Foodborne Diseases -- Keep Your Family Safe

What is foodborne disease?

Foodborne disease is caused by consuming contaminated foods or beverages. Many different disease-causing microbes, or pathogens, can contaminate foods, so there are many different foodborne infections. In addition, poisonous chemicals, or other harmful substances can cause foodborne diseases if they are present in food.

More than 250 different foodborne diseases have been described. Mostof these diseases are infections, caused by a variety of bacteria, viruses, and parasites that can be foodborne. Nausea, vomiting, abdominal cramps and diarrhea are common symptoms in many foodborne diseases.

What are the most common foodborne diseases?

The most commonly recognized foodborne infections are those caused by the bacteria Campylobacter, Salmonella, and E. coli O157:H7, and by a group of viruses called calicivirus, also known as the Norwalk and Norwalk-like viruses.

Campylobacter is a bacterial pathogen that causes fever, diarrhea, and abdominal cramps. It is the most commonly identified bacterial cause of diarrheal illness in the world. These bacteria live in the intestines of healthy birds, and most raw poultry meat has Campylobacter on it. Eating undercooked chicken, or other food that has been contaminated with juices dripping from raw chicken is the most frequent source of this infection.

Salmonella is also a bacterium that is widespread in the intestines of birds, reptiles and mammals. It can spread to humans via a variety of different foods of animal origin. The illness it causes, salmonellosis, typically includes fever, diarrhea and abdominal cramps. In persons with poor underlying health or weakened immune systems, it can invade the bloodstream and cause life-threatening infections.

E. coli O157:H7 is a bacterial pathogen that has a reservoir in cattle and other similar animals. Human illness typically follows consumption of food or water that has been contaminated with microscopic amounts of cow feces. The illness it causes is often a severe and bloody diarrhea and painful abdominal cramps, without much fever. In 3% to 5% of cases, a complication called hemolytic uremic syndrome (HUS) can occur several weeks after the initial symptoms. This severe complication includes temporary anemia, profuse bleeding, and kidney failure.

Calicivirus, or Norwalk-like virus is an extremely common cause of foodborne illness, though it is rarely diagnosed, because the laboratory test is not widely available. It causes an acute gastrointestinal illness, usually with more vomiting than diarrhea, that resolves within two days. Unlike many foodborne pathogens that have animal reservoirs, it is believed that Norwalk-like viruses spread primarily from one infected person to another. Infected kitchen workers can contaminate a salad or sandwich as they prepare it, if they have the virus on their hands. Infected fishermen have contaminated oysters as they harvested them.

How are foodborne diseases treated?

There are many different kinds of foodborne diseases and they may require different treatments, depending on the symptoms they cause. Illnesses that are primarily diarrhea or vomiting can lead to dehydration if the person loses more body fluids and salts (electrolytes) than they take in. Replacing the lost fluids and electrolytes and keeping up with fluid intake are important. If diarrhea is severe, oral rehydration solution such as Ceralyte*, Pedialyte* or Oralyte*, should be drunk to replace the fluid losses and prevent dehydration. Sports drinks such as Gatorade* do not replace the losses correctly and should not be used for the treatment of diarrheal illness. Preparations of bismuth subsalicylate (e.g., Pepto-Bismol)* can reduce the duration and severity of simple diarrhea. 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 or blood in the stools because they may make the illness worse. (*CDC does not endorse commercial products or services.)

When should I consult my doctor about a diarrheal illness?

A health care provider should be consulted for a diarrheal illness if it is accompanied by:

• high fever (temperature over 101.5 F, measured orally)
• blood in the stools
• prolonged vomiting that prevents keeping liquids down (which can lead to dehydration)
• signs of dehydration, including a decrease in urination, a dry mouth and throat, and feeling dizzy when standing up.

Do not be surprised if your doctor does not prescribe an antibiotic. Many diarrheal illnesses are caused by viruses and will improve in 2 or 3 days without antibiotic therapy. In fact, antibiotics have no effect on viruses, and using an antibiotic to treat a viral infection could cause more harm than good It is often not necessary to take an antibiotic even in the case of a mild bacterial infection. Other treatments can help the symptoms, and careful handwashing can prevent the spread of infection to other people. Overuse of antibiotics is the principal reason many bacteria are becoming resistant. Resistant bacteria are no longer killed by the antibiotic. This means that it is important to use antibiotics only when they are really needed. Partial treatment can also cause bacteria to become resistant. If an antibiotic is prescribed, it is important to take all of the medication as prescribed, and not stop early just because the symptoms seem to be improving.

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. Pregnant women, the elderly, and those with 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.

What can consumers do to protect themselves from foodborne illness?

A few simple precautions can reduce the risk of foodborne diseases:

COOK meat, poultry and eggs thoroughly. Using a thermometer to measure the internal temperature of meat is a good way to be sure that it is cooked sufficiently to kill bacteria. For example, ground beef should be cooked to an internal temperature of 160 degrees F. Eggs should be cooked until the yolk is firm.

SEPARATE: Don't cross-contaminate one food with another. Avoid cross-contaminating foods by washing hands, utensils, and cutting boards after they have been in contact with raw meat or poultry and before they touch another food. Put cooked meat on a clean platter, rather back on one that held the raw meat.

CHILL: Refrigerate leftovers promptly. Bacteria can grow quickly at room temperature, so refrigerate leftover foods if they are not going to be eaten within 4 hours. Large volumes of food will cool more quickly if they are divided into several shallow containers for refrigeration.

CLEAN: Wash produce. Rinse fresh fruits and vegetables in running tap water to remove visible dirt and grime. Remove and discard the outermost leaves of a head of lettuce or cabbage. Because bacteria can grow well on the cut surface of fruit or vegetable, be careful not to contaminate these foods while slicing them up on the cutting board, and avoid leaving cut produce at room temperature for many hours. Don't be a source of foodborne illness yourself. Wash your hands with soap and water before preparing food. Avoid preparing food for others if you yourself have a diarrheal illness. Changing a baby's diaper while preparing food is a bad idea that can easily spread illness.

REPORT: Report suspected foodborne illnesses to your local health department. The local public health department is an important part of the food safety system. Often calls from concerned citizens are how outbreaks are first detected. If a public health official contacts you to find our more about an illness you had, your cooperation is important. In public health investigations, it can be as important to talk to healthy people as to ill people. Your cooperation may be needed even if you are not ill.