Say bah-humbug to foodborne bugs this Thanksgiving

By Liz Meszaros, MDLinx
Published November 15, 2017

Key Takeaways

The holidays are upon us, and with all the wining, dining, and leftovers that will result from these the joyous-but-oft-grueling festive gatherings, food safety should be a big concern.

Each year, according to the Centers for Disease Control and Prevention (CDC), approximately 48 million people contract a foodborne illness (“food poisoning”), of whom 128,000 require hospitalization, and approximately 3,000 die.

In breaking it down, a report from the CDC’s Foodborne Diseases Active Surveillance Network (FoodNet), which tracks 15% of the US population, shows that the majority of reported bacterial foodborne illnesses in 2016 were caused by Campylobacter (8,547) and Salmonella (8,172), followed by Shigella (2,913), Shiga toxin-producing Escherichia coli (1,845), Cryptosporidium (1,816), Yersinia (302), Vibrio (252), Listeria (127), and Cyclospora (55).

The incidence is likely even greater.

"I have been seeing a lot of stomach viruses, gastroenteritis, a lot of diarrheal kinds of illnesses," said Vandana Y. Bhide, MD, a Mayo Clinic hospital internal medicine specialist, Rochester, MD. "There are always outbreaks of different kinds of stomach bacteria from foodborne illnesses."

So before you put that luscious turkey on the table, take that requisite after-dinner nap, or even raid the refrigerator on a late-night run, consider these tips from the experts at NIH’s National Institute of Diabetes and Digestive and Kidney Disease (NIDDK) and the Mayo Clinic for ensuring proper food safety:

  • Refrigerate and freeze foods right away. Keep your refrigerator below 40°.
  • Always use a meat thermometer to make sure food is thoroughly cooked. This is especially important for turkey preparation.
    • For whole beef, veal, lamb, fresh pork, ham, and fish: 145°
    • For ground beef, veal, pork, lamb, and for egg dishes: 160°
    • For all poultry, including ground chicken and ground turkey, as well as stuffing, leftovers, and casseroles: 165°
  • Both before and after handling raw meat, wash your hands for at least 20 seconds with warm, soapy water.
  • Do not cross-contaminate. Keep raw meat, poultry, seafood, and eggs away from ready-to-eat foods. "You don’t want to have your meat at the same place where your fruits and vegetables are. And that goes with any kind of uncooked meat, whether it’s poultry?whether it’s beef, pork, or fish," warned Dr. Bhide.
  • Rinse even fruits and vegetables under running water. "Things that we don’t even think about?things like lettuce?actually can have a lot of soil and dirt, a lot of bacteria," said Dr. Bhide. "I always say anything that can be washed should be washed. And you want to really wash it thoroughly. If there’s something that can be scrubbed, that has a hard rind, you want to do that."
  • Wash utensils and disinfect surfaces before and after food preparation.
  • Do not leave any food out at room temperature for more than 2 hours.

A feeling akin to the stomach flu may herald the onset of a foodborne illness, but the severity and onset of symptoms depends largely on how many ‘bugs’ were ingested. Onset can occur in as little as a few hours after eating, or as long as 9 days later.

“The difference (in the onset of food poisoning after eating the food) is the dose,” said Herbert L. DuPont, MD, infectious disease and travel medicine expert at UTHealth School of Public Health, Houston, TX. “The more bugs or toxins you swallow, the shorter the incubation period. The fewer you swallow, the longer the incubation period.”

Extra care and safety, however, is needed for those who are older, immunocompromised, diabetic, or who have cardiovascular disease.

“But for debilitated or elderly persons, AIDS patients or infants, it can be life threatening,” Dr. DuPont said. “You have got to be careful when preparing foods for these individuals.”

Although most people recover from foodborne illnesses on their own, advise patients to seek medical attention if they have any of the following symptoms:
• High fever (over 101.5° measured orally)
• Blood in the stool
• Frequent vomiting that prevents keeping liquids down
• Signs of dehydration, including decreased urination, dry throat and mouth, or dizziness upon standing

Remember: Tell your patients to eat safely and have a Happy Thanksgiving!

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