Food safety became a huge concern when a man introduced hazardous chemicals to grocery stores in Washtenaw County in May. In this week's "Issues of the Environment," WEMU's David Fair talks with Washtenaw County Environmental Health Director Kristen Schweighoefer about what to do if contaminated food becomes a serious problem.
* Recently, there have also been recalls of grocery store items thought to be tainted with serious pathogens, including listeria related to frozen organic vegetables and salmonella (thought to be connected to Easter chicks given as pets). However, Washtenaw County Public Health says that they receive reports of recalled food on a weekly basis and not all are worthy of alarm.
* While poisoning events such as this are believed to be rare, illness related to foodborne causes is quite common, and the CDC estimates that 1 in 6 Americans is sickened from contamination each year. While some illnesses are mild and relatively minor, in the United States thousands are hospitalized and 3,000 die every year from foodborne illnesses; children, the elderly, pregnant women, and those with suppressed immunity are most vulnerable.
* Washtenaw County Public Health receives several calls every week from citizens (and doctors regarding sick patients) who believe they have been sickened by contaminated food, and every complaint is thoroughly investigated.
CDC estimates that each year roughly 1 in 6 Americans (or 48 million people) get sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases. Estimating illnesses, hospitalizations, and deaths for various types of diseases is a common and important public health practice. One of the more common diagnoses made in medicine is acute gastroenteritis. The layman's term is "food poisoning" or "stomach flu." There is really no such thing as "stomach flu," but the symptoms of abdominal pain, vomiting and diarrhea are often the result of a food-borne bacteria or virus. You are just as likely to get food poisoning from food prepared at home as you are from a fast-food restaurant.
Foodborne illness occurs when a person gets sick by eating food that has been contaminated with an unwanted microorganism or pathogen. This condition is often called "food poisoning." Bacteria, parasites, and viruses are microorganisms that can cause foodborne illness. Many cases of foodborne illness go unreported because their symptoms often resemble the stomach flu. The most common symptoms of foodborne illness include stomach cramps, nausea, vomiting, diarrhea, and fever.
CDC has estimates for two major groups of foodborne illnesses:
*Known Foodborne Pathogens — 31 pathogens known to cause foodborne illness. Many of these pathogens are tracked by public health systems that track diseases and outbreaks.
*Unspecified Agents— Agents with insufficient data to estimate agent-specific burden; known agents not yet identified as causing foodborne illness; microbes, chemicals, or other substances known to be in food whose ability to cause illness is unproven; and agents not yet identified. Because you can’t “track" what isn’t yet identified, estimates for this group of agents started with the health effects or symptoms that they are most likely to cause—acute gastroenteritis.
What Causes Foodborne Illness?
Bacteria-related food poisoning is the most common form, but fewer than 20 of the thousands of different bacteria actually are the culprits. More than 90% of the cases of foodborne illnesses each year are caused by the The Big Five:
1) Norovirus - most common at 58% of illnesses. CDC estimate about 5.5 million are infected each year; 15,000 hospitalized and about 300 deaths a year. The fourth most deadly foodborne illness. Norovirus is a very contagious virus that can infect anyone. You can get it from an infected person, contaminated food or water, or by touching contaminated surfaces. The virus causes your stomach or intestines or both to get inflamed. This leads you to have stomach pain, nausea, and diarrhea and to throw up. These symptoms can be serious for some people, especially young children and older adults.
2) Clostridium perfringens - CDC estimate about 1 million infected each year in the US. Clostridium perfringens (C. perfringens) is a spore-forming bacterium that is found in many environmental sources as well as in the intestines of humans and animals. C. perfringens is commonly found on raw meat and poultry. It prefers to grow in conditions with very little or no oxygen and, under ideal conditions, can multiply very rapidly. Some strains of C. perfringens produce a toxin in the intestine that causes illness.
3) Campylobacter - 800,000 infections each year; 8,000 hospitalizations and 80 deaths per year. One of the top five deadliest foodborne infections. Most people who become ill with campylobacteriosis get diarrhea, cramping, abdominal pain, and fever within two to five days after exposure to the organism. The diarrhea may be bloody and can be accompanied by nausea and vomiting. The illness typically lasts about one week. Some infected persons do not have any symptoms. In persons with compromised immune systems, Campylobacter occasionally spreads to the bloodstream and causes a serious life-threatening infection.
4) Staphylococcus aureus - 250,000 infected each year. Few deaths.
5) Salmonella - second most common illness. 1 million infected annually; 20,000 are hospitalized and about 400 die each year. This is the most deadly infection. Most persons infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days, and most persons recover without treatment.
These illnesses are also tracked in Washtenaw County:
*Bacillus cereus-60,000 infections a year. No deaths. Diarrhea, vomiting caused by toxins released by bacteria. Sources, a variety of foods, particularly rice and leftovers, as well as sauces, soups, and other prepared foods that have sat out too long at room temperature.
*Escherichia coli (E. coil)--300,000 infections a year; 2,000 hospitalizations; 20 deaths. The CDC tracks four different strains of this bacteria, some are fairly benign, while the STEC strain O157 is the deadliest.
*Hepatitis A-1600 infections a year; 8 deaths.
*Listeria monocytogenes-250 deaths each year; 1500 hospitalizations; third most deadly infection: 250 deaths. Treated with antibiotics. At least 90% of people who get Listeria infections are in a higher risk group. Healthy children and adults occasionally get infected with Listeria, but they rarely become seriously ill. The following groups are at increased risk:
1) Pregnant women: About one in seven (14%) cases of Listeria infection occurs during pregnancy. Infection during pregnancy can cause fetal loss (miscarriage or stillbirth), preterm labor, and illness or death in newborn infants. Pregnant women are about 10 times more likely than the general population to get Listeria infection. Pregnant Hispanic women are about 24 times more likely than the general population to get Listeria infection.
2) Older adults: More than half (58%) of Listeria infections occur among adults 65 and older. Adults 65 years and older are about 4 times more likely than the general population to get Listeria infection.
3) People with weakened immune systems: Individuals within this group also have a higher risk for Listeria infection due to underlying medical conditions, such as cancer and immunosuppressive therapy (i.e., steroids, chemotherapy, radiation), liver or kidney disease, diabetes, alcoholism, and HIV/AIDS.
*Vibrio parahaemolyticus-35,000 infections, few deaths. When ingested, V. parahaemolyticus causes watery diarrhea often with abdominal cramping, nausea, vomiting, fever and chills. Usually these symptoms occur within 24 hours of ingestion. Illness is usually self-limited and lasts 3 days.
*Toxoplasma gondii-- is also tracked by the CDC, but it is not listed on the County website. 90,000 infections a year; 4,500 people are hospitalized annually, and about 330 die. Toxoplasmosis is considered to be a leading cause of death attributed to foodborne illness in the United States. More than 60 million men, women, and children in the U.S. carry the Toxoplasma parasite, but very few have symptoms because the immune system usually keeps the parasite from causing illness. However, women newly infected with Toxoplasma during pregnancy and anyone with a compromised immune system should be aware that toxoplasmosis can have severe consequences.
The CDC estimates that 91% of foodborne illnesses in the United States each year are attributable to these five infections.
*time and temperature abuse
*improper handwashing and other poor personal hygiene habits
*cross-contamination of raw foods and ready-to-eat foods
There is a lot you can do to prevent foodborne illness in your home. You probably already practice most of these preventative steps without knowing it, because practicing food safety means using common sense. Below is a list of measures you can take to keep your family safe.
*Wash your hands thoroughly and often, especially after handling raw meats, using the restroom or changing diapers. Also, make sure you wash your hands before you begin preparing any food!
*Make the grocery store your last errand before you go home.
*Buy dairy and meat products last. This way you minimize the time they are not refrigerated.
* Be sure to put perishable foods in the refrigerator as soon as you get home.
* Keep a thermometer in your refrigerator, and make sure the temperature stays below 40°F.
* When thawing foods, thaw in the refrigerator, under running water for less than two hours, as part of conventional cooking, or in the microwave as long as the food will be cooked immediately. Do not thaw foods on the counter top!
*Don't cross contaminate! Use separate cutting boards for meat and for vegetables. Don't put cooked meat back on a cutting board or plate that was used for raw meat. The same goes for knives - don't use the same knife for vegetables or cooked meat that you used for raw meat.
*Cover and store leftover cooked food in the refrigerator as soon as possible.
* Divide leftovers into smaller portions so that they cool faster and are convenient for reheating individual portions.
* Reheat all leftovers until they are steaming hot.
* Thoroughly cook all meat, poultry, and seafood - especially shellfish. Use a food thermometer to make sure you reach the following temperatures:
Stuffed products: 165°F
Hot Dogs: 135°F
Food service establishments like grocery stores, restaurants, coffee shops, etc. must submit a food service plan to the county prior to construction or remodeling. The plans are required to verify that the proper sanitation infrastructure is in place. This includes the placement of hot water lines, dishwashers, refrigeration, etc.
Washtenaw County Public Health also conducts ongoing food safety inspections. The Environmental Health Division licenses and inspects over 1,000 food service establishments within Washtenaw County. The purpose of conducting these inspections is to ensure that safe food is being served to the public. The results of the inspections are published to the public twice a month, and the violations are highlighted.
If you believe you have gotten sick from food you ate at a restaurant or grocery store in Washtenaw County, please call Washtenaw County Environmental Health at (734) 222-3800. (Please note that office hours are 8:30am - 5:00pm, Monday - Friday.)
Please be prepared to provide the following information:
*Your Name, Address, and Phone Number (you will remain anonymous to the restaurant)
*Name of restaurant
*Location/address of restaurant (it must be in Washtenaw County
*Date of suspect meal
*Specific information about the foods you believe made you sick
*3-day food eating history
*When your symptoms began and what they were