Better Safe Than Sorry: On Food Safety

“Open your mind to what I shall disclose, and hold it fast within you; he who hears, but does not hold what he has heard, learns nothing.” 
― Dante Alighieri, Paradiso

It's gleaming white. A font of purity. Grateful for its cool porcelain embrace, you're prostrated before it, awash in the fluorescence of this peculiar sanctuary's baptismal light. You could be a mendicant, hoping for a few crumbs of charity from the gods of intestinal fortitude as you grip tight onto the bowl's contours, but the sheer force of the projectile issuing from your praying mouth, rattling your knees and jangling your nerves, is no offering to a Supreme Being. It's the result of yet another bout of food poisoning. Amazing to think how something as tiny as a microbe from the bacterium Campylobacter jejuni could fell a mighty oak like you, but it does. There is no lovely poetic way of writing about it (though I did once pen a sonnet to Diarrhea just because I hate writing sonnets), so let's just ummm.... plunge right in, shall we?

Campylobacter jejuni is a common cause of food poisoning. Contaminated poultry, meat and milk are sources of infection. It can take up to 3 days for the symptoms to develop. I, sad to say, have had it, and who knows how many other foodborne illnesses to boot. I have spent many a miserable day in its grips places as far flung as Hong Kong to right here in my humble Russian Hill apartment. There is no safe haven from food poisoning. Let's face it, even if you cook your meals, unless you have your own farm, butcher your own meat, grow and harvest your own vegetables, and are scrupulously hygienic all the while, you are at the mercy of thousands of what are likely unwashed hands handling every morsel you munch which means the risk of succumbing to a foodborne germ or illness is high.

In fact, according to the CDC, each year, 1 in 6 Americans gets sick by consuming contaminated foods or beverages. That's about 48 million people - 128, 000 of them are hospitalized with 5, 000 of those cases being fatal.

Many different disease-causing microbes, or pathogens, can contaminate foods, so there are many different foodborne infections, almost as many infections, it seems, as there are foods that can carry them. More than 250 different foodborne diseases have been described. Most of these diseases are infections, caused by a variety of bacteria, viruses, and parasites that can be foodborne. In addition, poisonous chemicals, or other harmful substances can cause foodborne diseases if they are present in food.

Gastro-intestinal distress is a common symptom of all these maladies, no matter what the source. It isn't just raw food that is the culprit. Foods and beverages (particularly juices) prepared in restaurants, supermarket delis, anywhere and everywhere that cooked food is handled and served, including private homes (YOUR home) can be a veritable petri dish of contaminants.

Campylobacter infections commonly cause diarrhea and occasionally bacteremia, with consequent endocarditis, osteomyelitis, or septic arthritis. Campylobacter species are motile, curved, microaerophilic, gram-negative bacilli that normally inhabit the GI tract of many domestic animals and fowl. Several species are human pathogens. The major pathogens are C. jejuni and C. fetus. C. jejuni causes diarrhea in all age groups, although peak incidence appears to be from age 1 to 5 yr. C. jejuni can cause meningitis in infants. Contact with infected animals (eg, puppies) and ingestion of contaminated food (especially undercooked poultry) or water have been implicated in outbreaks. Person-to-person transmission through fecal-oral and sexual contact may also occur. However, in sporadic cases, the source of the infecting organism is frequently obscure. Although Campylobacter jejune is a well recognized infection associated with GBS, stool culture for Campylobacter jejuni is not essential for diagnosis. By the time the disease presents stool cultures are often negative.

Then of course, we have more in our foodborne illness buffet:

1) Enterotoxigenic E. coli causes the classic traveler's diarrhea. The infection is non-invasive and is acquired via the fecal-oral route through consumption of unbottled water or uncooked vegetables. The major manifestation is a copious outpouring of fluid from the GI tract presenting as explosive diarrhea. This is due to the action of one of two types of enterotoxins on the GI tract mucosa.

2) Shigella sonnei produces a syndrome very similar to C. jejuni. However, the organism appears as a gram-negative rod on Gram's stain. It does not have a comma shape. Transmission is from person to person via the fecal-oral route. Infection requires a low infective dose since the organism is fairly resistant to gastric acidity.

3) Staphylococcus aureus produces food poisoning due to the ingestion of a pre-formed enterotoxin. The organism is present in food that is high in salt content such as potato salad, custard, milk shakes, and mayonnaise. The patient presents with nausea, vomiting, and abdominal pain, followed by diarrhea beginning 1-6 hours after ingestion of the enterotoxin.

4) Vibrio cholerae produces a secretory diarrhea due to increases in cAMP in the intestinal cells. The organism is not invasive. The patient presents with the sudden onset of painless, watery diarrhea that becomes voluminous, followed by vomiting. The stool appears nonbilious, gray, and slightly cloudy with flecks of mucus, no blood, and a sweet odor.

And these are just the first four pathogens I picked out of a bucket of KFC Popcorn Nuggets. There are many, many more; each of them oodles of fun to describe, but I'll spare you my interpretations and provide you with this fun-filled graphic instead:

What to do?

It's not like we are going to stop eating or drinking anytime soon, much as I'd love to think I could subsist on love like every ethereal creature should. So... 

The CDC has a few recommendations:

1) CLEAN:

Wash hands and food preparation surfaces often. And wash fresh fruits and vegetables carefully. Keep all the surfaces, utensils (chef's knives and cutting boards) separate and clean. Anything raw that is to be cooked needs a separate cutting board, from anything that is going to be eaten raw. For instance:

Don't cut up chicken on a cutting board and then chop up tomatoes for a salad on that same cutting board with the same knife. Wash everything as you are preparing food, most especially when handling poultry. Almost 75% of chickens carry the Campylobacter jejuni bacteria which is why, in general, I try to handle poultry as little as possible, cooking it in large pieces before actually slicing it; though on the rare occasion, I do succumb to my husband's yen for General Tso's or Lemon Chicken and slice the raw into bite-sized morsels for breading and stir-frying, but when I do, I am washing my hands, sink, knives, and even faucet handles obsessively. Bleach mixed with water or bleach sprays with paper towels are good things to have right at your elbow whilst preparing high risk foods. Chicken blood is the worst, contain & clean it immediately if you have a spill on your counter.

2) SEPARATE:

Don't cross-contaminate! How you store and handle your food is of primary concern. When handling raw meat, poultry, seafood and eggs, keep these foods and their juices away from ready-to-eat foods - even when traveling from the supermarket to home. Make sure they are bagged separately. A hot rotisserie chicken should go in its own bag! Cross-contamination is the transfer of microbes from raw foods to prepared and cooked foods, it can take place by:

raw food touching or splashing on cooked food

raw food touching equipment or surfaces that are then used for cooked food

people touching raw food with their hands and then handling cooked food

To prevent cross-contamination it is important to maintain good kitchen hygiene such as storing cooked and raw food separately and good personal hygiene by washing hands correctly and tying hair back.

3) COOK:

Cook the food to the right temperature.

The bacteria that cause food poisoning multiply quickest in the “Danger Zone” between 40˚ and 140˚ Fahrenheit. And while many people think they can tell when food is “done” simply by checking its color and texture, there’s no way to be sure it’s safe without following a few important but simple steps:

Use a food thermometer.

Cooked food is safe only after it’s been heated to a high enough temperature to kill harmful bacteria. Color and texture alone won’t tell you whether your food is done, especially less experienced cooks. Instead, use a food thermometer to be sure.

Keep food hot after cooking (at 140 ˚F or above).

The possibility of bacterial growth actually increases as food cools after cooking because the drop in temperature allows bacteria to thrive. But you can keep your food above the safe temperature of 140˚F by using a heat source like a chafing dish, warming tray, or slow cooker. So your supermarket macaroni & cheese that you just stuck in to-go container may make you sick, unless it's kept hot and consumed hot.

Microwave all reheated food to 165 degrees.

*Note: I will never serve lamb, beef, or duck at 160 degrees, unless it's stewed. I serve steaks and racks rare to medium rare.. 125 degrees to 140 degrees. This is a risk I am willing to take, but when reheating stews & soups, I make sure it is piping hot - at least 165 degrees. As far as fish is concerned, I love my sushi, sashimi, and tartares, but if the fish is not absolutely pristine? I won't eat it. Know the source of your foods. Understand the practices of your food purveyors, too. 


However, here are the recommended USDA Guidelines:

Remember... Microbes like all living organisms need food for energy and growth. Sometimes microbes get in or on food and start to break it down to provide them with energy and nutrients. Microbial growth causes the food to look, taste and / or smell unappetizing, but it may very well be contaminated before that stage. Follow this simple maxim:

When in doubt? Throw it out.

4) CHILL:

At room temperature, bacteria in food can double every 20 minutes. The more bacteria there are, the greater the chance you could become sick. So, refrigerate foods quickly because cold temperatures keep most harmful bacteria from multiplying.

A mold is a type of fungus. Fungal spores (these are like the seeds of a plant) are all around us in the air. These spores can land on the fruit. If it is warm and moist the fungal spores grow. They send out very fine thread-like structures called hyphae. The molds that grow on fruit and vegetables produce enzymes that weaken the protective outer skin allowing penetration by the hyphae. The hyphae grow down into the fruit, digest it and absorb the nutrients. These threads criss-cross each other to form a large tangled structure known as a mycelium. The hyphae produce stalks that grow upwards. Spores form at the end of the stalks and are released into the air to start the process over again. Eventually the fruit becomes covered in a furry coat and is not fit to eat.

Food preservation reduces the rate at which food decays by slowing down the rate of growth of microbes or eliminating them. It can affect the flavor and texture of the food. Preservation techniques include, refrigeration, freezing, drying sterilization, curing with salts &/or sugars and pasteurization.

Fresh raw meat can be safely stored 3-5 days in your refrigerator.

Poultry should only be kept 1-2 days. Keep them in the coldest part of your unit. The following graphic will provide good guidelines to follow for the storage of a variety of foods
(click on the graphic to view full-sized):

The ideal temperature range for your fridge is 35 to 38 degrees Fahrenheit. Bacteria growth starts tripling around the 40 degree mark and things freeze at 32, so stick with 35 to 38 as a goal. The freezer should be set at 0 °F. Since few refrigerator controls show actual temperatures, using an inexpensive freestanding appliance thermometer will allow you to monitor the temperature and adjust the setting of the refrigerator and/or freezer if necessary. Buy one for the fridge, one for the freezer, and check them often. Most newer appliances have readouts, but if you don't or are in doubt, you can always buy a refrigerator-freezer thermometer at your local hardware store or online at sites like Amazon.  In addition to keeping the temperature in your fridge below 40 °F, you can take additional steps to make sure your refrigerated foods stay as safe as possible.

Avoid "Overpacking."

Cold air must circulate around refrigerated foods to keep them properly chilled.

Wipe Up Spills Immediately.

In addition to helping reduce the growth of the Listeria bacteria (which can grow at refrigerated temperatures), getting rid of spills — especially drips from thawing meats — will help prevent "cross-contamination," where bacteria from one food spread to another.

Keep It Covered:

Store refrigerated foods in covered containers or sealed storage bags, and check leftovers daily for spoilage.

Clean The Fridge Out Frequently.

Make this task part of your kitchen cleaning routine!

Whether you're dealing with leftovers or just-purchased foods, it's important to get foods that need refrigeration into your fridge quickly. Leaving perishable foods out for two hours or more allows bacteria to multiply rapidly — and can put you at serious risk of contracting foodborne illness.

Groceries: When you get home from the grocery store, put your refrigerated items away as quickly as possible. Never allow raw meat, poultry, seafood, eggs, or produce that requires refrigeration to sit at room temperature for more than two hours; the limit is one hour if the air temperature is above 90 °F. (If you're not sure whether certain produce requires refrigeration, ask your grocer.)   

Also, keep in mind that your car is probably even hotter than typical room temperature, so it's important not to leave groceries in your car longer than absolutely necessary — and never more than 2 hours (or 1 hour on a hot day).

Leftovers: These need to be refrigerated or frozen within two hours, as well. Despite what some people believe, putting hot food in the refrigerator doesn't harm the appliance. To help hot food cool faster, divide leftovers into smaller containers before putting them in the refrigerator.

Doggie Bags and Take-out Foods: Again, the "two-hour rule" applies to carry-home foods. Leftovers from takeout or restaurant meals need to go into the refrigerator within two hours at most. If you can't get home within two hours after eating out, don't request a doggie bag.

Marinated Foods: Always keep food in the refrigerator while it's marinating. Bacteria can multiply rapidly in foods left to marinate at room temperature. Also, remember this tip for marinating safely: never reuse marinating liquid as a sauce unless you bring it to a rapid boil first.

Thaw with Care: Because bacteria can multiply so rapidly in unrefrigerated food, it's simply unsafe to let food thaw at room temperature. If left unrefrigerated, some organisms can create toxins that will survive the cooking process even if the food is cooked to temperatures that kill the bacteria themselves.

There are three ways to thaw safely: in the refrigerator, in cold water, and in the microwave. If you thaw food in cold water, change the water every half hour to make sure it stays cold. Foods thawed in the microwave must be cooked immediately after thawing.

*****

I realize this is not a very appealing topic and after reading all this the sane person is likely to go on a diet of crackers and alcohol - most booze is mercifully free of foodborne pathogens (low-alcohol beers, however, are still susceptible), but let us be reasonable and rational consumers of comestibles and just exercise a bit of caution when purchasing, cooking, and storing food instead. Most municipalities have a Board of Health which oversees restaurants, delis & supermarkets, check your favorite haunts for their Restaurant Safety Scores. 

Better safe than sorry.