Don’t let food poisoning spoil your holiday meal

David J. Holcombe, M.D., M.S.A., Regional Medical Director, Region 6 (Alexandria Region)

The recent jambalaya fund-raiser in central Louisiana that resulted in an outbreak of Salmonella demonstrates the potential for food contamination when large meals are prepared. The outbreak made nearly 160 people getting sick, sent 45 people to the hospital and is suspected to have caused one death, staggering numbers for a city of only 384 people.

 Food borne illnesses are frequent, affecting well over 48 million people in the U.S. each year.  As shown in Louisiana last month, food borne illnesses are also a significant cause of sickness and result in over 128,000 hospitalizations and 3,000 deaths annually as reported by the CDC.  These numbers might be low because many outbreaks are small, mild and go unreported. The older and sicker (or younger) the patient, the more likely they are to have a tragic outcome.

In Louisiana, in addition to Salmonella, another germ was identified, Clostridium perfringens. These are both common causes of food poisoning, each sickening perhaps a million people annually in the U.S. 

Nothing will spoil a fund raiser, family gathering, church picnic, or a long-awaited cruise more than a case of food poisoning. The danger increases around the holidays when large meals are cooked by and for extended family under variable conditions of food safety. Who has not heard about a church picnic, wedding or holiday family gathering that ended in diarrheal disaster?

Food borne illnesses are caused by a great number of agents including viruses, bacteria, vibrios and others. Sometimes it is a situation where the food contains toxins already produced by the proliferation of the bacteria (such as Staphyloccocus aureus, which causes about 250,000 cases a year). At other times, it is by growth of the organism within the infected individual (such as with Salmonella). In any case, the symptoms usually include fever, nausea, vomiting, abdominal pain and diarrhea, sometimes explosive and even bloody.

The Top 10 Causes of Food Poisoning

Viruses, especially noroviruses, cause about 63 percent of all cases.  Noroviruses are the culprits in the infamous cruise ship outbreaks of diarrhea and are also responsible for the periodic closures of some Louisiana oyster beds. It requires very few viruses to cause an infection and the transmission potential is staggering, often affected an entire cruise ship in a matter of days. Noroviruses can also spread through an entire nursing home or other institution in a very short time.

Next is Salmonella, causing about 20,500 infections occurring every year in Louisiana with nearly all caused by food-borne transmission. Salmonella, like Escherichia coli, Shigella, Listeria and Campylobacter (all also among the top 10 culprits), invades the intestinal wall and causes significant fever, abdominal pain and diarrhea. Symptoms are preceded by an incubation period lasting anywhere between six hours to three days, with symptoms lasting up to week. Poultry products (including the annual holiday turkey) are particular culprits since up to 90 percent of chicken carcasses are contaminated with Campylobacter and around 20 percent with Salmonella and Listeria. Turkeys and chickens share similar germs (as do some reptiles).

Other agents include Clostridium perfringens (as was identified in the recent Louisiana incident), Staphylococcus aureus and Bacillus cereus. All three of these produce toxins, the former after being ingested and the latter two prior to being ingested. In other words, with Staph and Bacillus, the poison is already in the food before you take a bite, while Clostridium perfringens produces it in your gut. In any case, victims get sick in a few hours after eating the food, often prepared and stored under improper conditions for that special holiday dinner, but usually get better within a few days.

Rounding out the top 10 are Vibrio parahaemolyticus and its close cousin, Vibrio vulnificus, both saltwater organisms. Vibrio Parahaemolyticus (causing about 45,000 cases a year) is often associated with partially cooked shrimp, and can cause an unpleasant episode of diarrhea.

Vibrio vulnificus is found in raw oysters, another holiday favorite and causes about 100 cases a year. While most people can eat oysters with relative impunity, those with severe liver disease run a life threatening risk with Vibrio vulnificus.

Protect Yourself

So how do you protect yourself against this onslaught of food borne pathogens? Some common sense measures go a long way:

• Don’t leave food in a hot car.
• Keep your kitchen clean, especially cutting boards, sponges and knives.
• Make sure your refrigerator is 40 degrees and your freezer is zero.
• Cook red meat to 160 and poultry to 180 degrees F.
• Never leave perishable foods out of the refrigerator for more than TWO HOURS.
• Keep cold party foods on ice.
• Heat leftovers to 165 degrees and keep them above 140 F.
• Put hot foods into small units for rapid cooling.
• If it looks strange, throw it out.
• Wash your hands before, during and after food preparation.

Remember, a few simple precautions can keep some very unwelcome guests from spoiling your fund raiser or holiday feast.  Bon appétit!