Understanding Food Safety

By: the American Institute for Preventive Medicine

Food-Borne Illnesses

©2006 Publications International, Ltd. Raw oysters can cause vibrio poisoning, but any poorly refrigerated shellfish,especially shrimp and mollusks, are a risk.

Often, we assume everything we eat is healthy -- and that introducing illiness, bacteria or other problems into food when selecting, cooking or preparing food is next to impossible. We take for granted that the food we purchase, prepare and save as leftovers is safe, and that the chance of it making us sick is unlikely.

However, that isn't the case. If you think food-borne illness -- or "food poisoning" as it's commonly but incorrectly called -- is a relatively minor occurrence with relatively minor consequences, think again. There are millions of cases of food-borne illness in the United States each year. That's not even counting all the cases wrongly attributed to the nebulous "stomach flu."


Far from being innocuous, food-borne illnesses land many people in the hospital; some even die. The effects of food-borne illness can be long-lasting. Some fish-borne diseases can leave a victim with nerve damage. Reactive arthritis is an allergic-type reaction that has long-lasting effects on joints.

Unfortunately, these days, food-borne illnesses are only getting deadlier. New organisms are cropping up and minor players are becoming major players.

But it doesn't have to be this way. Prevention is the name of the game with food-borne illnesses. The solution lies in how often and how well you wash your hands and utensils, how you store your food, and how you cook it.

Fish Gone Bad

Many of the forms of food-borne illness that are on the rise originate in fish. They're not well-known, but they can be deadly. Many involve toxins that can't be detected and aren't killed by refrigeration or cooking. You can protect yourself by not eating raw fish or fish pulled from questionable waters, but the only foolproof prevention is to avoid eating susceptible fish. Here's a sampling:

  • Anasakiasis has symptoms (fever, nausea, diarrhea, and vomiting) that don't appear for a week, so diagnosis is often missed. It's not common, but it is a risk whenever you eat raw fish. The organism's larva can penetrate the stomach lining, causing severe pain that mimics an ulcer. Cooking and freezing will kill the organism (ask for sushi made from frozen fish).
  • Paralytic shellfish poisoning causes an immediate burning sensation of mouth and extremities, nausea, vomiting, and diarrhea and can lead to muscle weakness and paralysis. The neurotoxic form may take hours to appear, but it is milder. The illness is caused by toxins formed in mollusks -- mussels, clams, scallops -- off the Pacific, New England, and Florida coasts.
  • Ciguatera poisoning causes the typical nausea, vomiting, and diarrhea that starts 6 to 12 hours after eating, but it is followed by slowed heart rate, low blood pressure, severe itching, a characteristic temperature reversal (cold feels hot and vice versa), and tingling and numbness of extremities. These symptoms can last for days or months. Caused by toxins produced by algae and passed on to bottom-dwelling predator fish, such as amberjack, red snapper, and sea bass, caught near reefs in Florida, Hawaii, and the Caribbean, it is not destroyed by cooking.
  • Scombroid poisoning is an immediate reaction to a toxin produced by bacteria in fish that hasn't been refrigerated properly. It causes flushing, burning of the throat, itching, nausea, cramps, and vomiting and can lead to dangerously low blood pressure and difficulty breathing.
  • Vibrio poisoning is characterized by explosive, watery, or bloody diarrhea. The form found in raw oysters is the most dangerous and can cause fatal wound infections, but any poorly refrigerated shellfish, especially shrimp and mollusks, are risky.

Food Storage and PreparationIt's much easier to head off a food-borne illness than it is to suffer through it. Here are some prevention tips:

  • The maxim of food-borne illness prevention: Keep cold foods cold and hot foods hot. Bacteria grow best at temperatures between 40 degrees Fahrenheit and 140 degrees Fahrenheit. Don't let foods that can spoil sit at room temperature for more than two hours -- the longer it sits, the more organisms build up in the food.
  • Using hot, soapy water, wash your hands for at least 20 seconds before and after you prepare food. Wash your hands after blowing your nose, sneezing, or coughing; using the bathroom or changing diapers; handling pets; and taking care of a sick person. Wash all utensils that touch raw meats and poultry in a dishwasher or with hot, soapy water. When you grill, never put cooked food back on a platter that held raw meat or poultry.
  • Don't thaw at room temperature. Plan ahead so you have enough time to defrost meat in the refrigerator. If you can't, thaw the meat in a closed plastic bag in a sink of cold water that you change every half-hour. Or thaw it in a microwave and cook it right away.
  • Cook hamburgers until the juices run clear and the meat is no longer pink in the middle. Use a meat thermometer to cook meats to safe temperatures.
  • Don't eat foods with visible mold, unless it is a hard cheese. Even then, cut around it with a generous margin. Don't sniff mold or stick your nose into a bag of moldy food. Throw the bags away.
  • All eggs should be refrigerated. Even hard-boiled eggs should not be left out for more than two hours; boiling them destroys their protective coating, so they are even more likely to go bad than raw eggs. Eat hard-boiled eggs within seven days of cooking them.
  • Realize you run a risk of salmonella if you eat raw eggs. That includes foods made with raw eggs like homemade eggnog, fresh Caesar salad dressing, fresh Hollandaise sauce, homemade French vanilla ice cream, and homemade mayonnaise. Everyone should steer clear of these, especially the very young, the very old, and those with compromised immune systems.
  • Use a wooden cutting board; research shows it may resist bacterial contamination. Wash it with hot, soapy water. Wash plastic cutting boards in the dishwasher to remove fat that clings to them. Replace both kinds of cutting boards when scarred or splintered.
  • Don't store easily perishable foods -- such as milk -- in the refrigerator door; it doesn't stay as cold as the interior of the refrigerator.
  • Do not drink straight from the milk carton; germs from your mouth will contaminate the contents.
  • Don't reuse leftover marinade; it's contaminated from the raw meat or poultry.
  • Cook or freeze fish and shellfish within one day of purchase.
  • Discard any clams or mussels that do not close tightly when tapped before cooking. Steer clear of any that don't open after cooking.
  • Avoid raw milk. It has been linked to numerous outbreaks of food-borne illness, with serious outcomes.
  • Throw out soft cheeses after a week; they can harbor Listeria organisms.
  • Store whole-wheat flour and brown rice in the refrigerator to discourage rancidity and bug infestation.
  • Don't cook your Thanksgiving turkey by the slow low-temperature method-the meat will not get hot enough to kill bacteria.
  • Never stuff a turkey the night before. And always remove the stuffing immediately after removing it from the oven. A turkey cavity provides just the right temperature for bacterial growth.

Making educated choices when selecting food, as well as preparing and storing it safely, can help reduce the risk of food-borne illness. Another aspect of food safety to consider is toxins: Are the things we add to our food safe? In the next section, we'll learn about what toxins are and what to avoid.This information is solely for informational purposes. IT IS NOT INTENDED TO PROVIDE MEDICAL ADVICE. Neither the Editors of Consumer Guide (R), Publications International, Ltd., the author nor publisher take responsibility for any possible consequences from any treatment, procedure, exercise, dietary modification, action or application of medication which results from reading or following the information contained in this information. The publication of this information does not constitute the practice of medicine, and this information does not replace the advice of your physician or other health care provider. Before undertaking any course of treatment, the reader must seek the advice of their physician or other health care provider.