To Your Health
Food-Borne Disease

by Paulette Avery RN, MSN

One evening a year or two ago, my husband and I prepared and ate scallops for dinner. They were delicious, but almost immediately after consuming them we became ill. Without going into the details, the problem passed quickly, and we were fine by the next day. Fortunately, most food-borne disease (FBD) resembles the intestinal flu and is relatively mild. But when it involves botulism, or when the illness strikes the elderly, infants, or those with a compromised immune system, the results can be life-threatening. An estimated 76 million people in the US suffer from food-borne illness each year. Some 325,000 cases require hospitalization, with 5,000 resulting in death.

Food-borne illness results from eating foods contaminated with a variety of agents from bacterial and viral to chemical and parasitical. Because the onset of symptoms can vary from a few hours to several days or even weeks after eating the problem food, it is often difficult to determine the source. Here's information about the various causes, typical symptoms and their onset, and what you can do to help prevent FBD.

Food-borne diseases can be divided into four categories based on the length of time from eating the suspected food to the onset of symptoms. In the first category, short incubation, symptoms appear within 16 hours to a day of eating the problem food. A very short interval between eating the food and the onset of nausea, vomiting, and cramping occurs with chemical agents, including metals, fish toxins, shellfish toxins, monosodium glutamate, and mushrooms. Symptoms involving the nervous system may appear weeks later.

Bacterial agents can cause either vomiting, usually one to six hours later, or diarrhea, within eight to 16 hours.

The second category, intermediate incubation, covers FBD with symptom onset from one to three days later. The cause in this category is bacteria and viruses that affect the small or large bowel. Diarrhea is usually the primary symptom, but vomiting and fever may also occur. Salmonella poisoning, traveler's diarrhea, and botulism, a very serious and sometimes fatal FBD, also fall into this category.

The third category covers FBD with symptom onset three to five days later. Depending on the bacteria involved, symptoms may include bloody stools and abdominal pain or an appendicitis-like syndrome.

Symptoms that appear one to three weeks later are typical of FBD in the fourth category. The cause here varies from parasites to bacteria and viruses, and includes infection with Hepatitis A and toxoplasmosis. Symptoms vary widely depending on the cause.

Safe food handling provides the best protection against FBD, but since food safety is a huge topic, I will only hit the main points here. Always wash your hands with warm water and soap before handling food. Wash all cooking utensils and surfaces after use with hot, soapy water. Avoid using utensils from the preparation of raw meat, fish, or seafood for other foods unless you wash them well first.

Dr. Andrew Weil recommends buying organic produce whenever possible to avoid exposure to pesticides. The next best option is locally grown produce. Wash all produce in running water before use or in a solution made from one teaspoon of dishwashing detergent in a gallon of water and then rinse well in warm water. Peel carrots, potatoes, and cucumbers. If you use bagged greens, Dr. Weil suggests washing them again in cool running water even if they have been washed before bagging, and then drying them with paper towels. Discardbagged greens and other foods when they exceed the expiration date.

Keep cold foods cold and hot foods hot. Place perishable and prepared foods and leftovers into the refrigerator or freezer within two hours of purchase or use. Always thaw and marinate foods in the refrigerator rather than at room temperature.

I wish each of you a healthy and joyful holiday season!

Paulette Avery is a registered nurse and a freelance writer who specializes in health issues.