A few hours after lunch, your stomach is churning and you're flushed. But surely it couldn't be food poisoning. After all, you know better than to eat a rare hamburger. You had a light salad of vegetables and sprouts.
Sadly, almost no food is immune from contamination. Though most foodborne illness stems from raw animal foods -- such as eggs, meats and dairy products -- fruits
and vegetables may carry germs, too. Alfalfa and clover sprouts were tied to almost 23,000 cases of gastrointestinal illness and two deaths in the 1990s, according to the Centers for Disease Control and Prevention (CDC).
Foodborne diseases can be caused by bacteria, viruses and parasites.
Each year, foodborne disease hospitalizes 325,000 people and kills up to 5,000. As warm weather arrives, it's vital to protect yourself. You'll probably eat more raw fruits and vegetables, enjoy picnics and barbecues -- and store or transport food under less than perfect conditions.
Be careful with produce
Treat them with care, just as you would with animal-based foods. Fruits and vegetables often come from nations without rigid safety standards. "Wash fruits and vegetables thoroughly," says Tom Chiller, M.D., a CDC epidemic intelligence service officer. Don't skip fruits with inedible rinds. Bacteria on rinds can spread to the flesh during slicing.
Handle susceptible foods carefully
"Bacteria need moisture content, protein and carbohydrates to grow," says Susan Conley, director of food safety education for the U.S. Department of Agriculture. Potato salad and macaroni salad offer ideal conditions, she says. Keep those dishes well chilled. Never let a starchy salad touch raw meat or utensils used on raw meats.
Contain bacteria
Prevent bacteria from spreading from raw to cooked meats. If you carry a platter of burgers to the grill, use a second clean plate to take the meat from the grill.
Keep foods cold
Refrigeration doesn't kill bacteria; it stops or slows them from growing. Food can still go bad in the fridge -- meats from bacteria; fruits, vegetables and breads from molds. The bacterium Listeria is an exception in that it grows well in the cold.
Understand "sell-by" and "use-by" dates
"Sell by" applies to stores, which can keep things colder in the back room before display than you do in your refrigerator. Even if the sell-by date on raw poultry is a week away, you've only got two or three days to use it once you bring it home, Ms. Conley says. The "use-by" date refers to an unopened package.
Keep food preparation areas clean
Wipe your sink with diluted bleach once a week. Avoid using sponges; change your dishcloth at least once daily.
Four key ingredients
Clean. Wash your hands with soap and water. Discard outer lettuce and cabbage leaves. Wash fruits and vegetables.
Chill. Refrigerate leftovers promptly. When you arrive home from the grocery store, put refrigerated items away first. Don't let milk sit out during a meal; pour what you or your family needs and put the container back in the fridge.
Cook. Heat hamburgers to 160 degrees on a meat thermometer. Cook egg yolks until firm.
Separate. Don't let raw foods such as vegetables touch raw meats.
Major threats
Botulism (Clostridium botulinum)
- Symptoms: nausea, vomiting, fatigue, headache, dizziness, double vision, descending paralysis and difficulty breathing.
- Prevention: Don't use food in cracked jars or cans that are swollen, leaking or damaged or that have bulging ends. Don't give honey or foods that contain honey to children under age 1.
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Clostridium (Clostridium species -- not botulinum)
- Symptoms: primary symptoms are diarrhea and cramping 8-24 hours after eating spoiled food. Other symptoms may include nausea and fever. Vomiting may occur occasionally. Self-limiting and usually resolves in a day.
- Prevention: Thought to develop mostly in meats and meat products that have been warmed too long or rewarmed. Prepare food fresh and eat it soon after preparation.
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C. jejuni (Campylobacter jejuni)
- Symptoms: muscle pain, headache and fever followed by diarrhea, abdominal pain and nausea.
- Prevention: Avoid raw or undercooked poultry, unpasteurized milk and untreated water. Cook ground meats thoroughly.
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E. coli (Escherichia coli)
- Symptoms: abdominal cramps, stomach pain and watery or bloody diarrhea. Severe cases can be fatal.
- Prevention: Eat only thoroughly cooked meat and poultry. Wash produce, especially lettuce, thoroughly. Avoid unpasteurized milk and apple cider.
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Listeria (Listeria monocytogenes)
- Symptoms: nausea, vomiting, cramps, diarrhea, headache and fever. Can be fatal in the young and elderly.
- Prevention: Wash raw vegetables thoroughly, especially lettuce and cabbage leaves. Cook meat and poultry thoroughly and avoid unpasteurized dairy foods. Carefully observe "sell by" and "use by" dates on processed foods.
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Salmonella (Salmonella species)
- Symptoms: nausea, vomiting, abdominal cramps, headache, diarrhea and fever.
- Prevention: Thoroughly cook meat, poultry, fish and eggs. Don't eat raw eggs in salad dressing and baking dough. Use separate cutting surfaces and knives to prepare raw and cooked foods. Never eat unpasteurized, raw or undercooked foods of animal origin.
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Staphylococcus aureus (Staphylococcus aureus)
- Symptoms: nausea, vomiting, chills and shallow breathing.
- Prevention: Don't keep prepared foods -- particularly cooked and cured meats and cheese and meat salads -- sitting at room temperature for more than two hours. Store meat, fish and poultry in the coldest part of the refrigerator.
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