Microbes on the Menu

02/24/2004

If the old saying, "you are what you eat," is true, then some of us might become patients, cripples or corpses. Throughout much of history, finding food was an uncertain proposition. So was eating what you found. And it still is. In the U.S. each year, there are an estimated 76 million cases of foodborne illnesses, 325,000 hospitalizations and 5,000 deaths. All from eating the safest, healthiest food in the world. Probably everyone has experienced an episode of “food poisoning," "intestinal flu" or “stomach virus.” Foodborne illnesses are so common they almost seem to be an expected--and accepted--part of life. But there is a huge financial and public health price to pay for these common illnesses. There are more than 200 known illnesses acquired from foods and the culprits include bacteria, viruses, parasites, toxins, metals, chemicals and prions—the mysterious agents of "Mad Cow Disease." The main infectious agents responsible for so many cases of food poisoning are bacteria and viruses. For example, we get Salmonella bacteria from eating raw eggs and undercooked poultry. Two other bacteria, Campylobacter jejuni and E. coli can contaminate chicken and hamburger, respectively. Listeria monocytogenes is a tricky little bug that can grow at refrigerator temperatures to contaminate soft cheeses, deli meats and unpasteurized milk. Staphylococcus gets into potato and egg salads, and a cousin of bubonic plague, Yersinia enterocolitica, is common in undercooked pork. (Chit'lins, anyone?) Hepatitis A virus and Vibrio bacteria find their way into raw shellfish, and two

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parasites, Cryptosporidium and Cyclospora, can lurk in fresh produce. Foodborne outbreaks frequently make the news, partly because they often involve large numbers of people. For example, in January, 100 students at UNC-Chapel Hill were stricken with vomiting and diarrhea after eating from a salad bar contaminated with Norovirus. Last November, more than 600 people contracted hepatitis A from a Mexican restaurant in a Pennsylvania mall. (The hepatitis virus was probably from imported green onions.) In February, the U.S. Department of Agriculture issued warnings in New England about salmonella-contaminated ground beef. (Among the 37 cases, a few people reported eating the meat raw.) Also in January, 69 Philadelphia hotel guests were stricken by something one of them described as “a stomach virus, like a 24-hour bug.” Last October, Maryland’s Department of Health and Mental Hygiene investigated a possible cluster of Listeria infections in four counties, including Anne Arundel. Sometimes the illnesses, and the news, are much worse. E. coli O157, a contaminant of beef, causes about 60 deaths per year in the U.S. and is the principal cause of acute kidney failure in children. A small percentage of people develop a complication called hemolytic uremic syndrome and some of them will have life-long complications, including seizures, blindness, and paralysis. The poultry contaminant, Campylobacter jejuni, can cause Guillain-Barré Syndrome, a type of flaccid paralysis. Affected individuals develop weakness in their limbs and respiratory muscles. Recovery can take weeks or months. Listeria, found in soft cheeses and prepared foods, causes about 500 deaths a year. Pregnant women are especially at risk. Listeria infections can cause

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stillbirths, miscarriages, meningitis and sepsis. New research suggests Listeria can colonize the gall bladder to become a silent source of infection and contamination. Like the 19th century’s Typhoid Mary who spread typhoid bacteria to her employers, a “Listeria Larry” may emerge in the 21st century to cause similar havoc. Oddly enough, arthritis can be another complication following a bout of food poisoning. Bacteria can spread from the gut into the joints to cause permanent damage. Still other bacteria have been linked to chronic inflammatory conditions called Crohn’s disease or ulcerative colitis. These complications also can have a profound effect on our mental well-being. Writing in the journal, Emerging Infectious Diseases, University of Florida researcher James Lindsay noted that “continual pain from arthritis, an irritable bowel, or chronic diarrhea would be enough to make anyone temperamental, moody, or depressed.” Lindsay also writes, “Foodborne diseases are for the most part preventable.” True enough, but from farm to kitchen there is a long chain of players who have to do their part. They include growers and producers, shippers, government inspectors, sellers and finally, us, the consumers. What can we do? First, cook meats and fish thoroughly. Second, make sure your refrigerator temperature is low enough (40 degrees) to discourage bacterial growth. Third, eat prepared foods before their expiration dates. Fourth, don’t feed your pets raw chicken or beef; they might give something back to you.

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Finally, check the Annapolis Food Safety Education Campaign’s web site (www.fightbac.org) for information on the four basic food handling techniques: Clean, Separate, Cook and Chill. Bon Apetite!

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