From the WebMD Archives

April 27, 2018 -- About 48 million people become sick from a foodborne illness every year in the U.S., or about 1 of every 6 Americans, the CDC says.

Many cases are mild, causing simple discomfort up to misery from nausea, vomiting, diarrhea, and stomach cramps for 24 to 48 hours. But 128,000 of the people affected need to go to the hospital, and 3,000 die.

Any food can be infected with more than 250 foodborne diseases. Bacteria, parasites, viruses, chemicals, and toxins can contaminate food.

Pregnant women, young children, older adults, and people with a weakened immune system (such as people with diabetes, liver or kidney disease, or HIV or getting cancer treatments) are especially vulnerable.

"People think of foodborne illness as short term, as something that may sicken them for 24 or 48 hours," says Barbara Kowalcyk, PhD, assistant professor of food science and technology at Ohio State University, Columbus, and co-founder of the Center for Foodborne Illness Research and Prevention. While that may be the extent of it for many, ''there may be long-term health outcomes like irritable bowel syndrome (IBS) and reactive arthritis that have been associated with foodborne illness."

While it's unlikely you can avoid foodborne illnesses entirely, you can greatly reduce your chances by:

  • Knowing which foods are most likely to be affected.
  • Knowing where the most risk lies.
  • Learning safe food-handling techniques.

On the ''Most Likely" List

Foodborne illnesses are linked to certain foods more than others. On the CDC's most likely list:

  • Chicken, beef, pork, turkey
  • Vegetables and fruits
  • Raw milk, cheese, other dairy products
  • Raw eggs
  • Seafood and raw shellfish
  • Sprouts
  • Raw flour

Food can become contaminated in the fields, during processing, or at other places  in the food production chain. Animal feces may contaminate produce. Poor conditions in a manufacturing plant may allow bacteria to grow. Restaurant workers who don’t wash their hands properly can spread disease. A field irrigated with contaminated water can affect fruits and vegetables before harvest.

Cross-contamination can lead to foodborne illness, too. For instance, if you prepare raw chicken on a countertop, then use the unwashed surface to prepare vegetables, bacteria or other toxins from the raw chicken may contaminate the produce.

Among the common germs leading to foodborne illness are norovirus, salmonella, campylobacter, Clostridium perfringens, and Staphylococcus aureus.

Probably the biggest surprise for most people is that  produce is on the “most likely” list, says Dana Hunnes, PhD, MPH, senior dietitian at the Ronald Reagan UCLA Medical Center in Los Angeles. "Raw produce is the most common [cause], in my experience, followed by animal protein not cooked to the proper temperature.''

Eating In vs. Eating Out: What's Riskier?

According to the CDC, foodborne illness outbreaks are more likely to begin at restaurants than at home.

But Hunnes says some foodborne illnesses occurring at home may be mild and passed off as something minor.

To dine out smarter, check a restaurant's inspection score, which many are now required to post, Kowalcyk says. If you order a dish with eggs, meat, fish or poultry, be sure it's thoroughly cooked, she says. ''When in doubt, send it back." And if you send it back, be sure to ask the server also to give you a new, fresh plate with the fully cooked dish, she says.

If an outbreak involves a food from a certain region, ask your server where the ingredients in the dish you want come from. If they can't tell you, reconsider your order, she says.

Larger chain restaurants tend to be more aware of outbreaks and recalls, Kowalcyk says. "They have food safety staff that are often monitoring." However, she says, it doesn’t necessary mean they always follow through.

Staying Safe at Home

Staying aware of outbreak and recall news is vital, Kowalcyk says. Once you hear of one, "check the pantry and refrigerator to be sure you don't have recalled products in your home."

Kitchen habits count.

  • When preparing meat, poultry, and eggs, always use a food thermometer, Kowalcyk says. She prefers a digital model, which she says is more sensitive. To know the temperature needed to cook different foods thoroughly, refer to this chart.
  • "If you are handling raw eggs, make sure you wash your hands and clean the surface," Kowalcyk says.
  • If you use a sponge to clean up, ''throw it in the dishwasher daily to sanitize it." Sponges are an excellent breeding ground for germs, she says.
  • Between handling different foods, wash your hands with soap and water.  "Using a paper towel is best," Kowalcyk says. "Bacteria that isn't sticky will come off during the washing, but others will come off with the friction of the paper towel."
  • "Keep cold foods cold" and vice versa, Hunnes says. "Don't freeze, thaw, and freeze. Once a food is thawed, use it."
  • Produce should be washed with soapy water and rinsed well.
  • "Wash all utensils extremely well."
  • Refrigerate food that is perishable within 2 hours, the CDC says, or 1 hour if the outside temperature is 90 degrees or more.

Show Sources

Barbara Kowalcyk, PhD, assistant professor of food science and technology, Ohio State University, Columbus; co-founder, Center for Foodborne Illness Research and Prevention.

Dana Hunnes, PhD, MPH, RD, senior dietitian, UCLA Ronald Reagan Medical Center, Los Angeles.

CDC: "Surveillance for Foodborne Disease Outbreaks United States, 2015: Annual Report."

CDC: "Foods Linked to Foodborne Illness," Nov. 20, 2017.

CDC: "Food Safety Tips," Apr. 19, 2018.

CDC: "Foodborne Illnesses and Germs," Feb.16, 2018.

The American Journal of Gastroenterology, November, 2016.

CDC: "Annual Summaries of Foodborne Outbreaks." February 9, 2018.

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