E.Coli and food-borne illnesses

While outbreaks like the one involving spinach can be deadly and spread quickly, they are also rare. The best prevention is to follow healthy sanitation practices

By: Ronald G. Nahass, M.D.
   The recent national outbreak of E.coli linked to contaminated spinach grown in California highlights the dangers of food-borne illness and just how widely it can reach, in terms of geography and population. At last measure, it had appeared in 26 states and Canada, affecting nearly 200 people, and killing at least three.
   There are several strains of E.coli, but not all of them are so deadly. The most virulent strains produce poisons that destroy vital cells in the stomach and blood vessels. The contamination first manifests with nausea, vomiting, and abdominal cramps. This leads to diarrhea that can start out watery and then turn bloody. The organ most vulnerable to the toxins is the kidney, where red blood cells can break open, causing a dangerous form of kidney failure called hemolytic uremic syndrome.
   The ensuing effects, including dehydration, increased blood pressure and buildup of fluids near the heart, can result in death, especially for the most vulnerable in the population — the very young, the very old, and others who already have a weakened immune system.
   The Food and Drug Administration and other government inspection agencies have established standards that make the food supply in the United States safer than perhaps anywhere else in the world. Despite the best precautions, however, there are a variety of germs that can contaminate food.
   According to the Centers for Disease Control, food-borne illnesses sicken 76 million Americans every year. More than 300,000 are hospitalized. While most cases are mild, CDC statistics report that food-borne illnesses kill 5,000 people in the United States each year.
   Many kinds of food poisoning are caused by bacteria, including E.coli, which is most commonly found in food products that come from cows, especially ground beef.
   In the most recent case, the investigation focused on farms in California’s Central Valley, where 75 percent of the nation’s spinach is grown. It is believed that irrigation waters may have been tainted with cow manure that contaminated the spinach before it was packaged for sale.Most cases of food poisoning are preventable.
   The growth of dangerous bacteria in food is often caused by careless handling. Raw vegetables may be contaminated at the source, the soil in which they’re grown, and then not washed and packaged properly. Bacteria flourish at room temperature, which is why food should be kept very hot or refrigerated.
   The FDA says that at least 60 percent of all raw poultry sold in the United States carries some disease-causing bacteria, most commonly, salmonella. While these bacteria are normally killed off during the cooking process, when such meats as chicken or pork are not cooked at a high enough temperature or for a long enough time, these bacteria survive and multiply.
   Egg yolks from infected chickens are one of the main sources of salmonella. The CDC estimates that every year, 1 out of every 50 Americans consumes a contaminated egg yolk. Thorough cooking is the best way to prevent this common type of food poisoning.
   Staphylococcus aureus is most commonly caused by poor sanitary practices in the preparation of food. For example, a food handler who is ill may cough, or touch his nose, and then unknowingly transport germs to the food. He may use the bathroom, and then forget to wash his hands.
   Shigella affects the small intestine and is a very common cause of diarrhea for people who travel to other countries, where the standards of food preparation and water safety are not as stringent as they are in the United States.
   This bacterium thrives in food and water that is contaminated. Like other types of food poisoning, the most common symptoms are vomiting and diarrhea. Dehydration is a real threat, and in the most severe cases, the body’s fluids must be replaced with an intravenous treatment to deliver necessary water and nutrients.
   The most deadly form of food poisoning is botulism because it releases neurotoxins that quickly attack the nervous system, including the brain and spinal cord. This can result in paralysis, even before any of the other traditional symptoms of food poisoning, such as vomiting and diarrhea, have a chance to manifest.
   The Clostridium botulinum bacteria are usually produced in canned foods that are not heated to high enough temperatures. Improper canning procedures can also cause the bacteria to flourish.
   While outbreaks like the one involving spinach can be deadly and spread quickly, they are also rare. The best prevention is to follow healthy sanitation practices and careful food handling techniques.
   Prevention starts at the supermarket. Be attentive when you buy your produce and meats. Check expiration dates on everything, especially beef and chicken. If you’re picking out spinach or salad, take the packages at the bottom — the colder, the better.
   Kitchen hygiene is very important. You may cook the chicken all the way through, killing any bacteria, but if you use the same chopping block to chop your vegetables, they can be contaminated in the preparation process.
   Make sure hamburger meat is cooked thoroughly and is not raw or too rare. Again, use a different prepping board for the vegetables in case the meat harbored any bacteria.
   Water used in dishwaters should be heated to a temperature of 160 degrees Fahrenheit to make sure that any lingering bacteria on plates and cooking utensils are killed off.
   The good news is that most cases of food poisoning — with the exception of botulism — are mild and clear up within a few days without medical intervention. If symptoms persist, and dehydration becomes a real factor, the victim should seek immediate medical help.
   For more information about food-borne illnesses or to find a
Princeton HealthCare System physician who specializes in infectious disease, please
call (888) 742-7496 or visit www.princetonhcs.org.