There was no trend in any day of the week having more pathogen or illness related recalls than any other day in the seven years analyzed. This was true when only weekdays were analyzed, as well. This indicates that recall notices related to outbreaks of foodborne illness and due to specific pathogens found in food have been evenly spaced throughout the week. While this is the case, when taken as a whole there were more Class I and Class II recalls on Fridays than would be expected. The significance of this difference for Class I recalls was eliminated when analyzing only weekdays, but held true for Class II notices, perhaps showing a propensity for putting out more urgent recalls on Fridays. One particularly interesting finding was an observable pattern in an increasing number of Class II and Class III recalls during the time period studied, while Class I recall numbers remained relatively static. There was a significant difference in the number of Class II recalls starting in 2008 the percentage that Class II recalls make of the total number of recalls has continued to increase (P<.05). Class III recalls remain rare and, as such, there is little statistical power in any observations made. 
The increasing number of Class II and slightly Class III with the stagnant number of Class I led to an overall increase in the number of recalls per year by the USDA from 56 in 2005 to 108 in 2011. FDA Recalls The previous article on this topic did not evaluate FDA recalls. This oversight has been amended this time around, and the findings are similar to those for FSIS recalls. A glance at the total recalls per day chart shows that between 2005 and 2011 a significantly higher number of recalls were issued on Fridays than would be expected (P<.01). 
This holds when excluding the weekends that had so few recalls. 
The FDA data again points to a bias toward publishing recall notices on Fridays over other days of the week and, if anything, the tendency is more pronounced with this agency than with the FSIS. Indeed, recall announcements related to foods testing positive for pathogens and those associated with illnesses were also more common on Fridays, compared to the whole week or just the work week, a trend not seen in FSIS recalls. 
Fridays have consistently seen significantly more than an expected number of recall notices for both the whole week and weekdays only for the entire seven years examined. However, due to the low number of recalls related to illnesses in all the years, statistical tests cannot be performed on a per year basis. This is also true of pathogen-related recalls prior to 2009. There was again a pattern of certain types of recalls increasing over the years, as well as the overall number of FDA recalls increasing. The total number of recalls in 2005 was 145 and this reached a max of more than 800 because of multiple peanut butter-related recalls in 2009. Excluding that outlier, there was still a steady increase in the number of FDA recalls from 2005 to the end of 2011. Why Fridays? This tendency toward releasing recall statements on Fridays, more than on other days of the week, is likely not intentional but could be problematic, because people who do not consume media over the weekend might be less likely to be informed in a timely manner and, as a result, could eat recalled food. On the other hand, Friday recall notices may be the result of a sense of urgency to get make the information public before the work week ends. Indeed, processes within the regulatory agencies may be causing an inordinate number of recall notices to be issued on Fridays. Such factors could include laboratory procedures to find contamination in samples, communication delays between the lab, regulators and the companies voluntarily recalling their products, and the general timeline of work in the offices. These, along with other processes, including political pressures, could lead to significantly more recalls on Fridays. Importantly, recalls are initiated by private companies once the potential for hazard is found. The company distributing or producing the food recalls the products in coordination with the regulatory agency, but the company is ultimately responsible for when the recall is initiated. It could take days before information regarding potential hazards makes it from a lab or other area of initial discovery, through the regulatory agency to the producer, and then for a recall alert to be issued. Thus, the high number of Friday recalls could be seen as an attempt to get the information out before the weekend, while people are still likely to be tuned into the news. While the causes leading to the high number of Friday recalls cannot be determined with this small look into the past few years, what can be seen is a potential for lack of communication between the consumer and the food regulators. Easy access to information regarding potentially dangerous foods should be an issue of primary importance for both the USDA and FDA, and these agencies can work to ensure that the information is not going out when people are less likely to get it.
]]>The pathogen is particularly hard on children; 90 percent of all HUS cases in children are the result of diarrhea-associated E. coli O157:H7 infections.
But while the toxin generally is known to affect renal function and the central nervous system, it also can involve the pancreas, damaging the insulin-producing cells and causing an insulin deficiency–diabetes.
Children who suffer from severe cases of HUS, and need dialysis, for example, are the most likely to develop diabetes and to develop it quickly, within 14 days of their hospitalization.
One review of the studies in the scientific literature, published in the American Diabetes Association’s Diabetes Care journal, found that of 44 children whose HUS/diabetes cases were followed, 10 died and 34 survived. About one-third of these young HUS survivors were left with persistent diabetes, an estimate that may just be the tip of the iceberg.
The study said “the rate of permanent diabetes may in fact be higher than reported,” given that relapse can occur up to five years after the acute illness, and nearly half the recovering children studied were not followed after one year.
Another paper examined the case of a teenager who had HUS as a 3-year-old and developed diabetes 10 years later. HUS “may evolve to … non-autoimmune diabetes mellitus even after a long free interval,” the study concluded, adding that long-term follow up patients with HUS is recommended.
]]>
While Friday has had the largest number of recalls of any day of the week during this time period, the small difference between Friday and other week days is not statistically significant. There were 85 recalls on Fridays, while Tuesday through Thursday averaged 73 recalls during the same time period. But the increase in Friday recalls is apparently due to the new focus on allergens in meat as reported in FSN. These allergen-related recalls have been announced with the greatest frequency on Wednesdays and Fridays, according to the archive record. Taking only pathogen-related recalls into consideration, a different pattern emerges, with Tuesdays seeing larger numbers of recall announcements total and on average. Tuesdays are just shy of having statistically significantly more pathogen-related recall announcements than other days of the week. This particular pattern may be related to how meat samples are sent, received and tested at FSIS, because bacterial samples require time to grow and be analyzed. 
According to this analysis, the largest number of pathogen-related meat recalls occur on Tuesdays, when people may be more likely to learn about the call back via a variety of media.
]]>Here is a brief list of some of the past recalls and associated outbreaks of foodborne illness involving Cargill, a company that sells food and agriculture products around the globe and whose net profit was more than $26 billion in 2010:
1993 – Cargill supplied meat to Northwest Sizzler restaurants that was implicated in an outbreak of E. coli O157:H7 infection involving 39 confirmed and 54 probable cases. Public health investigators said the illnesses were the result of cross-contamination between raw Cargill Tri-tips and salad bar ingredients.
2000 – Cargill provided meat to Sizzler restaurants linked to an outbreak of E. coli O157:H7 illnesses that killed one person and sickened that 62.
2000 – Sliced turkey from a Cargill processing plant in Texas was found to be the source of a multi-state outbreak of Listeria monocytogenes. The company recalled 16 million pounds of turkey after reports of infection that eventually included seven deaths and 29 illnesses. Eight of the case patients were pregnant and three miscarriages/stillbirths were attributed to the contaminated turkey.
2001 – Cargill ground beef patties tested positive for E. coli O157:H7 after a child from Georgia became ill. Three of the patties were purchased at Kroger and one from Sam’s Club, but all of the ill children and the tested meat had genetically indistinguishable strains of E. coli. Emmpak recalled 254,000 pounds of potentially contaminated ground beef.
2002 – Antibiotic-resistant Salmonella Newport was found in ground beef from Emmpak, a Cargill subsidiary. The CDC reported one fatality, 47 illnesses and 12 hospitalizations linked to consumption of the ground beef. Emmpak recalled a record 2.8 million pounds of potentially contaminated ground beef.
2007 – After Minnesota health officials traced 46 E. coli O157:H7 illnesses to ground beef patties, Cargill Meat Solutions Corporation recalled 845,000 pounds of frozen ground beef patties from retail locations across the U.S.
2007 – Cargill recalled 1,084,384 pounds of ground beef after federal tests detected E. coli O157:H7 in the product. No illnesses were associated with this recall.
2008 – Beef cheek produced by Beef Packers, a Cargill subsidiary, tested positive for E. coli O157:H7, prompting a 1,560 pound recall. No illnesses were associated with this recall.
2009 – At least 40 cases of Salmonella Newport infection were linked to Beef Packers ground beef in the summer, sparking a summertime recall of 830,000 pounds of ground beef. Then, in December, more Salmonella illnesses tied to the producer’s meat led to a recall of 20,000 pounds of products. Both recalls involved contamination with drug-resistant Salmonella bacteria.
2010 – Cargill Meat Solutions recalled 8,500 pounds of ground beef after reports of illnesses caused by E. coli O26, a rare strain of the bacteria that produces the same Shiga-like toxin as the more common E. coli O157:H7. The meat was distributed by BJ’s Wholesale Club.
2011 – Cargill Meat Solutions recalled 36 million pounds of ground turkey linked to an outbreak of drug-resistant Salmonella Heidelberg. Current outbreak numbers: one dead, 78 ill, 22 hospitalized.
Since 1993, Cargill has been the source of contaminated meat implicated in at least 10 major outbreaks, 10 deaths, three stillbirths and 347 illnesses.
]]>safety. January through April of 2009 saw an extraordinary number of
recalls and elevated levels of illness due to the hundreds of products
that were contaminated with Salmonella-laced peanuts and, to a lesser
degree, pistachios. The number of recalls in the first few months of his
presidency is an extreme outlier. The average number of recalls per
month for January through April 2009 was around 155, and the average of
the following months through May 2011 was around 15.
While
the greatest number of recalls were issued in Obama’s first few months
in office, the largest number of outbreaks and illnesses occurred in the
summer of 2010. However, this data cannot show whether 2010 was an
exceptional summer, or only slightly higher than that of 2009. The
large outbreak of Salmonella caused by contaminated eggs is a likely
contributor to the number of illness but, in addition, there were
significant numbers of outbreaks involving many other pathogens in
2010’s summer months.
In
contrast to the norm, the levels of illness in early 2009 were elevated
for the winter months. Both Salmonella and Shiga-toxin producing E.
coli experience cyclical rises in the number of infections in the
summer.
Many factors have been implicated in this pattern, and a more detailed article can be found at Foodsafetynews.com.
It would follow that the number of outbreaks should also follow this
cyclical pattern, and they seem to, though less strongly.
However,
the number of recalls per month did not increase in summer months for
the past two years. The recall pattern seems erratic and unrelated
completely to the illness numbers or outbreaks, except for a slight
relation between STEC outbreaks being closely followed by recalls.
It
is difficult to see any meaningful changes to food safety in the short
period Obama has been in office, and the even shorter time since the
January 2011 passage of the Food Safety Modernization Act, which has yet
to be fully implemented. The Obama White House has made food safety and
nutrition a priority, but realizing this and translating it into fewer
recalls, outbreaks and illnesses will take more than a couple of months.
However if you look at a longer series of years, trends do emerge. From 2006 to May 2011 the number of illnesses due to pathogens commonly associated with foodborne transmission did not change significantly, while the number of recalls due to health risks did increase significantly. The increase in recalls does not appear to be due to an actual increase in contamination as the number of illnesses did not deviate from its normal seasonal patterns during theses years. Instead, the increase in recalls may be due to greater political pressure to ensure a safe food supply.
It should be noted that the peanut and pistachio recalls of early 2009 are outliers. However, even when January through April 2009 are removed from the chart, there is still a significant increase in the number of recalls during this time period. In fact, the increase in recalls becomes more apparent when these months are removed from the equation.
It will be interesting to see if the implementation of the FSMA leads to higher numbers of recalls and a decreases in the number of foodborne illnesses.
*Potential error due to the lack of official numbers of outbreaks for 2009-2011 as the CDC’s latest data is for 2008.
———————————————–
Sources:
FDA Recall List, USDA-FSIS Recall List, Outbreakdatabase.com, CDC
Morbidity and Mortality Weekly Notifiable Disease and Mortality Tables
DataTablesObamaYrs.pdf
The paper reviewed about 100 published works related to this concept to develop a list of possible causes for the seasonality of E. coli O157:H7 infections.
E. coli O157:H7, like all living organisms, prefers certain environments, the authors note. The bacteria tend to inhabit the intestinal tracts of ruminants, such as cattle and sheep, but have also been found in animals ranging from pigeons to horses. Cattle and other ruminants host the bacteria without becoming sick themselves, but can transmit the disease to others by contaminating food, water or soils.
Multiple studies have indicated E. coli O157:H7 can both survive and remain able to infect after long periods in both water and soil. One study indicated the bacteria could live up to 245 days in a cattle water trough and remain viable. In addition, E. coli can live up to 15 weeks in soil and stay infective. It may infect microscopic, protozoan inhabitants of the soil and use them as hosts during this time.
While E. coli O157:H7 seems capable of thriving year ’round, the review compiles data to show why infection trends show a propensity for infecting humans during the summer months.
A primary reason for this appears to be an increased number of bacteria shed in fecal matter during the summer months. Because only 100 bacteria can lead to an infection, the increased number leaving animal reservoirs could be a leading cause in the increased number of infections, although why there is increased fecal shedding of the bacteria remains elusive.
Some studies have found that it might relate to the host’s level of the hormone melatonin. The production of this hormone is related to the length of days, with low amounts produced during the summer and high amounts in the winter. Melatonin has also been linked to seasonal adjustments in immune function.
While this review examined only the geographic differences in infections in Great Britain, the information may provide clues to the geography of E. coli O157:H7 on a larger scale as well.
Studies have shown that areas with higher average rainfalls also had more infections, largely due to contamination of fields and drinking water by the feces of infected animals.
Human behavioral shifts may also account for some of the increase in the risk of infection–in the summertime people tend to spend more time cooking and eating outdoors with sometimes less than adequate facilities for proper sanitation.
Multiple factors lead to seasonal trends in illness. For E. coli O157:H7, the behavior of the bacteria, host, human and environment lead to an increase of incidence in the British summer. The areas with more cattle and higher rainfall see more cases, but just as importantly all places have a greater incidence of E. coli O157:H7 infections in the summer. This points to specific behavioral actions, such as camping on contaminated fields and cooking without running water, as being important factors leading to summertime illnesses.
Source: Money, P, A.F. Kelly, S.W. Gould, J. Denholm-Price, E.J. Threlfall, M.D. Fielder. “Cattle, weather and water: mapping Escherichia coli O157:H7 infections in humans in England and Scotland.” Environmental Epidemiology 12.10 (2010) 2633-2644
]]>That’s the message of a 2010 study in “Food Research International,” which investigates the varied effects of climate change on the “cold-chain”–a term that refers to the uninterrupted steps in refrigerated storage and distribution necessary to keep perishable food fresh and safe.
In particular, the study warns, developing nations and developed ones in the Southern Hemisphere face food security issues brought on not only by extreme weather shifts, but also less dramatic climate changes.
Over the past 50 years, many of these areas have shifted away from their traditionally domestic food markets and now rely on importing food while they grow and export monoculture crops. Monocultures are particularly vulnerable to environmental changes, which could leave countries that import the majority of their food at risk.
The international trade of food relies on a substantial investment of energy in the “cold-chain.” Refrigeration slows the growth of potential pathogens, delays rotting and discoloration, inhibits the creation of amines, and lessens water loss. That being said, only 10 percent of perishable foods are kept cool worldwide. This amounts to nearly 200 million tons of food lost to rot every year–14 percent of the total consumption in developing nations. Refrigerating perishables could help alleviate both hunger and foodborne illness in many places.
Because microbial growth is extremely temperature dependent, a change in temperature of a few degrees can have a dramatic effect on the growth of pathogens like Salmonella and Campylobacter in food such as poultry. As a result, foodborne illnesses follow seasonal trends with more cases in the warmer months. The fear is that as global temperatures increase, this trend will be extended later into what is now the cold season.
In the United Kingdom the rise in temperature could lead to 10,000 additional cases of foodborne illness per year, estimates suggest. Australia’s estimates are much higher–79,000 additional cases per year by 2050, following the prediction that the Southern Hemisphere will be hit far harder by climate change.
But expanding the cold-chain raises a parallel concern: the emissions created by cooling food. While maintaining temperature control from farm to dinner plate preserves the quality and safety of the food, the refrigeration along the way accounts for 15 percent of global electricity usage. On a national level, 2.4 percent of UK greenhouse gas emissions are due to refrigeration, the authors say.
As global temperatures rise, that percentage is expected to increase. An increase in temperatures of only 2-3ºC would halve the shelf life of food, so refrigeration would have to increase to maintain a safe food supply.
While refrigeration of perishable foods would simultaneously reduce the amount lost post-harvest and increase food safety, expanding the current forms of refrigeration could lead to increased greenhouse gas emission, the root cause of the climate change threatening food supplies.
]]>Such an attack has long been considered a remote but theoretical possibility, especially in a country like the United States, where Americans eat, on average, about four meals a week outside the home and where the restaurant industry has a very high rate of employee turnover.
Security experts speculate that the primary goal of such a scheme would not be target restaurants to sicken or kill scores of people, but to create mass panic over food that would lead to economic chaos.
In the U.S., the Department of Homeland Security is responsible for analyzing the risks associated with intentional food contamination and for communicating the threat levels to local governments. As part of this charge, the Food and Drug Administration, through the Center for Food Safety and Applied Nutrition (CFSAN), has developed a working framework for local and state governments to use as a means to assess potential threats to food.
This framework consists of identifying the three components necessary to lead to intentional contamination: the aggressor (whether a disgruntled employee or an agent working for a terrorist organization), the routes of gaining access to food and food-endangering pathogens or poisons.
A recent study led by Dr. Sudha Xirasagar and published in The Journal of Public Health Management Practice developed a standard survey to try diagnose the status of food defense in the restaurant industry. Funded by grants from the Centers for Disease Control and Prevention and the FDA, the survey’s aim is to identify potential gaps in food defense and also to raise awareness among hospitality industry workers about possible points of vulnerability within their own establishments.
In their abstract, the survey’s authors explain that food safety consists of following standard practices (for instance, hand washing, cooking to proper temperatures, preventing cross contamination) that, if violated, can cause foodborne illness.
By contrast, food defense requires being alert to unusual variations from the norm.
The survey was drafted with the help of experts and then validated with geographically representative restaurant-industry focus groups. It involves 41 items on food defense, 11 on restaurant characteristics and 6 on demographics with questions that relate to hiring and background checks in the high-turnover restaurant business, employee management and training, vendors and delivery, facility and operational security and monitoring.
For instance, the survey asks about the training practices for food handlers and other hourly workers, and whether procedures are in place to keep personal belongings and non-workers out of food preparation areas. In general, the survey seeks to understand how secure a restaurant or other food facility is and how this is monitored. Finally, the survey asks whether restaurant owners are concerned about intentional contamination and how vulnerable they think their facility might be food tampering.
“Food defense is best served by advisory guidelines for autonomous application … , ” the authors note, adding ” … public health agencies need survey tools that can yield action-relevant data …”
Contamination of food for malevolent purposes is nothing new but is rare, and typically has involved disgruntled employees. One example of intentional contamination that received widespread attention was seen in videos posted on YouTube in April 2009 that showed employees of one Domino’s deliberating adulterating food items. In 2003 an employee of a Michigan grocery store tainted ground beef with a nicotine-containing pesticide. In 1997 a lab worker laced doughnuts with Shigella and invited his co-workers to eat them.
In what has been the only known case of food terrorism for political gains in the U.S., followers of the Indian guru Bhagwan Shree Rajneesh in 1984 contaminated a salad bar in Oregon with Salmonella to keep local residents from voting in a county election.
]]>
To celebrate Thanksgiving here at Food Safety News we’re hosting our fourth virtual potluck (we’ve also held virtual picnics on Memorial Day, the Fourth of July and Labor Day).
We’ll be having turkey, of course, and for tips on how to cook a turkey, you can’t beat the Food and Drug Administration’s Keep Food Safe Blog. For instance, did you procrastinators know it’s safe to cook a frozen turkey? It will just take 50 percent longer than a fully thawed turkey. Check out the FDA’s helpful Turkey Roasting Chart and reminders that no matter what method you use — roasting, brining, deep frying or smoking — the bird isn’t safe until it reaches a minimum internal temperature of 165 degrees (and that goes for the stuffing).
In addition to the turkey, we’ve got two soups–Dan’s lentil
We’re sharing the recipes here, so you can join in our virtual potluck or use them at your next one.
Have a happy and food-safe Thanksgiving Day.
The Food Safety News team
Marijke’s Curry Kale Soup
This is best served with a crusty bread or corn bread as a starter for the feast!
Ingredients
— 1 butternut squash
— 1 bunch of kale
— 1/2 onion
— 2-3 cloves garlic
— 2 tbs olive oil
— 2-3 tbs curry powder
— Salt and pepper
— 1 qt stock
Directions
1. Steam or roast the squash until softened
2. While cooking the squash, heat the oil in a large soup pot
3. Add chopped onion and let cook until transparent
4. Add finely minced garlic and cook until fragrant
5. Season with salt and pepper
6. Chop the kale into large sections and add to the pot
7. Cover the kale with the oil, onions and garlic, cover the pot and cook over a low heat until the kale is fully cooked
8. Scoop the squash into the pot
9. Add stock and curry powder and simmer for 15-20 minutes
10. Blend the soup using an immersion blender, blender, or food processor
11. Season with salt and pepper
]]>
During October, Breast Cancer Awareness Month, it’s important to consider the dangers posed by contaminated food and water to women undergoing treatment for what is the second-most deadly cancer in U.S. women.
Cancer patients receiving chemotherapy have suppressed immune systems, making them part of the 20 percent of the U.S. population at increased risk of foodborne or waterborne illness. The outcome of exposure to dangerous pathogens depends on multiple factors, including the patient’s ability to elicit an immune response.
Chemotherapy treatments affect the body’s ability to detect pathogens and produce appropriate immune responses because the drugs used to stop neoplastic growth also kill immune cells.
Cancer treatment has three main medical interventions: radiation therapy, chemothereapy and bone marrow transplants. The first two treatments target rapidly dividing cells. However, other cells in the body also divide quickly and these, too, are killed as collateral damage.
The three main types of immune cells, lymphocytes, macrophages, and neutrophils, are among those destroyed. The destruction of these cells leads to a period of increased vulnerability to pathogens usually 1 to 2 weeks after treatment, and lasting 3 to 5 days.
Enteric pathogens take advantage of the weakened immune systems and “set up persistent and generalized infections.” These infections can be far more severe and endure for far longer in immunocompromised patients than in the general population.
For example, the case-fatality rate for adenovirus infection in immunocompromised cancer patients is 53 percent, whereas those with healthy immune systems rarely succumb to the virus.
In order to combat this increased risk of infection, those preparing food for immunocompromised cancer patients must use great care. The main areas of protection that can reduce the risk of infection are: proper personal hygiene, cooking foods to kill pathogens and avoiding cross-contamination, avoiding high-risk food.
Personal hygiene includes frequent hand washing and use of protective clothing, such as gloves and hair nets. Attention to kitchen hygiene requires clean tools, cooking, and preparation surfaces. These precautions reduce contamination of raw foods by the food handler. Pathogens often spread by ill food handlers include Shigella spp., Hepatitis A, Norovirus, and other viral pathogens.
Pasteurization and proper cooking of foods is particularly important. Raw dairy products should be avoided by cancer patients. These are ideal mediums for many bacteria to live and grow, including E. coli O157:H7, Campylobacter jejuni, and Listeria monocytogenes.
Raw and undercooked beef can contain E. coli O157:H7 and Toxoplasmosis gondii, a parasite that attacks the central nervous system. Undercooked meats in general should be avoided.
Specific foods have especially high risks of being susceptible to contamination. Shellfish from contaminated waters can contain Vibrio spp. and Norovirus. If shellfish must be eaten by the patient, ensure they come from licensed and inspected vendor and are not from contaminated waters. Alfalfa sprouts and other sprouted seeds also have a high risk of containing pathogens and should not be eaten.
Because raw foods can contain any number of pathogens, it may be necessary for immunocompromised cancer patients to avoid all raw foods. Cooked or canned vegetables and fruits can supplement the diet during these periods.
Foods known to contain Listeria monocytogenes, such as deli meats, hot dogs, soft cheeses, and raw dairy products, should not be given to cancer patients during periods of decreased immunity. Cancer patients with solid tumors are from 66 to 229 times more susceptible to infection with L. monocytogenes.
These food-handling and consumption guidelines show the importance of providing nutritious foods to cancer patients while protecting them from unintentional exposure to food pathogens. It is a sad fact that those most vulnerable in society often suffer disproportionately. The young, elderly and immunocompromised are far more likely to become ill from pathogens found in the food they trusted to be safe to eat.
For more information see:
Gerba, Charles, Joan Rose, Charles Haas. “Sensitive populations: who is at the greatest risk?” International Journal of Food Microbiology. 30(1996).
Medeiros, Lydia, Gang Chen, Patricia Kendall, Virginia Hillers. “Food Safety Issues for Cancer and Organ Transplant Patients.” Nutritional Clinical Care. 7.4 (2004).
Beef and Veal: Ground products 160 F Steaks and Roasts145 F Poultry: 165 F Eggs: 160 F Fish and Shellfish: 145 F Lamb: Ground160 F Steaks and Roasts145 F Pork: Raw, uncured160 F Pre-cooked Ham140 F Leftovers:165 F Leftovers always present a dilemma; the question being, “how long is this good for?” Fortunately, the USDA’s Food Safety and Inspection Service has a detailed chart to track your leftovers’ edibility. In general, fresh meats are safe for 1-3 days and leftovers for 3-5, but this depends greatly on the type of food. The complete list is below: Beef, Lamb, Pork and Veal With proper refrigeration, fresh ground, hamburger, stew meat or variety meat (tongue, liver, heart, kidney, chitterlings) will stay safe for 1-2 days; fresh chops, roasts and steaks will stay safe for 3-5 days; and fresh pre-stuffed chops will stay safe for 1 day. Leftover beef, lamb, pork or veal, including casseroles, will stay safe for 3-4 days. Corned beef in a pouch, with pickling juices, will stay safe for 5-7 days in the refrigerator. Bacon will stay safe for 7 days. Ham (Pre-Cooked) Fully cooked slices of ham will stay safe 3-4 days, half-hams for 3-5 days, and whole hams for 7 days if refrigerated properly. Pre-cooked ham that is labeled “keep refrigerated,” if opened, will stay safe for 3-4 days. Unopened canned pre-cooked ham will stay safe for 6-9 months. Vacuum-sealed ham that is unopened, fully cooked and dated can be safely refrigerated through its “use-by” date. Vacuum-sealed ham that is unopened, fully cooked and undated can be safely refrigerated for 2 weeks. Chicken, Turkey and Other Poultry With proper refrigeration, fresh, pre-stuffed chicken breasts can be kept safe for 1 day. Fresh ground poultry, patties and giblets can be kept safe for 1-2 days. Fresh poultry pieces can be kept safely refrigerated for 1-2 days while whole birds can be kept safe for 1-2 days. Leftover casseroles containing poultry will stay safe for 3-4 days in the refrigerator, chicken nuggets or patties will stay safe for 1-2 days, poultry pieces that are plain, fried, in broth or gravy, will stay safe for 3-4 days. Eggs Fresh shell eggs will stay safe for 3-5 weeks with proper refrigeration. Fresh egg yolks or whites will stay safe for 2-4 days. Leftover casseroles, quiches, or omelets will stay safe for 3-4 days, while hard-cooked eggs will stay safe for 1 week if refrigerated properly. Open liquid pasteurized eggs or egg substitutes will stay safe for 3 days. Unopened liquid pasteurized eggs or egg substitutes will stay safe for 10 days. Sausages and Lunch Meats Hard sausage like jerky sticks or pepperoni can be kept safe for 2-3 weeks with proper refrigeration. Raw beef, chicken, pork or turkey sausage can be kept safe in the refrigerator for 1-2 days. Smoked breakfast links or patties can be kept safe for 7 days. Lunch meat that is deli-sliced or store-prepared can be kept safe for 3-5 days if properly refrigerated. Opened hot dogs can be kept safe for 1 week with proper refrigeration, opened lunch meat that is vacuum-packed and sliced is safe for 3-5 days, and opened summer sausage labeled “keep refrigerated” is safe for 3 weeks. Unopened hot dogs and unopened lunch meat that is vacuum-packed and sliced can be kept safe for 2 weeks, and unopened summer sausage labeled “keep refrigerated” can be kept safely refrigerated for 3 months. Seafood Fresh fish and shellfish will stay safe for 1-2 days if properly refrigerated, while leftover fish and shellfish can be kept safely refrigerated for 3-4 days. Miscellaneous Food Items Frozen dinners and entrees marked “keep frozen” are unsafe to thaw and should not be kept in the refrigerator. Commercial mayonnaise marked “refrigerate after opening” will stay safe for 2 months if refrigerated properly. Gravy and meat broth can both be safely kept in the refrigerator for 3-4 days. Pizza will stay safe for 3-4 days with proper refrigeration. Soups and stews will stay safe in the refrigerator for 3-4 days. Stuffing will stay safe for 3-4 days if refrigerated properly. Store-prepared or homemade egg, chicken, ham, macaroni, or tuna salads can be kept safe for 3-5 days if properly refrigerated. Avoiding Foodborne Illness These general guidelines can help eliminate foodborne illness in the home. Keeping foods at safe temperatures and eliminating opportunities for cross-contamination decreases the likelihood of pathogens growing in food. It is also helpful to know what types of foods are associated with what types of illnesses. The risk of infection with certain pathogens can be decreased by specific actions noted below: Anisakis simplex: Avoid raw marine fish. The helminth is killed by cooking over 140 F or seven days of freezing below -4 F. Bacillus cereus: Cook rice at boiling for at least 30 minutes. Reheat all leftovers to 165 F and cool them below 40 F quickly, as well. Clostridium botulinum: Avoid consuming food from misshaped cans and packaging; this is a sign of bacterial growth inside. Infants should not be given honey, which is known to contain C. botulinum. E. coli: Cook ground beef products to 160 F using a meat thermometer. This is important because color does not always indicate the internal temperature. Salmonella spp.: Cook eggs to a safe temperature, 160 F. Wash the outside of melons and other fruits prior to cutting. The knife can move bacteria on the rind onto the edible portions of the fruit. Trichinella spiralis: Cook all pork products to 165 F. Hams must be either heated, frozen or cured to kill the helminthes. Vibrio parahaemolyticus, V. vulnificus and V. cholerae: Avoid raw shellfish. Yersinia enterocolitica: Cook raw pork products to 160 F and wash hands after contact. Marine toxins: Avoid eating fish and shellfish during algae blooms. The toxins produced by some algae remain in the flesh of fish and/or shellfish and, in most cases, are not denatured by heat. Scombroid toxin poisoning: Buy fish, especially tunas, from a supplier you trust to have kept the fish frozen or cold. Scombroid toxin is a buildup of histamine-like substances in fish that have been stored at unsafe temperatures. Mushroom poisonings: Only eat wild mushrooms that an experienced mycologist has identified as edible fungi. More information on safe food handling can be found at the USDA-FSIS website. If you would like to receive a free Food Safety News “Safe Cooking Temps” magnet, as shown above, please email us at [email protected] and use the word “magnet” in the subject field.
]]>Knowing the symptoms of foodborne illness can help save your life; it can also keep you from spreading diseases to others. Many foodborne pathogens are easily transferred from person-to-person via contaminated surfaces and foods.
This following list is not intended to diagnose foodborne illnesses. If you believe something you ate or drank has made you sick, seek medical help. That important step can shorten the duration of your symptoms and may keep you from suffering potentially long-term complications associated with enteric (intestinal) diseases. Severe infections of the intestine, especially by strong toxins and tissue-invading pathogens, can lead to chronic gastrointestinal problems such as Irritable Bowel Syndrome (IBS).
And some foodborne illnesses begin with gastrointestinal distress but can advance to systemic infections and become fatal.
Getting to a doctor also aids in providing information to help prevent others from becoming sick. The faster an outbreak of foodborne illness is recognized, the faster public health officials and medical professionals can respond to prevent an epidemic and treat the sick, respectively. A laboratory analysis of blood or stool samples can help determine if local or national food and water supplies are unsafe.
The list below describes the cause of the most common foodborne illnesses in the U.S. as well as the symptoms, usual sources, incubation periods, treatments, and potential complications.
Because the information describes a typical infection, it may not apply to each individual experience of foodborne illness.
Common Foodborne Pathogens and Toxins in the U.S.:
Anisakis simplex: Anisakisis is caused by ingesting a larval stage of a marine roundworm in undercooked or raw marine fish. Initial symptoms begin within hours of eating the seafood. These include severe abdominal pain, vomiting, and nausea. Because the worms initially remain in the upper digestive tract, the worm can be “coughed up.” If the worms pass into the intestines they can cause symptoms resembling Crohn’s Disease 1-2 weeks after infection. Diagnosis and treatment is done by removing larvae visualized during gastroscopic examination.
Bacillus cereus: There are two types of B. cereus illnesses: vomit-inducing and diarrheal; both are caused by bacteria that secrete an enterotoxin. The average incubation period for the vomit-inducing type is 2-4 hours, while the diarrheal type can take up to 16 hours to manifest symptoms. Boiled or fried rice dishes are commonly associated with the vomit-inducing type, while custards, sauces, meatloaf, cereal products, and refried beans typically contain the diarrheal type.
Campylobacter jejuni: Sometimes referred to as “Campy,” this is one of the most common foodborne illnesses, affecting 2.4 million people in the U.S each year. It is usually found in unpasteurized (raw) milk products, poultry, water, raw clams, and beef liver. Diarrhea, bloody diarrhea, abdominal cramps, fever and headache begin after an average 2-5 day incubation period, but can take up to 10 days. Most cases of Campylobacter require only supportive care and rehydration fluids. Severe cases can require antibiotics. Guillain-barre syndrome (GBS), a paralytic disease of the peripheral nervous system, can develop as a post-infection complication in about 1 in every 1,000 cases.
Clostridium botulinum: This bacteria secretes a neurotoxin into the food it grows in. When ingested, it can cause a multitude of symptoms including diarrhea, blurred vision, vomiting, descending paralysis, and possible death. Botulism grows in low-acid canned foods, smoked fish, baked potatoes, incompletely fermented marine mammals, garlic stored in oil, and shrink-wrapped mushrooms. Symptoms can begin from 2 hours to 8 days after consumption of the toxin. Treatment with an equine-derived antitoxin can stop progression of symptoms, as can removal of contaminated food through induced vomiting and enemas, but supportive care is usually necessary for weeks. A second type of botulism poisoning can occur when infants eat C. botulinum spores. Babies become lethargic, stop feeding, become constipated and paralysis sets in. The most commonly contaminated food–honey–should not be fed to infants. A human-derived antitoxin is used in conjunction with supportive care in these cases.
Clostridium perfringens: C. perfringens is an entertoxin-secreting bacteria most often found in inadequately heated or reheated meats, meat pies, stews, gravy, sauces, and refried beans. The incubation period averages 8-12 hours, after which diarrhea and abdominal cramps begin. C. perfringens symptoms usually persist for one day. A severe complication, necrotic enteritis (also known as pig-bel syndrome), can develop if large numbers of bacteria are ingested.
Cryptosporidium parvum: Cryptosporidiosis is caused by ingesting fecally contaminated food or water; the largest outbreaks have occurred due to contaminated recreational water facilities. Spores of this parasite are deposed in infected feces and can live for months outside a host. Upon ingestion, the spores leave their dormant state and become active in the intestines. Symptoms, which usually occur about a week after infection, include profuse watery diarrhea, nausea, vomiting, abdominal cramps and fever, lasting for a few days and sometimes resolving without medicine. Over-the-counter anti-diarrheal medicines can help relieve the distress. Immunocompromised people are at risk of chronic infections.
Cyclospora cayetanensis: Cyclospora cayetanensis is a single-celled, intracellular parasite transmitted via fecally contaminated food and water. Symptoms begin around one week after infection and include fatigue and watery diarrhea. These can last from a few days to a month, and some patients relapse until the infection is cleared. C. cayetanensis is considered a cause of “traveler’s diarrhea,” although outbreaks in North America have occurred due to contaminated imported foods. After diagnosis from a positive stool culture, sulfa antibiotics are often prescribed. No non-sulfa drugs have proven effective.
Entamoeba histolytica: Entomoeba histolytica infections cause a range of diarrheal illness from mild, chronic diarrhea to fulminant ameobic dysentery. The single-celled parasite enters the body via fecally contaminated food or water and invades the tissue of the intestines. This can lead to bloody diarrhea but, more dangerously, the amoeba can enter the bloodstream and infect other vital organs. Potentially fatal liver abscesses develop in a small number of untreated patients. Gastrointestinal symptoms develop in only 10-20 percent of those infected, usually within 2-4 weeks after infection but several months of incubation is possible. People in tropical regions with poor sanitation and homosexual men are at the highest risk of E. histolytica infection. Diagnosis of E. histolytica remains difficult because in stool samples it resembles a non-pathogenic amoeba E. dispar. One antibiotic is prescribed to clear the infection if there are no symptoms, and two are used if there are symptoms.
Escherichia coli O157:H7 (STEC): E. coli O157:H7 is a strain of E. coli that produces Shiga-like toxin. It is found in fecally contaminated undercooked ground beef, water, unpasteurized milk or juice, and soft cheeses. The bacteria colonize the intestine causing cellular destruction that leads to nausea, vomiting, diarrhea, bloody diarrhea and cramps. Symptoms of E. coli O157:H7 infections usually manifest 48-96 hours after infection. Hemolytic Uremic Syndrome (HUS) occurs when the toxins destroy the glomurelar endothelium, the lining of the blood vessels where the blood is filtered in the kidney, leading to renal failure. Treatment includes anti-diarrheal medications and supportive care. Antibiotics should not be given as these increase the risk of HUS. More information on this topic can be found here and here.
Escherichia coli (enterotoxigenic – ETEC): E. coli strains that produce enterotoxin, either heat stabile and heat libile, cause this type of infection. It is the main cause of “traveler’s diarrhea,” and the leading cause of diarrhea in the developing world. Symptoms, such as nausea, vomiting, diarrhea, bloody diarrhea, abdominal cramps, stiff neck and confusion, begin after an incubation period of around 10-12 hours and last for 3 to 5 days. The toxin secreted by the bacteria induces the lining of the intestine to, in turn, secrete more fluid leading to diarrhea and dehydration. These bacteria are found most often in undercooked vegetables, beef, water, and salads that have been fecally contaminated. Treatment with supportive measures is usually adequate and antibiotics are rarely used as most strains are resistant to common, broad-spectrum antibiotics.
Giardia lamblia: Giardia is one of the most common parasites in the United States. It infects via fecally contaminated food and water. Both wild and domesticated animals serve as reservoirs for the parasite, providing constant sources of the protozoa. After infection, it can take on average 7-10 days for symptoms to set in. Common symptoms include diarrhea, abdominal cramps, fatty or greasy stools, and bloating. These symptoms can persist for 1-3 weeks. Giardia is diagnosed by examination of a stool sample or blood test, and can be treated chemically.
Hepatitis A virus – One of the few viruses to cause foodborne illness, Hepatitis A infects via fecally contaminated food or water, as well as filter-feeding shellfish grown in contaminated waters. The virus’ incubation period averages 25 days but can range from 15-30 days. Symptoms of infection include nausea, diarrhea, fever, jaundice, and anorexia. A vaccine is available, as well as an immunoglobulin shot that will prevent disease post-exposure. Infections can also clear with only supportive intervention.
Listeria monocytogenes: Listeria bacteria can survive and thrive in low temperature and low oxygen environments, making them a dangerous foodborne pathogen. Refrigeration and even freezing does not significantly slow Listeria growth. It is commonly found in deli meats, soft cheeses, ice cream, milk, and frozen products. Symptoms present around 3 weeks after exposure and include diarrhea, abdominal pain, headache, and fever. If the infection spreads to the nervous system, other symptoms include headache, stiff neck, confusion, balance problems and convulsions. Pregnant women are especially vulnerable to infection, and the infection can cause premature birth of a likely Listeria-infected baby, still birth, and miscarriage. For this reason, antibiotics are often given to infected pregnant women and infants of mothers who were infected.
Noroviruses: Formerly known as “Norwalk” or “Norwalk-like” viruses, Noroviruses cause extreme gastrointestinal distress. They spread easily from person-to-person via contaminated surfaces and food once an outbreak has begun. Symptoms include nausea, projectile vomiting, diarrhea, abdominal cramps, body aches, headache, and fatigue lasting for 24 to 72 hours. The incubation period is between 10-96 hours. Medical professionals diagnose Norovirus infection by analyzing stool samples or environmental swabs. Supportive treatment through the replacement of fluids is administered as needed.
Salmonella spp. (non-typhoidal) – Salmonella bacteria are commonly found in poultry, eggs and egg products, meat, unpasteurized milk, and pre-cut melons. Many different serotypes of Salmonella exist but share the same symptoms–diarrhea, abdominal cramps, fever, headache and vomiting, which appear from 12 to 72 hours after exposure and last for about one week. Salmonellosis is diagnosed through laboratory analysis of stool samples. Treatment has become increasingly difficult as many strains are now resistant to common antibiotics, but antibiotic treatment remains the common means of decreasing the duration of salmonellosis. Even with treatment, a post-infection complication called Reiter’s syndrome can cause pain in joints, eye irritation and painful urination. These problems can persist for years and can lead to chronic arthritis.
Salmonella Typhi (Typhoid Fever): A serotype of Salmonella, typhoid fever causes a rather different disease than the other types. Untreated typhoid fever has three stages with different symptoms, ranging from a slowly progressing fever that reaches 104ºF, malaise, headache, cough, a rash, enlarged liver and spleen, and nosebleeds, to delirium, intestinal hemorrhage, intestinal perforation, sepsis, and death. Other symptoms include green diarrhea or constipation, and in the final stages the bacteria can infect the brain, heart and bones. Typhoid fever can be treated effectively with antibiotic drug. Onset of the first phase can occur between 3 days and 3 months after exposure, and infected persons can be asymptomatic carriers. Asymptomatic carriers can still spread the disease to others.
Shigella spp.: Shigella is an extremely contagious bacterial infection. Contamination of food and water by fecal matter leads to ingestion of the bacteria, which cause gastrointestinal issues including diarrhea, fever, nausea, vomiting, severe abdominal cramping, and tenesmus, plus straining during bowel movements. Symptoms of infection begin 1-3 days after exposure and last about a week. However, a return to normal bowel function may take months, and around 2 percent of patients develop post-infection arthritis. Shigellosis can be treated with antibiotics after diagnosis through analysis of a stool sample. Importantly, certain anti-diarrheal medicines can make the illness worse and should be avoided.
Staphylococcus aureus: Staph is better known as a hospital-associated infection of wounds rather than as a foodborne illness. Ingested Staph bacteria produce heat-stabile enterotoxin that induces nausea, vomiting, diarrhea, and abdominal cramps within 2-4 hours. These symptoms usually abate after a day. Staph is usually found in ham, meat and poultry, cream filled pastries, custard, unpasteurized milk and milk products, and high protein leftover foods. Staphylococcal food poisoning is diagnosed by identifying toxins in stool, vomit, or food items in outbreaks and by symptoms for isolated cases. Patients are given fluids and told to rest. Because the illness is due to a toxin, not bacteria, patients are not treated with antibiotics.
Trichinella spiralis: Trichanosis is caused by the parasitic roundworm Trichinella spiralis found in undercooked pork, bear, wild feline, fox, dog, wolf, horse, walrus, and seal meat. Initial symptoms of infection include diarrhea, nausea, vomiting, and abdominal discomfort. This is followed by muscle aches, swelling of the eyelids, fever, chills, cough, itchy skin, and, in the case of heavy infection, problems with muscle coordination and cardiopulmonary problems. Occasionally, life-threatening complications arise when the heart, lungs and nervous system are affected by the cysts. The severity and type of symptoms depend on the number of larva ingested. The ingested cysts-containing larvae enter the stomach where the cyst covering is dissolved, releasing the worm into the intestine where it matures and mates. Females lay eggs that travel in the bloodstream to the muscles, where they form cysts. The first symptoms appear 8-15 days after consumption of infected meat. Trichinosis is diagnosed through blood tests and muscle biopsy. Treatment with anti-helminth drugs clears the infection.
Vibrio cholera 01 or 0139: Cholera epidemics still plague the world’s population. This bacterial infection of the intestine causes sudden, profuse, watery, “rice-water” diarrhea accompanied by debilitating cramps and vomiting and leading to rapid dehydration. Untreated, cholera’s dehydrating effect can cause death in hours. It is spread via fecally contaminated water during an outbreak, but the bacteria are also found in shellfish that dwell in brackish water. Symptoms can begin as shortly as a few hours after exposure, but can start as late as 5 days afterward. Treatment with oral rehydration fluid remains the best way to treat cholera, though antibiotics can be prescribed in some cases. The rehydration mixture of salts, sugars and water resupplies fluids and electrolytes lost in the diarrhea and vomiting. A vaccine is available outside the U.S. by a Swedish company, but is not recommended to U.S. travelers.
Vibrio parahaemolyticus: A relatively newly discovered pathogen, V. parahaemolyticus,z infects marine fish, shellfish and crustaceans, both raw and cooked. The bacteria causes watery diarrhea, abdominal cramps, nausea, vomiting, fever, and headache. These occur within 12-24 hours of consumption of tainted seafood and last for 3 days. The illness is usually self-limited and does not require treatment beyond rehydration. In cases of severe or prolonged symptoms, a broad spectrum antibiotic may be prescribed.
Vibrio vulnificus: Found mostly in raw oysters, V. vulnificus bacteria cause fever, nausea, abdominal cramps, and muscle aches within a day or two of eating the contaminated shellfish. This infection can be especially dangerous to the immunocompromised, particularly those with liver disease, who can develop septicemia with a mortality rate of 50 percent. V. vulnificus infections are diagnosed through stool or blood cultures. Early treatment with antibiotics reduces the mortality rate and prevents the infection from spreading to the blood.
Yersinia enterocolitica: This bacterial infection leads to diarrhea, vomiting, abdominal cramps, fever and headache. In adults, abdominal pain may be centered on the right side, leading to a misdiagnosis as appendicitis. It is caused by eating contaminated foods, commonly chocolate milk, tofu, water, and undercooked pork such as chitterlings. Infants can be infected by caregivers who handle raw pork. Symptoms begin around 3-7 days after exposure and can last up to 3 weeks. Stool sample analysis provides a diagnosis, but, as most laboratories do not include tests for Yersinia bacteria in their standard tests, this must be ordered specifically. Normally, Yersinia infections resolve on their own, but in cases of severe infections a wide range of antibiotics may be prescribed. Long-term consequences of infection are rare, but include joint pain in the ankles, knees and/or wrists and a rash, called “erythema nosdosum,” on the legs and trunk. They resolve in 1 to 6 months and 1 month, respectively.
Heavy metals: Overdoses of heavy metals, such as arsenic, cadmium, copper, mercury, zinc and lead, can occur by consuming highly acidic foods stored or prepared in containers lined or contaminated with the metal. This type of food poisoning causes nausea, vomiting, diarrhea and abdominal cramps within minutes of eating the offending foods.
Ciguatoxin: This toxin forms in fish that have eaten dinoflagellates, a single-celled organism. When the fish is consumed the toxin causes initial gastrointestinal symptoms of vomiting, diarrhea, and cramping, followed by neurological manifestations. The neurological symptoms include burning or prickling at the lips, tongue, and extremities as well as alternating sensations of hot and cold, hallucination, and nightmares. Predatory reef fish such as barracuda, snapper, grouper and amberjack caught in the South Pacific and the Caribbean commonly contain ciguatoxin. The symptoms of Ciguatoxin start within 2-8 hours of ingestion and the neurologic ones can last several months. In severe cases, treatment with the drug Mannitol can has been shown to help.
Paralytic Shellfish Poisoning (PSP): This type of poisoning occurs after consuming filter-feeding shellfish, usually from the colder, coastal waters of the Pacific Northwest or New England, that have contaminated “red tide” toxins in their diet. When ingested, the toxins cause neurological symptoms, beginning with numbness and tingling in the lips and mouth that spreads to adjoining parts of the face and, sometimes, other parts of the body. It can be fatal in severe cases where the respiratory system becomes paralyzed. Symptoms vary depending on the amount of toxin ingested and can begin from 30 minutes and 3 hours after eating the shellfish.
Monosodium Glutamate (MSG) poisoning: Large amounts of MSG (usually greater than 1.5 grams) can lead to physiological symptoms. These include a burning sensation in the chest, neck abdomen or extremities, sensations of lightness and pressure over the face, or a heavy feeling in the face. These symptoms start within minutes of consumption.
Cyclopeptides Mushroom Poisoning: The most common form of mushroom poisoning is from the Aminita phalloides mushroom. The α-amatoxin found in this genus binds to RNA polymerase II, making it impossible for cells to synthesize proteins leading to cell death. The early symptoms of nausea, vomiting, and diarrhea present within a day, but usually abate on their own. However,after this the toxin affects the liver cells and continues to destroy them. If not treated, liver failure and death are likely to occur. There is no antidote to α-amatoxin so treatment consists of replacing fluids and electrolytes, stomac
h pumping, and consuming activated charcoal. Dialysis and profusion of the blood in the first 24 hours may be effective in removing the toxin already in the blood. If fulminant liver failure occurs, the only treatment option is a liver transplant.
Muscarinic Mushroom Poisoning: Many species of mushrooms in the genus’ Inocybe and Clitocybe contain muscarine, a substance that stimulates the parasympathetic nervous system causing sweating, shortness of breath, salivation, diarrhea, pupil constriction, low blood-pressure and a slow heartbeat. These symptoms occur within 1 hour of ingestion and last 4 to 24 hours. Most cases resolve on their own, but atropine can be given in severe cases.
Scrombroid fish poisoning: Scrombroid poisoning is caused by a histamine-like substance that develops in dead fish that have not been kept at safe temperatures as bacteria break down the tissues. Common fish sources include tunas, bluefish and mackerel. The histamine-like substance causes diarrhea, headache, nausea, vomiting, and flushing, as well as a peppery taste in one’s mouth. These reactions occur within 1 hour of eating the fish. Treatment with anti-histamines and epinephrine can be necessary in serious cases.
Neurotoxic Shellfish Poisoning (NSP): Caused by a dinoflagellate found in coastal Gulf of Mexico and Atlantic Seaboard waters, this toxin is ingested by humans via shellfish such as oysters, clams and mussels. The NSP toxin causes numbing in the mouth and face, coordination problems, nausea, vomiting, diarrhea and a reversal of hot/cold sensations. These symptoms usually last 2-3 days.
Amnesiac Shellfish Poisoning (ASP): A microscopic, aquatic plant, or diatom, called Nitchia pungens causes this type of shellfish poisoning. Gastrointestinal symptoms begin within 24 hours of ingestion. Other symptoms include headache, dizziness, short-term memory loss; severe cases can result in seizures, focal weakness, paralysis and death. Short-term memory loss can be permanent. There is no treatment for ASP.
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