If you've ever had food poisoning -- and chances are that you have -- you know how a little bug can throw off your entire week without warning.
An estimated 1 in 6 Americans, or 48 million people, will contract a foodborne illness this year, according to the Centers for Disease Control and Prevention. Of those who become ill, 128,000 will be hospitalized and 3,000 will die from eating foods contaminated with bacteria, viruses or other harmful organisms.
While deaths and hospitalizations are rare, most foodborne illnesses last long enough to seriously disrupt work and other daily activities. Most of these bugs last at least a day, according to the Food and Drug Administration, though some can last several days or even months. Those missed days add up: Illnesses due to food contamination cost $51 billion per year in lost productivity and health care costs, according to a study published in The Journal of Food Protection.
By understanding how foodborne illnesses spread, you can take steps to prevent them.
How Food Poisoning Occurs
Dozens of strains of bacteria, pathogens and viruses can live in your food and sicken you. According to Dr. Miriam Rahav, internal and functional medicine specialist at the Kellman Center in New York City, food contaminants can cause problems in different ways.
Most often, bacteria produce a toxin either in the food or in the stomach after the food is eaten, typically resulting in a milder illness. Stomach cramping, nausea, vomiting, fever and diarrhea lasting up to a few days are common symptoms of these toxins.
The other scenario, in which bacteria live and spread in the intestines, is the most likely to land you in a hospital.
"In this case the microbe first adheres to, and then invades, the cells lining the GI tract," causing damage, Rahav says.
If that happens, salmonella or campylobacter, two strains of bacteria found commonly in poultry meat and the intestines of animals, are the likely culprits. Together, these two bacteria are responsible for more than 70 percent of foodborne illness hospitalizations, according to the CDC. Symptoms of these infections are more severe and include blood or mucous in the stool, abdominal cramping, fever and diarrhea.
Once you've fallen ill, there's little you can do besides rest and rehydrate unless symptoms last more than three days or there is blood in the stool. If this is the case, it's time to see a doctor.
"For the most part, food poisoning resolves on its own, and people will heal with good hydration and smaller, easily digestible meals," Rahav says. Fluids with salt and sugar content, like sports drinks, are best, she says.
But don't take over-the-counter medicines to curb diarrhea.
"The symptoms of diarrhea or vomiting are your body's way of healing," Rahav says. "Slowing that process will only prolong the course of the illness."
Prevention at Home
The time to act against foodborne illness is before it happens, starting at home.
"Most commonly, we see exposure through animal contact, eating raw or undercooked poultry, or from cross-contamination of other foods," says Dr. Arta Bakshadeh, senior medical officer at Alignment Healthcare in Los Angeles.
You can prevent most of that exposure before you start cooking by separating animal products from other foods.
- At the grocery store, have the clerk bag your meats separately from other items.
- Store meat, poultry and eggs separately from other items, on the bottom shelf or in a pan to catch any dripping.
- Use separate cutting boards, utensils and containers for raw meat and eggs.
- Wash each dish thoroughly with hot water and antibacterial soap right after using it.
When it's time to cook, you can combine ingredients, so long as you cook everything thoroughly; heat will kill most microbes living in your food.
- You can combine items raw so long as they don't leave the pan before they're cooked.
- All poultry should be cooked until it reaches a minimum internal temperature of 165 degrees Fahrenheit.
- If you don't have a meat thermometer, make sure chicken is white throughout and juices run clear.
- All other meats should be cooked to at least 140 degrees Fahrenheit.
- All leftovers should be refrigerated within two hours of cooking.
If you happen to eat contaminated foods, you'll be better able to fight off the bug if you keep your immune system healthy by eating a diet rich in fruits and vegetables. Take a probiotic to ensure your gut is full of good bacteria that help fight any potentially bad bacteria, Rahav advises.
Varieties containing S. Boulardii may be particularly helpful, she says, "but any good multispecies formula with a high count of microbes, labeled 'billion CFU,' may be helpful." CFU stands for colony forming unit.
These small, simple preventive steps are your best defense against foodborne pathogens.
"In my experience, carelessness is usually the culprit in foodborne infections," Bakshandeh says. "Either someone forgot to wash their hands before and after handling certain foods, or cross contamination occurred."
Precautions for Eating Out
You have a lot of control over your own kitchen, but what about your favorite restaurant?
"It is difficult to predict the risk of foods prepared outside the home, given the variety of ways that food can become contaminated," says Dr. Eric Milefchik, chairman of infectious disease at Torrance Memorial Medical Center in California.
Because a common cause of food poisoning at restaurants is undercooked chicken, says Bakshandeh, "if you're at a restaurant and you don't think your chicken is cooked, send it back. The meat should be white, and the juices should run clear."
Before heading out, check Yelp or your favorite restaurant review site. Officials at the New York Department of Health and Mental Hygiene found that by analyzing Yelp reviews, they were able to identify and track cases of foodborne illness in New York restaurants. In total, they found evidence of three previously unreported outbreaks that caused a total of 16 illnesses.
However, outbreaks are rare; more commonly, contamination affects only a dish or two. The department also found nearly 500 reviews detailing symptoms consistent with foodborne illness not connected to outbreaks. Milefchik says it's safe to assume that singular cases of food sickness "are due to circumstances where contamination may have caused illness only in that individual." Outbreaks where several people are affected are much easier to identify, he adds.
Whether in a restaurant or at home, all three experts agree that if you do happen to get sick, you'll heal best if you have a healthy immune system to start with.
"In general, maintaining good health and nutrition will be the best defense against random exposures to contaminated foods," Milefchik says.