Physician Focus: Preventing food-borne illness is everyone's job

The cases always capture headlines: Outbreaks put worries on the table, tainted lettuce sickens 19, egg recall sparked by salmonella threat.

A report by cable channel ESPN even called a foul on stadium food after examining health department inspection reports at professional sports venues across the country.

Whether it's lettuce, peanut butter, pistachios, beef, cookie dough or eggs -- the last being the latest in a growing list -- contaminated food is grabbing our attention. And it's causing concern: A national survey by Thomson Reuters for National Public Radio found that 61 percent of Americans fret about food contamination, with meat the biggest worry.

As we shop the aisles, prepare meals and patronize the restaurants, we may silently ask: Is it safe to eat?

Food safety has become a hot topic, and tainted food leads to the problem of food-borne illness. The Centers for Disease Control and Prevention estimates that diseases from tainted food cause 76 million illnesses, 325,000 hospitalizations and 5,000 deaths each year.

But those numbers likely fall short of the real impact. Official reporting generally underestimates the problem, as many people may not attribute an illness to bad food or don't report it to their physician or public health officials. Some estimates indicate that for every reported case, as many as 40 go unconfirmed by laboratories or unreported.

While our food supply today is perhaps safer than it's ever been, lots of opportunities exist for consumers to contract food-borne illnesses. Food is grown and produced all over the world, so what we eat could come from anywhere. As such, contamination can occur anywhere along the chain -- in growing, production, transportation, in supermarkets or restaurants -- even in the home.

Most food-borne illnesses are infections caused by bacteria such as salmonella, E. coli and Campylobacter, the last being the most common bacterial cause of diarrhea in the developed world. Other illnesses result from toxins or chemicals that have tainted the food at some point along the supply chain.

Those most at risk are the very old, the very young, individuals whose immune systems are affected by other conditions, and healthy people exposed to large amounts of contaminants.

As public consciousness about food safety has grown, so has that of the growers, manufacturers and processors -- and the federal, state and local agencies responsible for setting standards, conducting inspections and ensuring compliance from those who produce and deliver our food supply.

Restaurants, long subject to regular, stringent inspections by local public health officials, are also part of the process. More sophisticated approaches to food safety assurance, such as hazard analysis critical control point methods, have been put in place at many levels.

The fact is that everyone has a role to play in preventing food-borne illness: from producers to suppliers, preparers and consumers to those at all levels of government. But even if everyone along the chain does everything exactly right, it's impossible to entirely eradicate contamination. Some just occurs as part of nature.

Consumers, therefore, also play a key role in preventing food-borne illness. Here's what all of us can do to reduce the risk of such diseases.

• Wash your hands with soap and water before preparing food.
• Cook meat, poultry and eggs thoroughly; use a thermometer to check for proper temperatures. Raw foods of animal origin -- raw meat, poultry, raw eggs and raw shellfish -- are the most likely to be contaminated.
• Avoid cross contamination of foods by washing your hands and tools, such as cooking utensils, cutting boards and cookware, before touching other foods.
• Refrigerate leftovers promptly, as bacteria can grow quickly at room temperature.
• Wash produce, fruits and vegetables in running water to remove visible dirt.
• Report suspected food-borne illnesses to your local health department.

The last step of reporting is particularly important, especially reporting of clusters of illness. It is by analyzing these reports that public health officials can intervene and investigate, identify the type and extent of contamination, block tainted food from reaching the shelves, and thus prevent further illness.

For more information on food safety and food-borne illness, visit the U.S. Department of Health and Human Services at www.foodsafety.gov. For a video discussion of food-borne illness, visit the Massachusetts Medical Society at www.physicianfocus.org.

Alfred DeMaria Jr., M.D. is the medical director of the Bureau of Infectious Disease for the Commonwealth of Massachusetts. Readers should use their personal judgment when seeking medical care and should consult with their personal physician for treatment. Physician Focus is a public service of the Massachusetts Medical Society. You are welcome to e-mail comments to PhysicianFocus@mms.org.