
Bacteria and Foodborne Illness
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What are foodborne illnesses?
Foodborne illnesses are caused by eating food or drinking
beverages contaminated with bacteria, parasites, or viruses. Harmful
chemicals can also cause foodborne illnesses if they have
contaminated food during harvesting or processing. Foodborne
illnesses can cause symptoms that range from an upset stomach to
more serious symptoms, including diarrhea, fever, vomiting,
abdominal cramps, and dehydration. Most foodborne infections are
undiagnosed and unreported, though the Centers for Disease Control
and Prevention estimates that every year about 76 million people in
the United States become ill from pathogens, or disease-causing
substances, in food. Of these people, about 5,000 die.
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What are the causes of foodborne illnesses?
Harmful bacteria are the most common cause of foodborne
illnesses. Some bacteria may be present on foods when you purchase
them. Raw foods are the most common source of foodborne illnesses
because they are not sterile; examples include raw meat and poultry
that may have become contaminated during slaughter. Seafood may
become contaminated during harvest or through processing. One in
10,000 eggs may be contaminated with Salmonella inside the
egg shell. Produce such as spinach, lettuce, tomatoes, sprouts, and
melons can become contaminated with Salmonella, Shigella, or Escherichia coli (E. coli) O157:H7. Contamination
can occur during growing, harvesting, processing, storing, shipping,
or final preparation. Sources of produce contamination are varied as
these foods are grown in soil and can become contaminated during
growth or through processing and distribution. Contamination may
also occur during food preparation in a restaurant or a home
kitchen. The most common form of contamination from handled foods is
the calcivirus, also called the Norwalk-like virus.
When food is cooked and left out for more than 2 hours at room
temperature, bacteria can multiply quickly. Most bacteria grow
undetected because they don’t produce a bad odor or change the color
or texture of the food. Freezing food slows or stops bacteria’s
growth but does not destroy the bacteria. The microbes can become
reactivated when the food is thawed. Refrigeration also can slow the
growth of some bacteria. Thorough cooking is needed to destroy the
bacteria.
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What are the symptoms of foodborne illnesses?
In most cases of foodborne illnesses, symptoms resemble
intestinal flu and may last a few hours or even several days.
Symptoms can range from mild to serious and include
- abdominal cramps
- nausea
- vomiting
- diarrhea, which is sometimes bloody
- fever
- dehydration
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What are the risk factors of foodborne illnesses?
Some people are at greater risk for bacterial infections because
of their age or an unhealthy immune system. Young children, pregnant
women and their fetuses, and older adults are at greatest risk.
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What are the complications of foodborne illnesses?
Some micro-organisms, such as Listeria monocytogenes and Clostridium botulinum, cause far more serious symptoms than
vomiting and diarrhea. They can cause spontaneous abortion or
death.
In some people, especially children, hemolytic uremic syndrome
(HUS) can result from infection by a particular strain of bacteria, E. coli O157:H7, and can lead to kidney failure and death.
HUS is a rare disorder that affects primarily children between the
ages of 1 and 10 years and is the leading cause of acute renal
failure in previously healthy children. A child may become infected
after consuming contaminated food or beverages, such as meat,
especially undercooked ground beef; unpasteurized juices;
contaminated water; or through contact with an infected person.
The most common symptoms of HUS infection are vomiting, abdominal
pain, and diarrhea, which may be bloody. In 5 to 10 percent of
cases, HUS develops about 5 to 10 days after the onset of illness.
This disease may last from 1 to 15 days and is fatal in 3 to 5
percent of cases. Other symptoms of HUS include fever, lethargy or
sluggishness, irritability, and paleness or pallor. In about half
the cases, the disease progresses until it causes acute renal
failure, which means the kidneys are unable to remove waste products
from the blood and excrete them into the urine. A decrease in
circulating red blood cells and blood platelets and reduced blood
flow to organs may lead to multiple organ failure. Seizures, heart
failure, inflammation of the pancreas, and diabetes can also result.
However, most children recover completely.
See a doctor right away if you or your child has any of the
following symptoms with diarrhea:
- High fever—temperature over 101.5°, measured orally
- Blood in the stools
- Diarrhea that lasts more than 3 days
- Prolonged vomiting that prevents keeping liquid down and can
lead to dehydration
- Signs of severe dehydration, such as dry mouth, sticky saliva,
decreased urination, dizziness, fatigue, sunken eyes, low blood
pressure, or increased heart rate and breathing rate
- Signs of shock, such as weak or rapid pulse or shallow
breathing
- Confusion or difficulty reasoning
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How are foodborne illnesses diagnosed?
Your doctor may be able to diagnose foodborne illnesses from a
list of what you’ve eaten recently and from results of appropriate
laboratory tests. Diagnostic tests for foodborne illnesses should
include examination of the feces. A sample of the suspected food, if
available, can also be tested for bacterial toxins, viruses, and
parasites.
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How are foodborne illnesses treated?
Most cases of foodborne illnesses are mild and can be treated by
increasing fluid intake, either orally or intravenously, to replace
lost fluids and electrolytes. People who experience gastrointestinal
or neurologic symptoms should seek medical attention.
In the most severe situations, such as HUS, hospitalization may
be needed to receive supportive nutritional and medical therapy.
Maintaining adequate fluid and electrolyte balance and controlling
blood pressure are important. Doctors will try to minimize the
impact of reduced kidney function. Dialysis may be needed until the
kidneys can function normally. Blood transfusions also may be
needed.
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How are foodborne illnesses prevented?
Most cases of foodborne illnesses can be prevented through proper
cooking or processing of food, which kills bacteria. In addition,
because bacteria multiply rapidly between 40°F and 140°F, food must
be kept out of this temperature range.
Follow these tips to prevent harmful bacteria from growing in
food:
-
Refrigerate foods promptly. If prepared food stands at room
temperature for more than 2 hours, it may not be safe to eat. Set
your refrigerator at 40°F or lower and your freezer at 0°F.
-
Cook food to the appropriate internal temperature—145°F for
roasts, steaks, and chops of beef, veal, and lamb; 160°F for pork,
ground veal, and ground beef; 165°F for ground poultry; and 180°F
for whole poultry. Use a meat thermometer to be sure. Foods are
properly cooked only when they are heated long enough and at a
high enough temperature to kill the harmful bacteria that cause
illnesses.
-
Prevent cross-contamination. Bacteria can spread from one food
product to another throughout the kitchen and can get onto cutting
boards, knives, sponges, and countertops. Keep raw meat, poultry,
seafood, and their juices away from all ready-to-eat foods.
-
Handle food properly. Always wash your hands for at least 20
seconds with warm, soapy water before and after handling raw meat,
poultry, fish, shellfish, produce, or eggs. Wash your hands after
using the bathroom, changing diapers, or touching animals.
-
Wash utensils and surfaces before and after use with hot, soapy
water. Better still, sanitize them with diluted bleach—1 teaspoon
of bleach to 1 quart of hot water.
-
Wash sponges and dish towels weekly in hot water in the washing
machine.
-
Keep cold food cold and hot food hot.
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Maintain hot cooked food at 140°F or higher.
-
Reheat cooked food to at least 165°F.
-
Refrigerate or freeze perishables, produce, prepared food, and
leftovers within 2 hours.
-
Never defrost food on the kitchen counter. Use the
refrigerator, cold running water, or the microwave oven.
-
Never let food marinate at room temperature—refrigerate it.
-
Divide large amounts of leftovers into small, shallow
containers for quick cooling in the refrigerator.
-
Remove the stuffing from poultry and other meats immediately
and refrigerate it in a separate container.
-
Wash all unpackaged fruits and vegetables, and those packaged
and not marked “pre-washed,” under running water just before
eating, cutting, or cooking. Scrub firm produce such as melons and
cucumbers with a clean produce brush. Dry all produce with a paper
towel to further reduce any possible bacteria.
-
Do not pack the refrigerator. Cool air must circulate to keep
food safe.
For more information about prevention of foodborne illnesses, the
U.S. Department of Agriculture provides a fact sheet on safe food
handling.
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What is food irradiation?
Food irradiation is the treatment of food with high energy such
as gamma rays, electron beams, or x rays as a means of cold
pasteurization, which destroys living bacteria to control foodborne
illnesses. The United States relies exclusively on the use of gamma
rays, which are similar to ultraviolet light and microwaves and pass
through food leaving no residue. Food irradiation is approved for
wheat, potatoes, spices, seasonings, pork, poultry, red meats, whole
fresh fruits, and dry or dehydrated products. Although irradiation
destroys many bacteria, it does not sterilize food. Even if you’re
using food that has been irradiated by the manufacturer, you must
continue to take precautions against foodborne illnesses—through
proper refrigeration and handling—to safeguard against any surviving
organisms. If you are traveling with food, make sure perishable
items such as meats are wrapped to prevent leakage. Be sure to fill
the cooler with plenty of ice and store it in the car, not the
trunk. If any food seems warmer than 40°F, throw it out.
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Links to Other Disorders Related to Foodborne
Illnesses
Scientists suspect that foodborne pathogens are linked to chronic
disorders and can even cause permanent tissue or organ destruction.
Research suggests that when some people are infected by foodborne
pathogens, the activation of their immune system can trigger an
inappropriate autoimmune response, which means the immune system
attacks the body’s own cells. In some people, an autoimmune response
leads to a chronic health condition. Chronic disorders that may be
triggered by foodborne pathogens are
- arthritis
- inflammatory bowel disease
- kidney failure
- Guillain-Barré syndrome
- autoimmune disorders
Further research is needed to explain the link between these
disorders and foodborne illnesses.
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Common Sources of Foodborne Illness
Sources of illness: Raw and undercooked meat and
poultry
Symptoms: Abdominal pain, diarrhea,
nausea, and vomiting
Bacteria: Campylobacter
jejuni, E. coli O157:H7, L. monocytogenes,
Salmonella
Sources of illness: Raw foods; unpasteurized
milk and dairy products, such as soft
cheeses
Symptoms: Nausea, vomiting, fever,
abdominal cramps, and diarrhea
Bacteria: L.
monocytogenes, Salmonella, Shigella, Staphylococcus aureus, C.
jejuni
Sources of illness: Raw and undercooked eggs.
Raw eggs are often used in foods such as homemade hollandaise sauce,
caesar and other salad dressings, tiramisu, homemade ice cream,
homemade mayonnaise, cookie dough, and
frostings.
Symptoms: Nausea, vomiting, fever,
abdominal cramps, and diarrhea
Bacterium: Salmonella enteriditis
Sources of illness: Raw and undercooked
shellfish
Symptoms: Chills, fever, and
collapse
Bacteria: Vibrio vulnificus, Vibrio
parahaemolyticus
Sources of illness: Improperly canned goods;
smoked or salted fish
Symptoms: Double vision,
inability to swallow, difficulty speaking, and inability to breathe.
Seek medical help right away if you experience any of these
symptoms.
Bacterium: C. botulinum
Sources of illness: Fresh or minimally processed
produce; contaminated water
Symptoms: Bloody
diarrhea, nausea, and vomiting
Bacteria: E.
coli O157:H7, L. monocytogenes, Salmonella, Shigella,
Yersinia enterocolitica, viruses, and parasites
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Points to Remember
Foodborne illnesses result from eating food or drinking beverages
that are contaminated with bacteria, viruses, or parasites.
People at greater risk for foodborne illnesses include young
children, pregnant women and their fetuses, older adults, and people
with lowered immunity.
Symptoms usually resemble intestinal flu. See a doctor
immediately if you have more serious problems or do not seem to be
improving as expected.
Treatment may range from replacement of lost fluids and
electrolytes for mild cases of foodborne illnesses to
hospitalization for severe conditions such as HUS.
You can prevent foodborne illnesses by taking the following
precautions:
-
Wash your hands with warm, soapy water before and after
preparing food and after using the bathroom or changing
diapers.
-
Keep raw meat, poultry, seafood, and their juices away from
ready-to-eat foods.
-
Cook foods properly and at a high enough temperature to kill
harmful bacteria.
-
Refrigerate foods within 2 hours or less after cooking because
cold temperatures will help keep harmful bacteria from growing and
multiplying.
-
Clean surfaces well before and after using them to prepare
food.
The U.S. Government does not endorse or favor any specific
commercial product or company. Trade, proprietary, or company names
appearing in this document are used only because they are considered
necessary in the context of the information provided. If a product
is not mentioned, the omission does not mean or imply that the
product is unsatisfactory.
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For More Information
American Dietetic Association
120 South
Riverside Plaza, Suite 2000
Chicago, IL 60606–6995
Consumer
Nutrition Hotline: 1–800–877–1600
Internet: http://www.eatright.org/
Center for Food Safety and Applied
Nutrition
5100 Paint Branch Parkway
College Park, MD
20740–3835
Food Information Line: 1–888–SAFEFOOD
(723–3366)
Internet: http://www.cfsan.fda.gov/
Centers for Disease Control and
Prevention
1600 Clifton Road
Atlanta, GA
30333
Phone: 1–800–311–3435 or 404–639–3534
Internet: http://www.cdc.gov/
Gateway to Government Food Safety
Information
Internet: http://www.foodsafety.gov/
Partnership for Food Safety Education
655
15th Street NW, 7th Floor
Washington, DC 20201
Phone:
202–220–0651
Internet: http://www.fightbac.org/
U.S. Department of Agriculture
1400
Independence Avenue SW
Washington, DC 20250
Meat and Poultry
Hotline: 1–888–674–6854
Internet: http://www.usda.gov/
U.S. Department of Health and Human
Services
200 Independence Avenue SW
Washington, DC
20201
Phone: 1–877–696–6775 or 202–619–0257
Internet: http://www.os.dhhs.gov/
U.S. Environmental Protection Agency
Ariel
Rios Building
1200 Pennsylvania Avenue NW
Washington, DC
20460
Phone: 202–272–0167
Internet: http://www.epa.gov/
U.S. Food and Drug Administration
5600
Fishers Lane
Rockville, MD 20857–0001
Phone: 1–888–INFO–FDA
(463–6332)
Internet: http://www.fda.gov/
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collects resource information about digestive diseases for the
National Institute of Diabetes and Digestive and Kidney Diseases
(NIDDK) Reference Collection. This database provides titles,
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You may view the results of the automatic search on bacteria
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If you wish to perform your own search of the database, you may
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Email: http://digestive.niddk.nih.gov/about/contact.htm
The National Digestive Diseases Information Clearinghouse (NDDIC)
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Gastroenterology; and Howard Sutter, U.S. Food and Drug
Administration.
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