Read an Excerpt
"IT MUST'VE BEEN SOMETHING I ATE":
An Overview of Food-borne Illness
Hungry after playing tennis, Cindy L. heads over to a neighborhood restaurant that happens to be a popular hangout for local retirees. On her way in, she passes a group of senior citizens sitting on plastic chairs outside the restaurant door, greeting friends who stream in for a bite to eat. Inside the restaurant, everyone seems oblivious to the fact that their lives may be in danger. The peril isn't an armed robber, a ticking bomb under the cash register, or even a grease fire. The threat is dangerous food-borne microorganisms that are tasteless, odorless, and invisible to the naked eye.
A glance around the restaurant reveals a confluence of human errors that could lead to abdominal pain, diarrhea, vomiting, long-term disability, or even death for anyone who eats at the restaurant that day--particularly the most elderly patrons. Waitresses wipe tables with dirty cloths. Behind the lunch counter, three dozen eggs, which should be refrigerated, are stacked next to the grill. The cook uses the same spatula to flip partially cooked hamburgers and to remove fully cooked hamburgers from the grill. The server nonchalantly sticks her thumb into the pancakes as she delivers them to Cindy's table. To top it all off, the pancakes are slightly raw inside.
Cindy has read about food-borne diseases, and she is outraged by her experience at the restaurant. This book will show you why--from a microscopic point of view--she has every right to be. More important, Safe Eating will help you protect yourself and your family from food-borne infections byexplaining:
As a consumer, you have more control over eating safely than you probably realize. The Centers for Disease Control and Prevention (CDC) estimates that 85 percent of identified cases of food-borne infections stem from two primary sources: failure to keep hot foods hot and cold foods cold, and poor hand-washing practices.
The Scope of Food-borne Illness
Each year in the United States, millions of people experience food-borne infections, but only a tiny fraction of these cases are ever recognized or reported. Since 1980, various researchers have come up with estimates ranging from 1.4 million to 150 million food-borne infections occurring annually across the country. In a May 1996 report, the General Accounting Office concluded that there are 6.5 million to 81 million cases of food-borne illness a year. Bob Howard, special assistant to the director of the National Center for Infectious Diseases, says he has heard figures ranging as high as 300 million cases. Stephen J. Knabel, Ph.D., a food-safety specialist at Pennsylvania State University and the lead author of a scientific status report on food-borne illness prepared for the Chicago-based Institute of Food Technologists, estimates that about one in four Americans suffers a food-borne infection each year. By his assessment, no American family is untouched.
Food-borne illness is so widespread because bacteria and other microorganisms are ubiquitous on Earth. Scientists have gathered bacteria from clouds above mountain peaks and from the deepest depths of the ocean. Bacteria exist in and on animals and people. They are even in the air we breathe. Most of these microorganisms are harmless, or even helpful; some are not.
"Part of the problem is that we don't really understand food-borne diseases in this country. We only understand bits and pieces," says Dr. Michael T. Osterholm, Ph.D., M.P.H., Minnesota state epidemiologist and a nationally known authority on food-borne infections. A survey conducted by Osterholm's department in 1997 indicated that there were probably 7.8 million episodes of diarrheal illness in Minnesota that year. However, fewer than 2,000 cases of Salmonella, Campylobacter, E. coli, Shigella, and Yersinia infections were reported to the state health department. While diarrheal diseases can be triggered by numerous factors, Osterholm says a substantial proportion of these episodes are probably caused by food-borne microorganisms. Not counted by the Minnesota survey were food-borne infections that create symptoms other than diarrhea, and illnesses caused by food-borne microorganisms that no one is looking for.
Osterholm cites other studies suggesting that stomach illnesses are on the rise in the United States. One conducted in Cleveland, Ohio, between 1948 and 1957, and a study done in Tecumseh, Washington, between 1965 and 1971, both found an average of one stomach illness per person per year. But studies in five cities around the United States done in the late 1990s found a rate of 1.4 stomach illnesses per person per year. In Minnesota, where food-borne illness has been more intensely investigated, the rate was even higher--1.8 illnesses per person per year. It is not uncommon for multiple cases of food-borne illness to occur in a single individual who is in a high-risk group and who does not take proper precautions when handling food. A similar pattern can be seen among children who share food or eating utensils in daycare, school, or summer-camp settings.
The Centers for Disease Control and Prevention (CDC) receives reports of about 500 food-borne disease outbreaks annually involving a total of about 20,000 people, which represents just the tip of the iceberg.
The vast majority of food-borne illnesses resolve themselves without treatment after a few days, but a significant number of victims develop such serious complications as kidney failure, arthritis, and paralysis. Campylobacter jejuni, which frequently contaminates raw or undercooked poultry, has become the most common cause of nonaccident-related paralysis in the United States. E. coli O157:H7 infection is now the leading cause of acute kidney failure in children. According to one mathematical model endorsed by the National Center for Health Statistics, up to 9,100 Americans die of a food-borne infection each year. That figure translates to about twenty-five fatalities a day, on average.
"I think most people believe that food-borne illness is just temporary discomforts, and they don't realize the seriousness of other possible consequences," says Christine M. Bruhn, Ph.D., director of the Center for Consumer Research at the University of California at Davis.
The good news is that food-borne illnesses are often preventable. "Fight BAC! The Partnership for Food Safety Education," a consortium of industry, government, and scientific groups, recommends that consumers follow four key steps--clean, separate, cook, and chill. These and many other food-safety precautions are elaborated upon throughout this book.
The information we are presenting about food safety and food-borne illnesses is based on the latest scientific and medical research and on the insights and recommendations of dozens of food-safety experts working in academia, government, and industry. These experts include biologists and microbiologists, public health specialists, home economists, food-safety educators, epidemiologists, consumer advocates, physicians, food technologists, food industry consultants, researchers, nutritionists, infectious disease specialists, and officials from the Centers for Disease Control and Prevention, and officials from the Food and Drug Administration (FDA) and the United States Department of Agriculture (USDA), the two agencies that regulate the production and processing of almost all of the food sold in this country. In addition, victims of food-borne infections candidly share their experiences in the hope of helping others avoid similar misfortunes.
Safe Eating is divided into three parts. In Part 1 we explain how food-borne microbes can make people sick. In addition to presenting the possible short- and long-term medical consequences of food-borne infections, we explain how physicians diagnose and treat these diseases. We also show how individual cases fit into the overall public-health scheme. Except for the scenarios we created to illustrate medical facts in Chapter 2, the anecdotes included in this book represent actual cases, although names have been changed or surnames omitted to protect people's privacy.
Part 2 takes an in-depth look at how meat and poultry, seafood, produce, eggs and dairy products, and drinking water can become contaminated by disease-causing microbes; how the government and industry are tackling the problem; and how consumers can make the wisest food choices possible. Some of the information about contamination routes is very explicit and may be disturbing to some readers. We have included it here because we believe it is an essential part of your food-safety education and that it will motivate you to take extra care when you buy, store, prepare, and serve food. Each chapter in this section includes a summary of what consumers can do to protect themselves.
Part 3 offers a cornucopia of general and specific food-safety tips and guidelines that have been culled from a wide variety of authoritative sources.
The final chapter, "Challenges Ahead," presents information about the future of food safety and the importance of food-safety education. Resources to help you stay abreast of the fast-paced world of food safety appear in Appendix A.