MMS Physician Focus: August 2010
By Alfred DeMaria, Jr., M.D.
The cases always capture headlines: Outbreaks put worries on
the table, Tainted lettuce sickens 19, Egg recall sparked by
salmonella threat. A report by cable channel ESPN even called
a foul on stadium food, after examining health department
inspection reports at professional sports venues across the
country.
Whether it's lettuce, peanut butter, pistachios, beef, cookie
dough, or eggs - the last being the latest in a growing list -
contaminated food is grabbing our attention. And it's causing
concern: A national survey by Thomson Reuters for NPR found that 61
percent of Americans fret about food contamination, with meat the
biggest worry. As we shop the aisles, prepare the meals, and
patronize the restaurants, we may silently ask, is it safe to
eat?
Food safety has become a hot topic, and tainted food leads to
the problem of foodborne illness. The Centers for Disease Control
estimates that diseases from tainted food cause 76 million
illnesses, 325,000 hospitalizations, and 5,000 deaths each year. In
Massachusetts, we estimate about 1.5 million cases a year.
But those numbers likely fall short of the real impact. Official
reporting generally underestimates the problem, as many people may
not attribute an illness to bad food or don't report it to their
physician or public health officials. Some estimates indicate that
for every reported case, as many as 40 go unconfirmed by
laboratories or unreported.
While our food supply today is perhaps safer than it's ever
been, lots of opportunities exist for consumers to contract
foodborne illnesses. Food is grown and produced all over the world,
so what we eat could come from anywhere in the world. As such,
contamination can occur anywhere along the chain - in growing,
production, transportation, in supermarkets or restaurants -- even
in the home.
Most foodborne illnesses are infections caused by bacteria -
such as salmonella, E. coli, and Campylobacter, the last being the
most common bacterial cause of diarrhea in the developed world.
Other illnesses result from toxins or chemicals that have tainted
the food at some point along the supply chain. Those most at risk
are the very old, the very young, individuals whose immune systems
are affected by other conditions, and healthy people exposed to
large amounts of contaminants.
As public consciousness about food safety has grown, so has that
of the growers, manufacturers, and processors, and the federal,
state and local agencies responsible for setting standards,
conducting inspections, and ensuring compliance from those who
produce and deliver our food supply. Restaurants, long subject to
regular, stringent inspections by local public health officials,
are also part of the process. More sophisticated approaches to food
safety assurance, such as hazard analysis critical control point
(HACCP) methods, have been put in place at many levels.
The fact is that everyone has a role to play in preventing
foodborne illness: from producers to suppliers to preparers to
consumers and those at all levels of government. But even if
everyone along the chain does everything exactly right, it's
impossible to entirely eradicate contamination. Some just occurs as
part of nature.
Consumers, therefore, also play a key role in preventing
foodborne illness. Here's what all of us can do to reduce the risk
of such diseases.
- Wash your hands with soap and water before preparing food.
- Cook meat, poultry and eggs thoroughly; use a thermometer to
check for proper temperatures. Raw foods of animal origin - raw
meat, poultry, raw eggs, and raw shellfish - are the most likely to
be contaminated.
- Avoid cross contamination of foods by washing your hands and
tools, such as cooking utensils, cutting boards, and cookware,
before touching other foods.
- Refrigerate leftovers promptly, as bacteria can grow quickly at
room temperature.
- Wash produce, fruits and vegetables in running water to remove
visible dirt.
- Report suspected foodborne illnesses to your local health
department.
The last step of reporting is particularly important, especially
reporting of clusters of illness. It is by analyzing these reports
that public health officials can intervene and investigate,
identify the type and extent of contamination, block tainted food
from reaching the shelves, and thus prevent further illness.
For more information on food safety and foodborne illness, visit
the Mass. Department of Public Health's Food Protection Program at
www.mass.gov/dph/fpp and
the U.S. Department of Health and Human Services at www.foodsafety.gov. For a
video discussion of foodborne illness, visit the Massachusetts
Medical Society at www.physicianfocus.org.
Alfred DeMaria Jr., M.D. is the Medical Director of the
Bureau of Infectious Disease for the Commonwealth of Massachusetts.
Physician Focus is a public service of the Massachusetts Medical
Society. Readers should use their own judgment when seeking medical
care and consult with their physician for treatment. Comments
toPhysicianFocus@mms.org
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