.

When shopping, separate raw meat, poultry and seafood from other foods in the grocery cart, and place them in plastic bags to prevent their juices from contaminating other products. Separate these foods at checkout, and keep them in separate grocery bags.

When refrigerating foods, place raw meat, poultry and seafood in containers or sealed plastic bags to prevent their juices from dripping onto other foods. Do not leave eggs, meats or milk for extended periods of time at room temperature. Promptly refrigerate leftovers and food prepared in advance. Do not consume food that has been refrigerated for too long, and never consume outdated foods or liquids.

Always wash your hands with soap and warm water before and after handling food. Prepare animal products on clean cutting boards, and use separate utensils. Cook foods to the recommended temperature prior to eating, and beware of undercooked or rare meat.

Thoroughly wash fruits and vegetables under running water rather than in a bowl or sink, and ensure that they do not come into contact with other raw foods or unclean surfaces. Never cut meat with a knife and then immediately use it to chop or slice vegetables.

In relation to the food we eat, cleanliness and compulsive attention to appropriate preparation are the keys to preventing serious illness.

Dr. David Lipschitz's weekly column, "Lifelong Health," can be found at

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