How to Stop Food-Borne Illness Before it Starts

Despite the fact that America's food supply is among the safest in the world, 76 million cases of food-borne diarrheal disease occur in the United States every year. The US Food and Drug Administration (FDA) has given high priority to combating microbial contamination of the food supply, but consumers also have a part to play, especially when it comes to following safe food handling practices in the home.

Prime causes of food-borne illness include bacteria, parasites and viruses such as E. coli, Salmonella, Listeria, Shigella, Giardia, Cyclospora, Cryptosporidium and hepatitis A virus. These organisms can be found in a wide range of foods and drinks, including meat, milk and other dairy products, spices, chocolate, seafood and even water.

Poultry is the food most often contaminated with disease-causing organisms. (It's been estimated that 60% or more of raw poultry sold at retail outlets probably carries some disease-causing bacteria.) Unpasteurized fruit and vegetable juices; foods made with raw or undercooked eggs; chicken, tuna, potato and macaroni salads; and cream-filled pastries harboring these pathogens have also been implicated in food-borne illnesses, as has fresh produce. Bacteria such as Listeria monocytogenes, Vibrio vulnificus, Vibrio parahaemolyticus and Salmonella have been found in raw seafood; and oysters, clams, mussels, scallops and cockles may be contaminated with hepatitis A virus.

Shopping
Prevention of food poisoning starts with your trip to the supermarket.

• Select packaged and canned foods first, saving frozen for last so it doesn’t thaw.
• Look for expiration dates on labels and never buy outdated food. Likewise, check the "use by" or "sell by" date on dairy products and pick those that will stay fresh longest in your refrigerator.
• Don't buy food in cans or jars that are bulging, dented or cracked or have loose or bulging lids.
• Avoid foods containing raw eggs, such as homemade ice cream, mayonnaise, eggnog, cookie dough, and cake batter, mayonnaise, and eggnog, because they carry a Salmonella risk. Commercial products are usually not a risk because they're made with pasteurized eggs.
• Choose eggs that are kept refrigerated in the store. Before buying, open the carton and make sure they are clean and uncracked.
• Check for cleanliness at the meat or fish counter and the salad bar. (For instance, cooked shrimp lying on the same bed of ice as raw fish could become contaminated.)
• Select frozen foods and perishables such as meat, poultry or fish last. Put these products in separate plastic bags so that drippings don't contaminate other foods.
• Don't buy frozen seafood if the packages are open, torn or crushed on the edges. Avoid packages that are above the frost line in the store's freezer. Look for signs of frost or ice crystals inside clear packages – this could mean the product has been stored for a long time or thawed and refrozen.
• If it will take more than an hour to get your groceries home, take an ice chest along to keep frozen and perishable foods cold.

Storage
The first rule of food storage in the home is to refrigerate or freeze perishables immediately. Refrigerator temperature should be 5° C (41° F), and the freezer should be -18° C (0° F). Check these periodically with a good thermometer.

• Poultry and meat can be stored in the refrigerator in its plastic wrap for a day or two. If part of the meat or poultry is going to be used, it can be wrapped loosely for refrigerator storage, but make sure the juices can't escape to contaminate other foods.
• Tightly wrap any foods destined for the freezer.
• Store eggs in the carton in the refrigerator rather than in the door, where the temperature is warmer.
• Keep seafood in the refrigerator or freezer until preparation time.
• Store leftovers in tight containers.

For foods that can be stored at room temperature, some precautions will help make sure they remain safe. Don't store foods near household cleaning products or chemicals. Potatoes and onions should not be stored under the sink, because leakage from the pipes can damage the food. Potatoes don't belong in the refrigerator either – store them in a cool, dry place.

Keep it Clean
Careless food handling and improper cooking often set the stage for the growth of disease-causing organisms. Cross-contamination can occur when cutting boards and kitchen tools that have been used to prepare one contaminated food (such as raw chicken) are not cleaned before being used for another food (such as vegetables). Hot or cold foods left standing too long at room temperature provide an ideal climate in which bacteria can grow. The first rule of safe food preparation in the home is to keep everything clean – this applies to the areas where food is prepared and to the cook.

• Wash hands with warm water and soap for at least 20 seconds before starting to prepare a meal and after handling raw meat or poultry.
• Wash the lids of canned foods before opening to keep dirt from getting into the food, and clean the blade of the can opener after each use.
• Always use clean utensils and wash them between cutting different foods.
• Wash fresh fruits and vegetables thoroughly, rinsing in warm water.
• Machinery such as food processors, meat grinders and juicers should be taken apart and cleaned as soon as possible after they are used.
• Wash countertops with a solution of 1 teaspoon chlorine bleach in 1 liter (about 1 quart) of water or with a commercial kitchen cleaning agent. When done with counters, pour the solution down the drain to sanitize it.
• Dishcloths and sponges can harbor bacteria. Wash them in the washing machine (hot water) weekly.
• Use smooth cutting boards made of hard maple or plastic with no cracks. Always wash and sanitize cutting boards after using them for raw foods and before using them for ready-to-eat foods. (Wash cutting boards with hot water and soap, using a scrub brush, then sanitize them in an automatic dishwasher or by rinsing with a solution of 1 teaspoon chlorine bleach in a liter of water.)

Watch the Temperature
The second rule of home food preparation is to keep hot foods hot and cold foods cold.

• Don't thaw meat and other frozen foods at room temperature. Instead, defrost by moving them from the freezer to the refrigerator for a day or two; by submerging in cold flowing water; or by defrosting in the microwave or during cooking.
• Use a thermometer to ensure that meats are completely cooked. Don't eat poultry that is pink inside.
• Seafood should be thoroughly cooked. (Fish is done when the thickest part becomes opaque and the fish flakes easily when poked with a fork.)
• Eggs should be cooked until the white and the yolk are firm.
• Protect food from cross-contamination after cooking, and eat it promptly. Do not put cooked foods on unwashed plates or on plates that have held raw foods.
• If a dish is to be served hot, get it from the stove to the table as quickly as possible. Cooked foods should not be left standing on the table or kitchen counter for more than two hours.
• Keep cold foods in the refrigerator or on a bed of ice until serving – especially in summer.
• Refrigerate leftovers as soon as possible, and use within three days.

Symptoms of Food-Borne Illness
Common symptoms of food-borne illness include diarrhea, abdominal cramping, fever, headache, vomiting, severe exhaustion and sometimes blood or pus in the stools. However, symptoms will vary according to the type of bacteria and by the amount of contaminants eaten.

Rarely, symptoms appear as soon as 30 minutes after eating contaminated food, but they typically do not develop for several hours. Symptoms usually show within two days, but in some instances they might appear up to several weeks after exposure. The illness usually lasts a day or two, but in some cases can persist up to 10 days. For most healthy people, food-borne illnesses are neither long-lasting nor life-threatening. However, they can be severe in the very young, the very old, and people with certain diseases and conditions. These conditions include:

• liver disease from excessive alcohol use, viral hepatitis, or other causes
• hemochromatosis, an iron disorder
• diabetes
• stomach problems, previous stomach surgery or low stomach acid (e.g., from antacid use)
• cancer
• immune disorders, including HIV infection
• long-term steroid use, as for asthma and arthritis

If you have a health problem, especially one that may have impaired your immune system, don't eat raw shellfish and use only pasteurized milk and cheese, and pasteurized or concentrated ciders and juices.

When symptoms are severe, the victim should see a doctor or get emergency help. This is especially important for those who are most vulnerable. For milder cases of food poisoning, make sure to maintain an adequate liquid intake to replace fluids lost through vomiting and diarrhea and get plenty of rest.

This article includes information from the US Food and Drug Administration.