Anyone who has ever suffered from a bout of food poisoning knows how horrible it can bebut where does food poisoning really come from? When 600 people got sick and 3 children tragically died after eating burgers from a national fast food chain in 1993, it thrust a little known foodborne illness called E. coli into the spotlight.

What many of us don’t know is that  foodborne illnesses have a devastating impact on countless Americans each year. The CDC estimates that each year, roughly 1 in 6 Americans (or 48 million people) gets sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.

We often think of food poisoning as something that isn’t so seriousperhaps the thought of two or three days of a little abdominal distress and a couple of extra trips to the bathroom isn’t so scary. But the reality is that with hundred of thousands of hospitalizations and thousands of deaths each year in the United States, foodborne illnesses pose a significant health threat that can be mitigated with proper education and awareness about food safety.

Becoming More Informed About Food Poisoning

Since the 1993 E. coli outbreak, an organization called STOP Foodborne Illness has dedicated itself to preventing foodborne illness and being advocates for public policy and the victims of foodborne illness. Community Coordinator of STOP, Stanley Rutledge, stated:

“Today, we are working on pushing a policy that promotes earlier testing of foodborne pathogens. Food poisoning is often mistaken for something else and diagnosed when it’s too late. We’re hoping early testing will save lives.”

Especially in our fast-moving, populous society that thrives on mass food production, restaurants, and shared spaces (daycares, school, shopping mall bathrooms, etc.), we need to be informed and prepared.

Here’s what we all ought to know.

What is Foodborne Illness (Food Poisoning)?

Foodborne illness is an infection or irritation of the gastrointestinal (GI) tract caused by food or beverages that contain harmful bacteria, parasites, viruses, or chemicals which can cause vomiting, diarrhea, abdominal pain, fever, and chills. While food poisoning is typically mild and is resolved on its own without treatment, in some cases, it can lead to serious complications that require prompt emergency care.

Symptoms of Food Poisoning

It can take minutes after you consume contaminated food or beverages to start feeling symptoms. Sickness caused by food poisoning generally lasts from a few hours to several days. Although food poisoning symptoms vary with the source of contamination, possible symptoms to watch for include:

  • Nausea
  • Vomiting
  • Watery diarrhea
  • Abdominal pain and cramps
  • Fever 

People living in the same home as someone with foodborne illness who are exposed to pathogens can actually fall ill at different times and can have different degrees of illness, depending on the type and amount of pathogens they were exposed to, as well as the person’s immune system.

If You Think You Have a Bad Case of Food Poisoning, Go to the ER.

If you’re experiencing any of the following signs or symptoms, seek emergency care as soon as possible and demand to be tested for food poisoning.

  • Frequent vomiting:
  • Inability to keep liquids down
  • Bloody vomit or stools
  • Diarrhea for more than 3 days
  • Extreme pain or severe abdominal cramping
  • An oral temperature higher than 101.5 F (38.6 C)
  • Signs or symptoms of dehydration such as excessive thirst, dry mouth, little or no urination, severe weakness, dizziness, or lightheadedness
  • Neurological symptoms such as blurry vision, muscle weakness, and tingling in the arms

*Make sure you drink plenty of fluids to avoid dehydration from diarrhea or vomiting.

Complications from Food Poisoning

Dehydration is the most common complication of food poisoning. Infants, the elderly, and people with weak immune systems are the most vulnerable to dehydration and may need to seek emergency care if they have continuous vomiting or diarrhea from food poisoning. Complications can arise from different bacteria, viruses, and parasites, but here are some of the more known complications:

  • Listeria complications (Listeria monocytogenes) Babies in the womb are at high risk for dehydration and other effects of listeria poisoning. Even if a mother isn’t greatly affected by exposure, Listeria can lead to complications in pregnancy, including miscarriage, premature labor, and stillbirths. 
  • E. coli complications (Hemolytic Uremic Syndrome). The effects of E. coli complications on young children can be devastating. They are at higher risk for an E. coli complication known as Hemolytic Uremic Syndrome (HUS) that can cause the kidneys to stop functioning. HUS develops an average of seven days after the first symptoms occur and can lead to lifelong complications. In an older population, conditions such as Thrombotic Thrombocytopenic Purpura (TTP), pancreatitis, diabetes, and high blood pressure may also develop.

Who is Most at Risk for Food Poisoning?

Food poisoning can happen to anyone. However, some people are more likely to develop foodborne illnesses than others, including infants and children, pregnant women and their unborn children, older adults, and people with compromised immune systems. These groups also have a greater risk of developing severe symptoms or complications from foodborne illnesses.

Where Does Food Poisoning Come From?

There are several known pathogens that cause food poisoning, but more than half of the cases of illness, hospitalizations, and deaths in the United States are caused by unknown pathogens.

E. coli, Listeria, and Salmonella are some of the more well-known pathogens that you hear about more often than others. You’ve probably gotten word of a pool contaminated by E. coli, or a recall of food products tainted with Listeria or Salmonella. But there are many other known and unknown pathogens that have been linked to illnesses:

Bacterial:

  • Botulism (Clostridium botulinum)
  • Brainerd Diarrhea
  • Brucellosis  (Brucella infection)
  • Campylobacteriosis (Campylobacter infection)
  • Cholera (Vibrio cholerae infection)
  • Clostridium perfringens
  • Escherichia coli
  • Diarrheagenic Escherichia coli
  • Enterohemorrhagic Escherichia coli
  • Enterotoxigenic Escherichia coli  (ETEC)
  • Helicobacter pylori
  • Leptospirosis
  • Listeriosis (Listeria infection)
  • Rat-bite fever
  • Salmonella
  • Shigellosis (Shigella infection)
  • Staphylococcus food poisoning (Staphylococcus aureus)
  • Traveler’s diarrhea
  • Typhoid Fever (Salmonella typhi infection)
  • Vibrio parahaemolyticus
  • Vibrio vulnificus
  • Yersinia (Yersinia enterocolitica infection)

Viral:

  • Hepatitis
  • Hepatitis A
  • Norovirus
  • Rotavirus
  • Viral gastroenteritis

Parasitic:

  • Amebiasis (Entamoeba histolytica infection)
  • Anisakiasis (Anisakis infection)
  • Ascariasis (Intestinal roundworm infection)
  • Cryptosporidiosis (Cryptosporidium infection)
  • Cyclosporiasis (Cyclospora infection)
  • Cysticercosis (formerly known as Isosporiasis)
  • Diphyllobothriasis (Diphyllobothrium infection)
  • Giardiasis (Giardia infection)
  • Toxoplasmosis (Toxoplasma infection)
  • Traveler’s diarrhea
  • Trichinellosis/Trichinosis (Trichinella infection)

How Does Contamination Happen?

Food can be exposed to pathogens at many different stages during its lifecycle: growing, harvesting, processing, storing, shipping, handling by customers, or during preparation. If food is cooked properly, most pathogens are killed. But anything you consume can become contaminated with bacteria, viruses, and parasites from surface to surface cross-contamination. You typically think of meat when you think of food poisoning, but things that aren’t cooked before serving like beverages, raw vegetables, and raw foods are an even bigger risk.

What Types of Foods Cause Food Poisoning?

Although there’s speculation that bacteria, such as E. coli, originates from animal feces, the top five foods most likely to cause food poisoning don’t include chicken, pork, or beef:

    • Sprouts because they are difficult to clean. It’s time-consuming and nearly impossible to clean every sprout.
    • Cantaloupe because consumers neglect to wash them because they think they don’t have to. But bacteria can easily transfer from the rind to the edible parts of the fruit through cutting and handling.
    • Raw Milk: Consuming raw non-pasteurized milk is just as risky as eating raw meat.
    • Tuna: Tuna in particular is especially susceptible to scombrotoxin, a toxin which can cause serious cramps, headaches, and rashes, if it’s stored above 60 degrees. This goes for most scombroid fish, which also includes skipjack, bonito and mackerel, but there are also other non-scombroid fish, such as sardines, herring, pilchards, marlin and mahi mahi that have been responsible for many outbreaks of illness over the years. Scombrotoxin and high histamine levels are generally more likely to occur in fast swimming and migratory fin fish species with red coloured meat. This can be toxic to humans. If not stored at proper temperatures after being caught, histamine may be present in fresh, frozen, canned, and cured fish products at high enough concentrations to cause illness.
    • Berries: Because we are under a false impression that frozen berries don’t have to be washed, people can easily get sick from contaminated berries.   

Contrary to popular belief, organic vegetables can be a source of foodborne illness. They can be tainted from fertilizer or bird feces, or from coming in contact with contaminants during the shipping and handling process. Imported foods are also highly susceptible to bacteria from other foods.

How to Prevent Food Contamination and Food Poisoning

According to CDC recommendations, you can reduce your risk for food poisoning by taking the following steps during food prep:

  • Rinse off dishware from your cabinets before using, in case you have a pest/rodent problem.
  • Rinse off aluminum cans before opening.
  • Wash your utensils, cutting boards, and food surfaces with hot, soapy water before use.
  • Wash your hands thoroughly with warm, soapy water before and after handling or preparing food.
  • Prevent cross-contamination by keeping raw foods separate from ready-to-eat foods. Keep raw meat, poultry, fish and shellfish away from other foods when shopping, preparing food, or storing food.
  • Cook foods to a safe temperature. Use a food thermometer to ensure meat has been fully cooked. You can kill harmful organisms in most foods at the following temperatures:
    • Cook ground beef to 160 F (71.1 C); steaks, roasts chops, such as lamb, pork and veal, to at least 145 F (62.8 C).
    • Cook chicken and turkey to 165 F (73.9 C).
    • Make sure fish and shellfish are cooked thoroughly.
  • Refrigerate or freeze perishable foods promptly— within two hours of purchasing or preparing them. If the room temperature is above 90 F (32.2 C), refrigerate perishable foods within one hour.
  • Defrost food safely. Don’t thaw food at room temperature. The safest way to thaw food is to defrost it in the refrigerator. If you microwave frozen food using the “defrost” or “50 percent power” setting, be sure to cook it immediately.
  • When in doubt, throw it out. If you aren’t sure if a food has been prepared, served or stored safely, discard it. Food left at room temperature too long may contain bacteria or toxins that can’t be destroyed by cooking. Don’t taste food that you’re unsure about—just throw it out. Even if it looks and smells fine, it may not be safe to eat.

How to Practice Good Hygiene to Prevent Food Poisoning

    • Encourage frequent hand washing at home and at school. Forty percent of food poisoning can be avoided if people washed their hands. Encourage your kids to wash their hands after they use the bathroom at school and at home, especially before eating or handling food.
    • Reduce germs that come into your home. Schools and daycares are notorious for germs. Clean your child off with a warm soapy washcloth every day when they get home from school or daycare.
    • Eliminate fecal matter from your home: Properly clean/disinfect/dispose of dirty diapers, soiled clothes, and pet waste. Check your cabinets for rodent or insect droppings.

What Foods to Avoid to Prevent Food Poisoning:

Pregnant women, young children, the elderly, and anyone with a weakened immune system should avoid raw and unpasteurized foods and the following:

  • Raw or undercooked fish or shellfish, including oysters, clams, mussels and scallops
  • Raw or rare meat and poultry
  • Raw or undercooked eggs or foods that may contain them, such as cookie dough and homemade ice cream
  • Raw sprouts, such as alfalfa, bean, clover and radish sprouts
  • Unpasteurized juices and ciders
  • Unpasteurized milk and milk products
  • Soft cheeses, such as feta, Brie and Camembert; blue-veined cheese; and unpasteurized cheese
  • Refrigerated pates and meat spreads
  • Uncooked hot dogs, luncheon meats and deli meats

As a general rule of thumb, the best prevention against food poisoning is making sure that anything you consume is washed and cooked at appropriate temperatures. And anything that comes in contact with your food or drinks— utensils, dishes, hands— needs to be cleaned properly as well. But controlling contamination gets difficult when you aren’t the person preparing the meal. So your best bet is to choose restaurants and cooks that are reputable.

If you think you’ve caught a severe case of food poisoning, go to the emergency room immediately and ask to be tested for food pathogens.