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Public Health - Foodborne Illness

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1. What is foodborne disease?

Foodborne illnesses are caused by germs (disease-causing microorganisms) that enter the human body through foods. People with a foodborne illness often display common symptoms such as nausea, vomiting, diarrhea, or fever; so many people may not recognize the illness is caused by bacteria or other germs in food.

2. What are the symptoms of foodborne illness?

Common symptoms include:

• Abdominal Cramping
• Diarrhea
• Fever
• Headache
• Severe Exhaustion
• Sometimes Blood or Pus in the Stools
• Vomiting

However, symptoms will vary according to the type of pathogen and by the severity of the disease.

3. Are some foods more likely to cause foodborne illness than others?

Just about any food can become contaminated if handled improperly. However, foods rich in protein, such as meat, poultry, fish, and seafood, are frequently involved in foodborne illness outbreaks for two reasons:

• Protein-rich foods tend to be of animal origin. Some animals have microorganisms that can cause disease in humans if not properly cooked.
• Animal foods are rich in protein that bacteria break down into amino acids, which are an important nutrient source to some bacteria.

Bacteria also need moisture in order to survive and reproduce. Thus, they thrive in foods with high moisture content. These include starchy, egg-rich foods, and cream-based foods, such as potato or pasta salads, cream-based soups, and custard or cream pies.

4. What foods are associated with foodborne illness?

Raw foods of animal origin are the most likely to be contaminated; that is, raw meat and poultry, raw eggs, unpasteurized milk, and raw shellfish. Foods that mingle with the products of many individual animals, such as bulk raw milk, pooled raw eggs, or ground beef, are hazardous because a pathogen present in any one of these animals may contaminate the whole batch. Fruits and vegetables consumed raw are a particular concern. Washing can decrease but not eliminate contamination. Using water that’s not clean can contaminate many boxes of produce. 

Fresh manure used to fertilize vegetables can also contaminate them. Unpasteurized fruit juice can also be contaminated if there are germs in or on the fruit that’s used to make it.

5. How long after I eat contaminated food (or consume bacteria) will I become sick?

Symptoms can occur between hours or weeks after eating contaminated food. Symptoms typically don’t develop for several days after eating contaminated food. Symptoms of viral or parasitic illnesses may not appear for several weeks after exposure. Symptoms usually last only a day or two, but in some cases can persist a week to 10 days. For most healthy people, foodborne 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 (immune disorders, including HIV infection, liver disease, diabetes, etc.)

6. If I ate out at a local restaurant in my area and the next day I became ill, what should I do?

All suspected cases of foodborne illness should first be reported to your local health department. You can obtain the phone number for your local health department by contacting your borough/ township clerks’ office. Gloucester County residents can call 856-218-4102 to report the suspected foodborne illness. Food Service regulations for restaurants and other foodservice establishments, often based on the FDA Food Code, are developed by the States. 

The health department in your State, city, or county inspects retail food service establishments and institutions. They also offer food service training courses and other programs. Seek medical attention if you experience bloody stools, fever greater than 101.5, dehydration, or diarrhea that lasts more than 3 days.

7. What can I do at home to help protect my family from foodborne illness?

Individuals and their actions at home play an important role in food safety. To help prevent foodborne illness, food safety experts recommend the following four simple steps:

1. Clean: Wash hands and surfaces often with hot, soapy water.
2. Separate: Don’t cross-contaminate. Keep raw meat, poultry and seafood, and their juices away from ready-to-eat foods.
3. Cook: Cook to proper temperatures; don’t rely on color alone. Remember to use a food thermometer to check if food is done. Thorough cooking is the most important step in preventing foodborne illness.
4. Chill: Refrigerate promptly. The growth of harmful bacteria can be slowed or stopped by refrigeration or freezing. The refrigerator temperature should be kept at or below 40°F. The freezer should remain under 0°F at all times.

8. How can a customer best assure safe food in a food establishment?

Customers expect good, safe food, clean surroundings, and pleasant service. The most important questions they can ask themselves are, "Is the hot food hot and the cold food cold?" and "Is my food thoroughly cooked?" If the answer to these questions is "no," send the food back. If you can see food workers at work, notice whether they are washing their hands when they come into the kitchen and whether they are using utensils or gloves when touching food that is ready to be served. Be certain there are warm water, soap, and paper towels in the restroom. 

If there is no warm water, tell the management right away. If there is no soap or no towels, ask the manager to restock. An establishment that appears neat and clean generally gives the impression that the management cares about doing things right and well. However, cleanliness doesn’t correlate with safe food handling practices, nor does it guarantee the food is safe. View more information on the Gloucester County Health Food Establishment Inspection Ratings website.

9. How are foodborne diseases diagnosed?

The infection is diagnosed by specific laboratory testing during the illness which will identify the organism. In order for the diagnosis is to be made, the patient must seek medical attention, and the physician must decide to order diagnostic tests. Because many ill persons do not seek attention, many cases of foodborne illness go undiagnosed.

10. How long can I keep meat in my freezer?

If a freezer stays at 0°F or lower, meats will keep for several months. Store roasts and whole poultry for 6 to 12 months; steaks and chops for 4 to 6 months, and ground meats or stew meats for 3 to 4 months. Cured and processed meats lose quality more rapidly than fresh meats because of the presence of salts. Don’t store luncheon meats, franks, ham, or sausage longer than 1 or 2 months.

11. How are foodborne diseases treated?

Depending on the symptoms they cause, foodborne diseases may require different treatments. Illnesses that are primarily diarrhea or vomiting can lead to dehydration if the person loses more body fluids and salts (electrolytes) than they can take in. Replacing the lost fluids and electrolytes and keeping up with fluid intake is important. If diarrhea and cramps occur, without bloody stools or fever, taking an antidiarrheal medication may provide symptomatic relief, but these medications should be avoided if there is high fever, blood in the stools, or signs of infection because the antidiarrheal medication may make the illness worse.

12. How does food become contaminated (made impure)?

Harmful germs - such as bacteria, viruses, and parasites - can be on food that if not handled or cooked safely can cause illness. Toxins (poisons) produced by certain bacteria can cause food intoxication (poisoning). Food can also be contaminated by chemicals such as pesticides, certain cleaning compounds, and sometimes by use of improper containers (pots) for cooking or storing food. When ingested in large amounts, these chemicals will cause serious foodborne illness. Food contamination can be caused by:

• Contamination of food, utensils, and equipment from flies, roaches, and other insects and pests
• Improper handling, preparing and storing of food
• Improper washing of hands and fingernails
• Improperly cleaned and sanitized eating and cooking utensils and equipment
• People who may seem well but who carry germs that can make other people sick
• Poor personal hygiene habits of food employees
• Use of foods from unapproved sources

13. Are some people more likely to contract a foodborne illness? If so, are there special precautions they should take?

Some persons at particularly high risk should take more precautions.

Weakened Immune Systems

Pregnant women, the elderly, and those weakened immune systems are at higher risk for severe infections such as Listeria and should be particularly careful not to consume undercooked animal products. They should avoid soft French style cheeses, pates, uncooked hot dogs, and sliced deli meats, which have been sources of Listeria infections. Persons at high risk should also avoid alfalfa sprouts and unpasteurized juices. A bottle-fed infant is at higher risk for severe infections with Salmonella or other bacteria that can grow in a bottle of warm formula if it is left at room temperature for many hours. Particular care is needed to be sure the baby’s bottle is cleaned and disinfected and that leftover milk formula or juice is not held in the bottle for many hours.

Liver Disease

Persons with liver disease are susceptible to infections with a rare but dangerous microbe called Vibrio vulnificus, found in oysters. They should avoid eating raw oysters.

14. Does hot water kill bacteria?

Bacteria must reach 160°F to ensure they are destroyed. Certainly boiling water (212°F) would be hot enough to destroy bacteria.

15. Does freezing destroy bacteria and parasites?

Freezing doesn’t kill all bacteria, yeasts and molds present in food, but it does prevent their multiplication if the food is held at 0°F or less. When thawed, the surviving organisms can multiply again and lead to foodborne illness.

16. How can a person prevent food poisoning?

To prevent food poisoning, take the following steps when preparing food:

• Carefully wash your hands and clean dishes and utensils.
• Use a thermometer when cooking. Cook beef at least 160°F, poultry to at least 180°F, and fish to at least 140°F.
• Do not place cooked meat or fish back onto the same plate or container that held the raw meat, unless the container has been thoroughly washed.
• Promptly refrigerate any food you will not be eating right away. Keep the refrigerator set to around 40°F and your freezer at or below 0°F. Do not eat meat, poultry, or fish that has been refrigerated uncooked for longer than 1 to 2 days.
• Do not use outdated foods, packaged food with a broken seal, or cans that are bulging or have a dent.
• Do not use foods that have an unusual odor or a spoiled taste.

17. Where can I learn more about food safety and foodborne diseases?

View the Centers for Disease Control and Prevention Food frequently asked questions.

18. Where can I find information on Food Safety, Bacteria or Spoilage?

• Food Safety
• Center for Disease Control and Prevention Vital Signs - Food Safety
• Medline Plus
• United States Department of Agriculture (USDA) Food Safety Education
• USDA Food Safety Fact Sheets