It Must Have Been Something I Ate

The trots, the collywobbles, and gut graffiti are euphemisms for what food poisoning really is--pure hell. "At first you're afraid you're going to die, and then you're afraid you won't," says Dr. Julie Miller Jones, a nutrition professor at the College of St. Catherine in St. Paul, Minn., and author of Food Safety.

No one knows for sure how many people are stricken with food-borne illness every year, but the Centers for Disease Control estimates that more people end up clutching their tummies after a tainted meal annually than catch the common cold. And some 9,000 died from food poisoning last year, according to a study by the Council of Agricultural Science & Technology in Ames, Iowa. As a result, President Clinton earmarked $43 million in his 1998 budget to improve food safety.

The problem is not limited to the deadly outbreaks caused by raw oysters and unpasteurized apple juice that have been in the news lately. Such incidents "represent only a small piece of the pie," says Dr. Kate Glynn, an epidemiologist with the CDC's food-borne illness branch. Food poisoning is a greater threat today than it was 10 years ago, because Americans consume more "handled," or prepared, meals and choose fresher foods devoid of preservatives, which are more likely to be adulterated, says Glynn. Although the bacteria and other pathogenic varmints that cause food poisoning are often impossible to detect without a microscope and bacterial culture, careful food selection and preparation can reduce the risk of infection.

BURGER BUGS. Of course, anything raw or unpasteurized is more likely to contain gut-wrenching germs, but also remember that the more hands and surfaces that touch a food, the higher the risk of contamination. Ground beef, for example, passes through many blades, blenders, and fingers during processing, increasing the chances of picking up a disease-causing microbe. Conversely, steak has only two sides exposed to a carving tool or someone's hands. That's why it's important to cook a hamburger thoroughly (until the inside is brown and the juices run clear) to kill any lurking organisms, while it's O.K. to eat a steak rare as long as the exterior is adequately seared.

Also risky are deli favorites that involve lots of chopping and mixing, such as tuna, potato, and chicken salad. "People used to blame the mayonnaise when they got sick from these things, but it's the fact that they are highly handled that increases the likelihood that bacteria will find its way onto the food," says Jones. And it doesn't matter how reputable the restaurant or market is, because it only takes one employee with unwashed hands or who forgets to clean a knife to make you sick.

Since only the fearful few will completely forsake eating out or taking out, choose established places that have loyal customers or are consistently busy. No one recommends or returns to a restaurant or deli that made them sick. Furthermore, take a look in the bathroom. Is it clean? Is there plenty of soap? A well-kept bathroom often indicates a well-kept kitchen.

Food temperature is also a concern. Hot foods should be piping hot, and cold foods should be near freezing. If not, don't eat them. Better for you to send it back to the kitchen than have your stomach send it back to you. Bacteria and other food-borne pathogens thrive between 40F and 140F. Therefore, keeping foods either hotter or colder than these temperatures is essential to preventing illness. Defrost foods in the refrigerator, not on the counter, and reheat leftovers until they bubble, sizzle, or steam. When food shopping, buy perishable groceries last and put them away first--especially meat and dairy products.

Additionally, be careful when dealing with large quantities of food that do not heat or cool uniformly. For example, a big pot of chili or spaghetti sauce might be hot or cold enough on the edges to kill bacteria, while the center is just right for the little buggers to thrive. So beware of vats of vittles at buffets and salad bars. It's better to divide things into portions small enough to cool or heat quickly and evenly. Furthermore, don't be shy about putting extremely hot food not destined for immediate consumption in the fridge. If the refrigerator was made within the past three decades, it can take the heat and will cool things off quickly enough to prevent a gastrointestinal disaster.

SCRUB-A-DUB. When playing chef, never baste raw meat with the sauce it marinated in, and don't put food back on the plate it was on before it was cooked. Keep track of utensils, too. Tongs used to put raw hamburger patties on the grill shouldn't be used to take them off again when they're done. And as for roasting turkeys, cook the stuffing separately. The cavity of the bird acts like an insulated petri dish for growing bacteria if packed with moist goo when it's raw. Additionally, keep your fingers out of the pot. Sampling food before it's thoroughly cooked is asking for trouble. This is true for cake and cookie batter as well. If this takes all the fun out of baking, use pasteurized egg products.

Finally, cleanliness is key, especially when handling fresh foods without preservatives. "Wash all fruits and vegetables prior to eating, and wash your hands with soap and hot water both before and after you touch any kind of raw food," says Glynn. Even give produce with throwaway peels and rinds a good rinse, because a knife has to go through it to get to the edible part inside. Really scrub, too, and make sure to remove any jewelry, which can harbor tummy-turning toxins. Use the same rigor when cleansing counters, utensils, and chopping boards. (It doesn't matter if the boards are wooden or plastic, as long as they're appropriately sanitized.) Furthermore, use washable rags and cloths for cleaning rather than bacteria-friendly sponges that can't take a disinfecting trip to the laundry.

What if, despite these precautions, a food-borne bug finds its way into your gastrointestinal tract? The onset of illness can be anywhere from 1 to 96 hours. Symptoms vary from cramps and diarrhea to fever, chills, and vomiting. Most people will suffer acutely for 12-48 hours but will be all right if they take care to prevent dehydration, says Dr. Sheldon Jacobson, chairman of emergency medicine at New York's Mt. Sinai School of Medicine. He recommends slowly drinking at least four ounces of a clear juice (apple juice, for example) hourly to replenish lost fluids and essential electrolytes, but no solid foods. Consult a doctor immediately if it's difficult to keep fluids down, vomiting or diarrhea is near constant for more than two hours, or there is bloody diarrhea. Don't delay. Such symptoms could be indications of a life-threatening pathogen that can penetrate intestinal linings to damage the kidneys, cause meningitis, or trigger neurological disorders.

"BRAT" DIET. Assuming that your food poisoning is not mortally dangerous (though it may feel like it), continue on a clear-liquid diet until the vomiting or diarrhea subsides. Most physicians advise food-poisoning victims against using over-the-counter antidiarrheal remedies so as not to inhibit the body from flushing out the offending germs. After a day or so on clear liquids, introduce bland foods in small quantities. Dr. Christopher Stevens, a gastroenterologist and assistant professor of medicine at Harvard Medical School, suggests a "BRAT" diet of bananas, rice, applesauce, and toast. Potatoes and saltine crackers are also good bets. If all goes well for another 24 hours, "eat what you're hungry for," says Stevens, although it's wise to avoid dairy products, which are difficult to digest. If you're still not quite right after four days, see a doctor: A colly shouldn't wobble that long.

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