That burger you barbecued last night -- or even the eggs you made for breakfast -- could make your child very sick. Follow our plan to keep your kids healthy.
By Beth Turner
September 15, 2006
Common Culprits
Dana and David Bray were having a great time on vacation with their two daughters, so the last thing on their minds was whether the fancy theme-park restaurant where they had dinner was clean enough. But a few hours after 18-month-old Madeline and 3-year-old Gabrielle shared a crab cake, they suddenly got very sick. "It was the most violent vomiting I've ever seen," says Dana, a nurse from Memphis. "Both girls threw up about 10 times in the first hour."
The hotel staff called an ambulance to take the children to the emergency room, where they continued to throw up for seven hours in the waiting room until they were finally seen at 6 a.m. After running tests, the doctors diagnosed the girls with food poisoning and gave them IV fluids to rehydrate them. They were able to leave the hospital several hours later, but it took them a week to fully recover and eat normally again.
Food-borne illnesses can strike after meals at restaurants or at home, and young children -- who can get dehydrated quickly -- are at greatest risk. But while you're planning end-of-summer picnics and barbecues and lingering over outdoor suppers, it's easy to forget about the looming threat of food poisoning. The scary truth: Staples like burgers, fresh seafood, chicken, egg salad, and even watermelon can make your family sick if you don't wash, handle, cook, and store them properly.
Common Culprits
Bacteria that can make us sick -- such as
Salmonella,
Campylobacter jejuni, and
E. coli -- often inhabit the intestinal tracts of animals and frequently linger on raw chicken breasts, hamburger meat, shellfish, and eggs. Particularly hazardous: foods that mix products of individual animals. A pound of ground beef, for example, can include meat from many cows. Humans can inadvertently pass along germs too: Norovirus, another frequent cause of food poisoning, is usually spread by restaurant kitchen staff who don't wash their hands carefully.
Fortunately, most pathogens are killed by high temperatures, so even problem foods are safe as long as you cook them thoroughly. Refrigerating or freezing foods prevents most bacteria from multiplying. But if you leave lightly contaminated hot food -- or your baby's bottle of formula -- at room temperature for hours, the number of organisms can skyrocket. The bacteria Staphylococcus aureus grows easily in moist, salty foods -- such as a ham sandwich -- and produces a toxin that causes intense vomiting.
According to the Centers for Disease Control and Prevention (CDC), some types of food poisoning could be dramatically reduced if the meat industry started irradiating meat and poultry with high-energy radiation to kill harmful bacteria. This sounds scary -- and officials expect that consumers will be slow to accept the practice -- but it's similar to pasteurization and has been proven to be safe, says Robert Tauxe, MD, chief of the CDC's food-borne and diarrheal diseases branch.
Many people assume that pork is particularly dangerous because their parents often warned them about the risk of getting trichinosis. However, commercial pork is now free of the Trichina parasite, says Dr. Tauxe. "In an extraordinary effort, the pig industry and the people at the USDA who regulate it eliminated the parasite by changing the feed that pigs eat." (However, like other meat, pork can still be contaminated with bacteria.)
Unfortunately, raw fruits and vegetables -- which can become contaminated if they're washed or irrigated by water containing animal feces or human sewage, or if they're fertilized with fresh manure -- are becoming an increasingly common source of food poisoning. And organic produce (or meat or poultry) isn't necessarily less risky. Most likely to be affected: watermelons, cantaloupes, strawberries, lettuce, sprouts, and tomatoes. "So much of the produce we eat year-round now comes from countries that have lower sanitation standards than ours," says Michael Posner, MD, a pediatrician in West Springfield, Massachusetts. "We need to be thinking about the possibility of food-borne illness all year long."
A Difficult Diagnosis
Although millions of kids get sick every year after eating contaminated food, parents and pediatricians often assume they've got just an ordinary stomach bug. Of course, you'll be more likely to suspect that food is the culprit if more than one person who ate the same meal gets sick. "However, most of the time, food poisoning is never diagnosed," says Dr. Tauxe. "For every reported case of Salmonella infection, for example, we estimate there are 37 others out there."
While some cases are relatively mild, kids can have severe abdominal pain, frequent diarrhea, vomiting, and fever starting many hours or even days after they've eaten the toxic food. Bloody diarrhea is a major red flag that your child's stomach woes were triggered by bacteria in food.
"Most cases of food poisoning resolve on their own without treatment," says Parents advisor Ari Brown, MD, author of Toddler 411. But it's crucial to give your child rehydration solution -- not sports drinks or juice -- to prevent her from becoming dehydrated. Children under age 2, and older kids who have signs of dehydration despite drinking, may need to go to the hospital for IV fluids.
Even when food poisoning is caused by bacteria, pediatricians usually don't prescribe antibiotics, Dr. Brown says. Some forms of E. coli can lead to kidney failure in young children, and experts believe that antibiotics can trigger this serious complication. And when a child has been infected with Salmonella, antibiotics may actually prolong the time it takes for the bacteria to leave the intestinal tract. However, antibiotics do help treat severe diarrhea caused by Shigella. Before prescribing antibiotics for your child, your pediatrician will probably do a stool culture to identify the organism.
If you're not sure whether your child has been stricken with food poisoning, should she be tested to find out? "If she's getting better, most doctors won't do a stool culture," says Dr. Brown, since they're expensive and it takes a few days to get results back. But getting a definitive diagnosis is crucial if your child is under age 1 or has bloody diarrhea or other persistent symptoms.
If your child has Salmonella, he can also be contagious. Kathleen Walter, of Landisville, Pennsylvania, thinks she'd contracted it after eating a sandwich, and then passed the infection on to her 18-month-old son, Reese. Both of them ended up in the hospital. Reese continued to test positive and couldn't go back to his church childcare for five months. (Some people shed Salmonella in their stool long after their symptoms resolve, and daycare centers have restrictions about allowing a child back.) From a public-health perspective, it's certainly helpful for officials to know if a restaurant or brand of bagged lettuce is responsible for food poisoning. (Contact your local health department; go to cdc.gov for a link.) "DNA fingerprinting" tests can now identify the specific strain of E. coli or Salmonella that your child is infected with, and the CDC can use that information to investigate outbreaks. But food-borne illness can be difficult to track. "It's often impossible to know for certain that symptoms were caused by a particular food," says Dr. Tauxe.
So where does that leave parents like Dana Bray, who was sure her children's food poisoning came from the theme park's crab cake? Probably frustrated. "The staff insisted that there was no proof that the girls got sick from it," Bray says. "I wanted them to pay our medical bills and extend our stay -- we'd paid for an expensive vacation and we lost a significant portion of it."
Food-Prep Checklist
You know that you need to wash your hands often when you cook, that you shouldn't use the same cutting board for raw chicken and other foods, and shouldn't let your kids eat cookie dough, but here are 10 key steps you may not be taking.
Thaw frozen seafood, meat, and poultry in the refrigerator overnight, not on the counter. If you need to thaw food quickly, seal it in a plastic bag and put it in cold water for an hour, or microwave it on "defrost" and cook it immediately.
If you plan to cook seafood, meat, or poultry within two days after you buy it, store it in the coldest part of the refrigerator. Otherwise, freeze it.
Don't buy cooked seafood, such as shrimp or crab, that is displayed in the same case as raw fish.
Marinate food in the refrigerator, not on the counter. If you want to use the marinade as a dip or sauce, boil it before serving it.
Keep hot food hot and cold food cold. Bacteria multiply rapidly between 40 degrees F. and 140 degrees F. Refrigerate leftovers after no longer than two hours.
Periodically check that your fridge temperature is no higher than 40 degrees F. and your freezer is 0 degrees F.
Sanitize your cutting board in the dishwasher or with hot, soapy water after and between cutting raw meat, poultry, or fish. It's best to keep two boards on hand; designate one for fresh produce and the other for meats and seafood.
Buy a meat thermometer. It makes it much easier to tell when meat or chicken is cooked thoroughly. Be sure to wash it between uses.
Remove and discard the outer leaves of heads of lettuce, and thoroughly rinse bagged lettuce.
Look for the new freshQ labels on packages of meat and poultry at the supermarket; the stickers -- developed using military-defense sensor research -- change color when the meat is spoiled.
Call the Doctor!
Most food poisoning clears up on its own, but you should call the pediatrician if your child has:
Bloody or mucusy diarrhea.
Signs of dehydration: urinating less than once every eight hours (or you can't tell how frequently your child is urinating because of diarrhea); lethargy; sunken eyes; dry mouth; few tears when crying.
Vomiting episodes that continue for 12 hours.
Watery diarrhea every hour or two or less frequent diarrhea for more than three days.
Fever for more than three days.
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The Lancaster News reported that at least eleven people have been culture-confirmed with Salmonella infections since eating food from Mazzi, a restaurant whose owner also co-owns the Leola Village Inn & Suites. According to the story:
The settlement terms are confidential, according to Sheetz attorney Gary Zimmerman and Marler, who represented more than 130 of the sickened customers.
