Let us begin with a scene I call “The Ghost of Foodborne Illness Past.” You’re at what looks to be a swanky new restaurant and you order the special: shrimp ceviche. It looks magical. Music is definitely playing in the background when you snap the perfect photo and post online (#foodie!). Sure, the shrimp might smell slightly off, but it tastes even better than it looks. Fast-forward to the present and you’re pretty sure you won’t survive to see beyond the four walls of your bathroom. All kinds of ungodly things have taken place that you are definitely not ready to talk about. This, my friend, is the disarraying rollercoaster that is foodborne illness. According to the Centers for Disease Control and Prevention (CDC), an estimated 48 million people get sick from food in the U.S. each year. “Remember, bacteria are not visible to the human eye, and there could easily be enough to give you a full-blown case of food poisoning, even if everything looks, smells, and tastes fine,” says Kristin Koskinen, RDN, a registered dietitian nutritionist based in Washington. If only you had known what to look for. If only you could go back in time. We feel you, and we’re here to help. Consider this your primer on risky foods and tips for avoiding this travesty altogether.
Foodborne Illness for the Uninitiated
Let’s rewind and cover the basics. Foodborne illness occurs when a person ingests food that has been contaminated or has been prepared or stored in a way that allowed existing pathogens to survive and multiply. “The initial bout of foodborne illness can be life-threatening, depending on the pathogen and the person,” says Koskinen. According to the Mayo Clinic, symptoms of foodborne illness (that you’re probably well acquainted with by now) include nausea, vomiting, watery or bloody diarrhea, abdominal pain or cramps, and fever. And any of these can last from a few hours to several days. However, if you find yourself with an oral temperature higher than 100.4 degrees Fahrenheit (38 Celsius), it’s time to seek medical attention. Also be on the lookout for signs of dehydration (including dry mouth and little or no urination) or symptoms like blurry vision and muscle weakness.
What are the causes?
Foodborne illness can come from pathogens such as bacteria, viruses, parasites, or molds, as well as contaminants such as dust with heavy metals, chemicals, or other toxins. Some of the most common forms of foodborne illness come from norovirus, salmonella, listeria, Clostridium perfringens, Campylobacter, and Staphylococcus aureus. “People with compromised immune systems, young children, the elderly, and pregnant women are more susceptible to food poisoning,” Koskinen notes. Assuming you live to tell the tale, you may end up with long-lasting effects from the infection, she adds. While we’ve all experienced the unpleasantness of the occasional stomach bug, foodborne illness can pose some serious risks ranging from kidney failure and brain damage to death. In fact, Foodsafety.gov reports that in the U.S. alone, approximately 3,000 people die each year of illnesses associated with foodborne illness.
The Usual Suspects
“Many people think of undercooked poultry or potato salad left in the summer sun as top food sources of foodborne illness,” says Koskinen. But the truth is a lot shadier. “The thing about foodborne illness is that all foods are possible carriers,” she insists. “If not because they are breeding grounds for microorganisms, but due to cross contamination.” For example, bread is typically considered a safe food. However, invisible mold spores from one piece may contaminate other pieces without any fuzzy evidence. Likewise, if you handle contaminated raw meat and then touch an otherwise ready-to-serve item, the ready-to-serve item is now contaminated. Still, some foods have a worse rap than others, which is why we’ve broken it down for you with this handy list of a few common risky foods to look out for:
You probably guessed this immediately—and for good reason. The harbinger of multiple bacteria types, raw poultry can become contaminated with salmonella or Campylobacter. Eating an undercooked bird (or even digesting its juices) puts you at risk for foodborne illness. Stay on the safe side by employing these four simple steps when handling and preparing poultry.
What came first, the salmonella or the egg? While we may never know the answer, one thing’s for sure: Finding out ain’t no walk in the park. The CDC warns that a normal-looking egg can be the culprit for making you really, really sick. But take heart, you can reduce your risk by cooking eggs to an internal temperature of 160 degrees Fahrenheit (71 degrees Celcius) or hotter, refrigerating them promptly after cooking, and making sure to wash your hands and basically all the things that came into contact with them afterward.
Raise your hand if you’re starting to feel personally attacked. Turns out our favorite food comes with a high risk for listeria. Brie, camembert, ricotta, and feta all sound delicious but can be huge risk factors, especially for pregnant women. Even a mild infection can cause miscarriage or premature birth.
Before you pop another unwashed berry in your mouth, consider this: A dime-sized morsel can be your downfall. There’s a reason your mom was always yelling at you to wash your fruit before eating—the little suckers have been linked to a germ called Cyclospora, which causes severe diarrhea, dehydration, and cramps.
Not to scare you off your next ceviche, but it turns out some deadly Vibrio infections are associated with eating raw shellfish (sushi lovers take heed: Your favorite treat may carry parasites and liver flukes). Even scarier? According to WebMD, there’s no specific cure available for shellfish poisoning, and antibiotics don’t shorten the illness. Meaning…I’m out.
Foods You’d Never Expect to Cause Foodborne Illness
When not properly washed before slicing, this tasty fruit can become contaminated with salmonella. In fact, pre-cut melon sold in clear, plastic containers accounted for over sixty cases of salmonella outbreak earlier this year as reported by Alix Langone at Time.
While you’re fretting about the potato salad or ground beef at your friend’s BBQ, romaine lettuce is yet another thing to add to your list of concerns. The leafy vegetable was recently associated with five deaths and numerous illnesses caused by E. coli infections.
Not-so-fun fact: listeria or Staphylococcus aureus can occur after factory cooking or at the deli counter (I mean, are there any safe foods?). Turns out, the bacteria that causes listeriosis live in soil or animal intestines and can contaminate food. If you think that is way more info than you needed to know—you would be right. Heat up all your meats, basically.
You probably have a box of these stashed in your fridge somewhere (especially if you’ve recently hopped onto the healthy-eating bandwagon) but here’s something you should know: They’ve been known to carry salmonella, E. coli, and listeria. It’s like the jackpot of risky foods. In other words, be afraid, be very afraid. All kidding aside: Cook before you eat.
Restaurant goers beware: Your favorite menu items can easily be contaminated with norovirus. The most commonly contaminated prepared foods, according to Koskinen, include salads, sandwiches, ice, cookies, and fruit. This is just another reason to be picky about which establishments you choose to frequent.
Meat and Poultry Products Like Stews, Casseroles, and Gravy
These staples are linked to institutional-style food service, like what you might see in cafeteria or banquet settings, explains Koskinen. When made in large batches and kept warm for too long before serving, these products may include a helping of Clostridium perfringens.
Signs to Look Out For
Koskinen warns us against relying on obvious tell-tale signs to determine when foods have gone bad (e.g. off color, off smell, a furry coat of mold). “It’s foolish to depend on your senses to decide if a pathogenic overgrowth has happened.” Similarly, we shouldn’t buy into the belief that refrigeration and freezing kill bacteria. They don’t. “Refrigeration and freezing simply slow down the pathogen reproduction,” she explains. “Freezing slows it down more, which is why we can keep foods longer in the freezer than the refrigerator, and why you can get food poisoning from foods left in the refrigerator too long.” So what then is the key to knowing whether your meal is safe or not? According to Koskinen, we should look to our local newspaper to find out if any restaurants have been flagged by the health department. “I follow which restaurants are issued infractions and what those infractions are.” Keep an eye out for establishments that have been cited for having limited access to a hand washing sink or with no soap at the sink. If you aren’t privy to a health department report, you can get a feel for whether a food purveyor’s prioritizing sanitation by the way they keep the rest of the restaurant. Dirty restrooms or dining areas are a good indicator that things may not be as clean as they should be in the kitchen, Koskinen notes. Overall, she asks us to keep in mind that “quality restaurants are obsessive about cleanliness, as not only the safety of their guests, but their reputations depend on it.” Needless to say, any signs of vermin should be a red flag. (In other words, RUN.)
Tips for Avoiding Foodborne Illness.
While you can never get back those precious hours of life back, there are a few things you can do to avoid another 12-hour bathroom fiasco:
Wash your hands.
Always wash your hands before you eat or prepare food. Also, remember to wash thoroughly before cooking, and even more often if you’re dealing with raw meats or produce. “Thorough hand washing means using soap and warm water,” Koskinen insists, stressing that any wanna-be cooks should remember to wash the fronts, backs, palms, between the fingers and under the nails for 20 seconds or more. “Sing the ABC song as a good guideline of what 20 seconds is,” she says.
Cook foods thoroughly.
Especially meats (even more important for those who like their steaks on the rare side). Also, remember to use this chart provided by the CDC for safe food-cooking temperatures. Be sure to keep hot food hot and cold food cold. “Hot food should be kept at 140 degrees or warmer, cold foods at 40 degrees or cooler,” Koskinen says. “Anything else puts your food in the ‘Danger Zone,’ which is where bacteria most rapidly multiply.”
Keep raw meat, poultry, seafood, and eggs separate from ready-to-eat foods. This means not storing raw animal proteins directly above the latter in the fridge. Food should be stored within two hours of being served, but that time goes down to one hour if service is outside and the ambient temperature is 90 degrees or warmer.
So you’ve survived to tell the tale of your food poisoning misfortunes—now what? Aside from becoming a restaurant-hermit for the next few months, you can opt to pay it forward (your new-found wisdom, that is). The CDC has outlined a few key ways you can help prevent future foodborne disease outbreaks, namely, by reporting your illness to our Health Department, speaking to your health care provider, and keeping track of what you ate and did before getting sick (gather food receipts and sharing this info with investigators). All of this sounds well and good, but if you’re still feeling wary of ever dining out again, remember this: the best treatment is prevention and trusting your gut (if the ceviche smells off, please don’t eat it). Or as Koskinen puts it: “When in doubt, throw it out. A bit of leftover picnic food for lunch isn’t worth a trip to the hospital.” I think we can all heartily agree with that logic.