The holidays bring presents, decorations, merriment, and often, lots of wonderful food. Whether it be a special celebration in your facility or family members bringing items to share with loved ones, it is critically important to keep a focus on food safety, as every year there are millions of people who get sick from foodborne illness, thousands who are hospitalized, and even some who die. There are many different germs that can contaminate foods and cause infection, and the dining model varies between different types of healthcare organizations, leaving numerous opportunities for contamination and foodborne infection.
Protect your patients and clients this holiday season. Be knowledgeable about foodborne illnesses, their causes, and steps you can take to prevent them.
Facts About Foodborne Illness
Foodborne illness is the direct result of ingesting contaminated food or contaminated water. Often individuals who are experiencing the symptoms of foodborne illness mistakenly believe that they have the flu, so many incidences of foodborne illness and disease go undetected and unreported. Anyone can develop foodborne illness, but there are vulnerable populations who may become seriously ill and even die as a result. Those populations include the very young, older adults, pregnant women and their babies, and people who have compromised or weak immune systems, such as those with cancer, diabetes, HIV/AIDS, and who have received a transplant.
It might surprise you to learn that:
- Approximately 128,000 people are hospitalized annually due to foodborne illnesses.
- Around 3,000 people die every year from a foodborne illness.
- Nearly 17% of the population does not wash their hands after using a public toilet.
- Many foodborne illnesses can be prevented by properly washing your hands.
Every year in the United States it is estimated that there are approximately 48 million cases of foodborne illness, meaning 1 in 6 people in the U.S. becomes ill from food. Illness related to food usually has a sudden onset and lasts a short time, but the symptoms can be mild, serious, or even life-threatening.
Symptoms of foodborne illness include:
- Abdominal cramps and pain
Other symptoms are potentially more serious, such as multiorgan failure and cancer, and may also cause dysfunction in the brain and neurological system, the reproductive system, and the immune system.
Your organization will have policies and procedures for you to follow that will guide you through every step of food service, including:
- Hand washing and using disposable gloves
- Employee health protocols
- Wearing your hair in a restraint and covering beards and body hair if you are a food service employee
- Keeping your fingernails in a certain manner
- Minimizing jewelry
- Receiving, storing, and serving food
Foodborne illness occurs when food or water that is contaminated with bacteria, viruses, parasites, physical contaminants, or chemicals enter the body. Some of the most common causes of foodborne illness include:
Types of bacteria that may contaminate food include salmonella, campylobacter, E. coli, cholera, and listeria.
Types of viruses that may contaminate food include norovirus and the hepatitis A virus. Norovirus can be transmitted by water and any type of food. The hepatitis A virus is usually found in undercooked seafood and raw produce.
Some parasites are only transmitted through food such as fish. Others are transmitted through the food chain by water or soil that contaminates fresh produce, or through direct contact with an animal.
Yet another cause of foodborne illness involves ingesting the brain tissue of an affected animal, specifically cows, as in “mad cow disease”. This can lead to a brain disease in humans called Creutzfeldt-Jakob Disease.
The most worrisome chemicals are:
- Toxins in food products containing corn and grain
- Pollutants in animal products
- Heavy metals in foods from environmental pollution
It’s also important to acknowledge that physical contamination of food can occur with foreign objects such as fingernails, staples, hair, jewelry, glass, metal shavings from can openers, and bones from chicken or fish.
The Big 6
The Center for Disease Control & Prevention (CDC) and the Food & Drug Administration (FDA) identify the top 6 foodborne pathogens that cause disease, known as the Big 6. The FDA requires specific safeguards that are to be followed in food service, and the Big 6 are addressed within their Food Code last published in 2013. These 6 were chosen because they can cause illness when introduced to an individual at a low dose, are easily spread, and can result in severe disease.
This is the most common cause of foodborne illness in the U.S., and this highly contagious virus can live on surfaces for up to 2 weeks. Norovirus causes nausea, vomiting, non-bloody diarrhea, abdominal cramps, aches, and low-grade fever. It is transmitted by touching a surface that has been contaminated and then ingesting the virus, or by ingesting food contaminated with the virus.
The 2013 FDA Food Code requires that employees report a diagnosis of non-typhoidal salmonella to their employer, as it is the primary cause of hospitalizations and deaths in the U.S. from foodborne illness. It causes fever, abdominal cramps, and diarrhea. It is transmitted by eating contaminated foods, drinking contaminated water, and touching a contaminated surface, animal, or object and then ingesting the salmonella pathogen.
This is a rare foodborne illness, but can cause:
- High fevers
- Muscle aches
- Diarrhea, constipation, and abdominal pain
- Loss of appetite
- A rose-colored rash
Shiga Toxin-Producing Escherichia Coli
This is a specific strain of the more commonly-used term, E. coli that causes foodborne illness. It causes severe abdominal cramping and pain, nausea and vomiting, and diarrhea that becomes bloody over time. It can be life-threatening, especially for children under age 5 and older adults.
This highly contagious pathogen causes a disease known as shigellosis. It often occurs in places where there is overcrowding and poor personal hygiene, such as prisons, day care centers, and mental health facilities. Shigellosis causes:
- Abdominal pain and cramps
- Nausea and vomiting
- Stools with blood, pus, or mucus
In young children, the symptoms can also include rectal bleeding, dehydration, and seizures.
Hepatitis A Virus
This is most commonly spread through water or food that has been contaminated with fecal waste. It is preventable using an immunization, although the U.S. does not currently recommend giving the immunization to food service employees. Symptoms include:
- Nausea and vomiting
- Abdominal pain
- Yellow discoloration of the skin and eyes, called jaundice
- Dark urine
- Light-colored stools
What You Can Do
Foodborne illness and disease can be prevented. The first step is washing your hands effectively and maintaining appropriate personal hygiene, and then keeping the food service area around you clean and sanitary. Additionally, remember the importance of knowing that you MUST report symptoms to your supervisor when you experience them.
It is critically important that you intervene to prevent foodborne illness; you might just save lives!
For additional information on best practices in senior care, read our blog post, Caring for Older Adults.