Foodborne Illness: Guess Who Came to Dinner

Have you ever had food poisoning? Food poisoning is the common term many people use to refer to foodborne illness. The exact number of foodborne illness cases that occur each year is difficult to determine because many people attribute their illness to a virus or flu. Public health officials cannot record the number of cases accurately unless the ill person reports their illness to their local health department and/or seeks medical care, which is unusual in mild cases. The Centers for Disease Control and Prevention (CDC) has calculated an estimate of the number of cases of foodborne illness based on corrections for underreporting, misdiagnosis, and the number of cases that are not caused by contaminated food. The CDC estimates 9.4 million cases of foodborne illness, over 56,000 hospitalizations, and over 1,000 deaths each year (in the United States) that are caused by 31 pathogens (bad bugs).

Anyone can get a foodborne illness, but the people who are most susceptible are young children, pregnant women, individuals with weakened immune systems (having diabetes, an autoimmune disease, an organ transplant, etc.), and the elderly. Young children are susceptible due to their immature immune systems. Pregnant women and their unborn baby are susceptible because the mother's immune system is slightly reduced during the months of pregnancy, and because some pathogens can be transferred to the fetus. Chronic illnesses could compromise a person's immune system; medical treatment that patients receive for a condition might also affect their immunity, leading to foodborne illness susceptibility. Likewise, the elderly are susceptible because of aging and because of the incidence of other chronic diseases that affect the immune system.

Some symptoms of foodborne illness are similar to flu symptoms and include nausea, diarrhea, fever, stomach cramps, and vomiting. Severe illnesses can cause septicemia or meningitis. Pregnant women could miscarry. The severity of the symptoms may depend on how much food was eaten and the person’s age and health status.

A common misconception is that people can tell if food is “bad” by the way it looks or smells. The truth is that harmful pathogens cannot be seen, and a food may or may not smell when contaminated. Food can be contaminated if it is not handled properly. Many of the pathogens that cause foodborne illnesses can be controlled by careful food preparation. The following basic principles can be followed to prepare food and keep it safe:

• Use safe sources. Purchase foods and ingredients from places you trust. Use clean, potable water (water and ice should be safe for consumption). Use safe raw materials, such as milk that has been pasteurized for safety.
• Wash hands and surfaces often. Wash hands before handling food. As you prepare food, wash hands often with soapy water and keep everything clean that comes into contact with food.
• Prevent cross contamination. Raw food can harbor bacteria that could contaminate other foods. Wash hands, utensils, cutting boards, and work surfaces with hot soapy water after contact with raw meat and poultry.
• Cook foods to proper temperatures. Meats should be cooked to a safe internal temperature (see safe minimum internal temperature table below). Using a meat/food thermometer to check temperatures is the only science-based way to determine that food is properly cooked. If reheating foods, they should also reach a temperature of 165 degrees Fahrenheit. Eating raw or undercooked meat should be avoided by anyone who is susceptible to foodborne illness.

• Store food at a safe temperature. If foods should be served cold, be sure they remain cold and don’t reach room temperature. The refrigerator should maintain a temperature between 35 and 40 degrees Fahrenheit. Hot prepared food should be held at 135 F or higher until food service is completed. Then the food should be packaged in shallow containers (2 to 3 inches deep maximum) and refrigerated. If leftovers can't be eaten in four to seven days, freeze until needed for a future meal.

References

Abraham, A., Al-Khaldi, S., Beaudry, C., Benner, R. A., Bennett, R., Binet, R., Cahill, S. M., Burkhardt III, W., Chen, Y., Day, J., Deeds, J., DeGrasse, S., DePaola, A., Feng, P., Foley, S., Fry, F. S., Granade, H. R., Hait, J…Ziobro, G. (2022). Bad bug book. Handbook of foodborne pathogenic microorganisms and natural toxins. (2nd ed.). Center for Food Safety and Applied Nutrition, U.S. Food and Drug Administration, U.S. Department of Health and Human Services.
fda.gov/food/foodborne-pathogens/bad-bug-book-second-edition

FoodSafety.gov. (2020). People at risk for food poisoning. U.S. Department of Health and Human Services.
foodsafety.gov/people-at-risk

Scallan, E., Hoekstra, R. M., Angulo, F. J., Tauxe, R. V., Widdowson, M. A., Roy, S. L., Jones, J. L., & Griffin, P. M. (2011). Foodborne illness acquired in the United States—Major pathogens. Emerging Infectious Diseases 17(1): 7–15.
doi: 10.3201/eid1701.P11101

Tack, D. M., Logan, R., Griffin, P. M., Cieslak, P. R., Dunn, J., Rissman, T., Jervis, R., Lathrop, S., Muse, A., Duwell, M., Smith, K., Tobin-D’Angelo, M., Vugia, D. J., Zablotsky Kufel, J., Wolpert, B. J., Tauxe, R., & Payne, D. C. (2020). Preliminary incidence and trends of infections with pathogens transmitted commonly through food—Foodborne diseases active surveillance network, 10 U.S. sites, 2016–2019. Morbidity and Mortality Weekly Report, 69(17), 509–514.
digitalrepository.unm.edu/hsc_path_pubs/188/

U.S. Department of Agriculture Food Safety and Inspection Service. (2020). Safe minimum internal temperature chart. U.S. Department of Agriculture.
fsis.usda.gov/food-safety/safe-food-handling-and-preparation/food-safety-basics/safe-temperature-chart

World Health Organization. (2006). Five keys to a safer food manual. Nutrition and Food Safety, World Health Organization.
who.int/publications/i/item/9789241594639

Original reviewers: Lydia C. Medeiros, Specialist, The Ohio State University and Jeffrey LeJune, Professor, College of Veterinary Medicine, The Ohio State University
Original author: Barbara Rohrs, Educator, Family and Consumer Sciences, Ohio State University Extension

For more information about food safety, visit Foodsafety.osu.edu.