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The Warm and Sunny
Season of Culinary Peril
(Food Poisoning)

By Dr. Peter W. Kujtan, B.Sc., M.D., Ph.D.

Article printed on page 29 in the June 26, 2013 issue of
The Mississauga News under the feature: Health & Beauty, Medicine Matters.
Portrait of Dr. Peter W. Kujtan, supplied 2005
Dr. Peter W. Kujtan

The warmer days of summer can be fraught with some degree of culinary peril. It presents in the food we eat, and is more likely to occur when someone else prepares your food. It is related to poor food storage, handling and under-cooking when ambient temperatures accelerate bacterial growth.

The symptoms range from nothing more than a mild stomach upset, all the way to experiencing blood heavy diarrhea, fever, vomiting, dehydration and hospitalization. Adolescents are a good case in point. Iron bowels that accept three day old pizza, milk less cusps of sugar also known as cereal, assorted meats barbecued to a blushing shade of pink and yet the thought of sliced tomatoes throw this honed system into a tizzy.

The truth of the matter is that our immune system does protect us from an awful lot of the assorted microbes that hitch a ride on our food. It comes as no surprise when we notice that immunodeficient persons suffer more food poisoning. These include infants, the elderly, diabetics, cancer patients and people taking medicines that modify immunity.

About 75% of food poisoning is due to bacterial culprits, but we also see parasites such as giardia, and toxoplasmosis, viruses such as Hepatitis A and rotavirus, and chemicals in the form of pesticides, mushroom toxins, fungal aflotoxins and reef fish poisons. These last few are the easiest to diagnose because numerous symptoms appear almost immediately and you know that you are in trouble.

There are some clues to deciphering what food caused your illness. When nausea and vomiting begin within 6 hours of ingestion, it suggests that you ate something containing a toxin. Bacteria such as staphylococcus aureus and bacillus cereus produce toxins that reside on foods, and can produce symptoms within hours of ingestion. Bacillus is found most commonly in cooked rice and vegetables that sit at room temperature for long periods. S.Aureus is a culprit found in deli-meats, fish, canned mushrooms, cheese, dairy products and poultry. Cramps and diarrhea that begin 7 to 17 hours after ingestion are often associated with another type of toxin produced by Clostridium perfringes bacteria. This is more commonly seen after consumption of contaminated meat pies, stews, gravies and seafoods.

Fever may appear once bacteria successfully invade through the bowel walls into the blood. This takes between 12 to 48 hours. It is associated with the classic Salmonella poisoning, which is the most common type. Salmonella has many sub-types including typhoid and is found in common meats, eggs, dairy and poultry, but also on uncommon sources such as peanuts, vegetables and chocolate. The typhoid sub-type is rare but dangerous. Other bacteria also produce these symptoms.

Shigella is found in egg salads and mayonnaise. Campylobacter is found in clams, shellfish, pork, poultry and milk. And of course the rare "hamburger disease" caused by toxic strains of E.Coli.0157:H7 found in cattle feces, and put Walkerton on the map. This contrasts with the friendly E.Coli. happily living in our gut. After a day or so, some of these bacterial invasive species produce cytotoxins that interfere with bowel functions and watery diarrhea results. When bacteria produce toxins such as the verotoxin of "hamburger disease" inflammation and bleeding ensues. This results in bloody diarrhea and possible kidney failure.

Contamination of food is often caused by persons handling the food. Poor hygiene and improper preparation are common sources of contamination. Frequent hand washing and frequent utensil washing helps. Contamination can be limited to a small portion of food. For example it may only affect the first steak off the grill that is placed on the same plate used to season the raw meat. In this case it follows that only the person eating that steak and no one else stands to get ill.

Use your sense of smell. If it smells bad, avoid it. Cooked food which has sat out for more than 2 hours should be viewed with suspicion. When re-heating, get the food steaming hot. Use a temperature probe for cooking. Wash fruits and vegetables well using a scrub brush. In unfamiliar territory try to sneak a peak at the prep area if possible. If you would not be tempted to cook there, then do not eat there. Remember the next time you have a loose bowel movement, that it may be more than just wholesome food selection. Statistically, we will all suffer 2-3 bouts of some form of food related symptoms each year.

Related resources:

Summer food safety tips from HealthyCanadians.gc.ca. The risk of food poisoning increases during the summer because harmful bacteria grow quickly in warm, moist conditions.

Barbecue food safety from NHS.uk.

The Essential Summer BBQ Accessory by Jim Morelli, MPH, WebMD Feature. Reviewed by Michael W. Smith, MD.

How Safe Is Your Barbecue? 4 Deadly Food Safety Sins. Posted on June 6, 2012 by Keri Glassman, M.S., R.D. Women's Health.

Beware of barbecue food poisoning dangers by WalesOnline.

Avoid Food Poisoning at Your Summer BBQ from Shape.com.

Tips for Preventing Food Poisoning This Summer by Denise Kawaii, Yahoo! Contributor Network.

Food Poisoning: Eat Safe All Summer! by Tracy Simons, Silver Cross Hospital, New Lenox, IL.

What Causes Food Contamination? By Pam Pleasant, eHow Contributing Writer.

Foodborne illness from Wikipedia, the free encyclopedia.

Gastroenteritis from Wikipedia, the free encyclopedia.

Bacteria and Foodborne Illness from National Digestive Diseases Information Clearinghouse (NDDIC).

Digestive Diseases: Food Poisoning from MedicineNet.com. How Is Campylobacter Infection Diagnosed and Treated? How Is Salmonella Infection Diagnosed and Treated? How Is Shigella Diagnosed and Treated? How Is E. Coli Infection Diagnosed and Treated? What Is Listeria Infection? How Is Botulism Diagnosed and Treated?

Food Poisoning from eMedicineHealth.

Poison Prevention Website. Steps to take to help prevent accidental poisonings.

Bacterial Food Poisoning by Al B. Wagner, Jr.

Food Contamination and Poisoning from MedlinePlus.

Food Poisoning from Foodlink, Food and Drink Federation, UK.

About Food Poisoning from VDACS (Virginia Department of Agriculture and Consumer Services).

Food Poisoning by Roberto M Gamarra, MD, from eMedicine, WebMD.

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