Burgers, Slaw -- and Salmonella

By Milton Lakin
WebMD Feature

Reviewed By Gary Vogin

Summer in Iowa ... ahh, there's nothing like it. High temperatures and high humidities -- neither of which seem to wither the spirits of hearty Iowans. Parks are filled with large family picnics, where good food is always a major attraction. Fried chicken, burgers on the grill, and Grandma's homemade potato salad are a must.

Once upon a time the only bugs we had to fret about were ants and centipedes marching across the tablecloth. Now we worry about the kinds of bugs that are transmitted in foods. They are a lot smaller and potentially a lot more dangerous ... with creepy names like Campylobacter and E. coli 0157:H7.

There are plenty to be concerned about. According to the Centers for Disease Control and Prevention (CDC), there are more than 200 diseases that can be spread through food. In a report in the September 1999 issue of the journal Emerging Infectious Diseases, approximately 76 million food-borne illnesses -- resulting in 325,000 hospitalizations and 5,000 deaths -- occur in the United States each year.

The outbreaks can strike almost anywhere. And they spread very quickly. One such outbreak of food poisoning struck the small town of Oskaloosa in southern Iowa. It was a Thursday evening in November of 1996 and about 1,000 people (nearly 10% of the town's population) had attended an annual church dinner. Soon after eating the turkey dinner, people started getting sick. The culprit: Salmonella. Before the weekend was over more than 200 people became ill, 60 were seen in local emergency rooms, and 21 were hospitalized. Officials felt lucky that no one died.

"On the Memorial Day, the Fourth of July, and the Labor Day weekends you can be sure we'll have several outbreaks of food poisoning," says Patricia Quinlisk, MD, state epidemiologist and medical director for the Iowa Department of Public Health. She was called in to help with the investigation of the Oskaloosa outbreak, and every summer she and her colleagues watch for "blips" -- food poisoning outbreaks -- over the holiday weekends.

Quinlisk offers plenty of reasons why the problem heats up in summer. "People aren't as careful about handling foods properly when they cook and eat outside, and they don't always have access to warm water and soap for washing." But during the summer, precautions are most important because the hot and humid weather promotes the growth of bacteria -- the source of most forms of food poisoning.

Potato salad, turkey sandwiches, or other foods left out in the sun can all become hotbeds of bacteria. This happens more often during outdoor picnics and gatherings, where it's more difficult to keep cold foods cold and hot foods hot -- temperatures at which bacteria are less of a threat.

So serious is the problem that the U.S. Department of Agriculture and the U.S. Department of Health and Human Services will soon release food safety tips as part of the recently revised Dietary Guidelines for Americans. "This is an important step in changing the way we think about food safety," says Johanna Dwyer, a Tufts University professor and member of the advisory committee that is drawing up the new guidelines. "The 'Keep Food Safe to Eat' guidelines will focus on ways to avoid trouble in our own kitchens."

And although the guidelines have not yet been officially released, experts agree that these four simple food-handling tips can go a long way toward reducing your risk of food poisoning this summer:

Lather up: Hand washing is the single most effective way to prevent food-related illness. Always wash your hands before preparing food and after using the bathroom or changing diapers. Antibacterial hand sanitizers are no substitute for soap. Analyses indicate that warm water and soap get rid of about 95% of the bacteria; antibacterial gels and towels eliminate only about 5%.
Wash fresh fruits and vegetables thoroughly in cold water to rinse off any microorganisms that may lurk on them. Sponges can harbor battalions of nasty microbes. Experts recommend microwaving sponges for 15 to 30 seconds every few days to disinfect them (but be careful because they will be very hot).
Divide and conquer: Cross-contamination during preparation, grilling, and serving food is a prime cause of food-related illness. Don't let raw meat or poultry juices drip onto other foods when you're grocery shopping, or in the refrigerator or ice chest. Don't use the same cutting board, platter, or utensils for raw meat as for other raw or cooked foods. And keep your cooking surfaces clean by sanitizing them with a solution of one tablespoon household bleach in a gallon of water.
Be cool: Keep cold foods cold. Load perishable groceries in your car, not in the hot trunk, and take them home immediately. Pack cold picnic foods in a chest filled with ice -- full coolers maintain cold temperatures longer than half-empty ones. Use one cooler for perishables and another that will be opened often for beverages.
Get the leftovers back into the cooler as soon as possible. Bacteria can begin to grow to dangerous levels in food that sits out for over two hours at room temperature (one hour if temperatures are 90 degrees or higher). When in doubt, throw it out.
Turn up the heat: Cook food long enough and at high enough temperatures to kill harmful bacteria. Use a meat thermometer to check internal temperatures whenever possible. Cook whole steaks and roasts to at least 145 degrees and ground meats to 160 degrees. Poultry should reach a temperature of 180 degrees in the thigh and 170 degrees in breast meat. Juices should always run clear, and hamburger and poultry should never be pink. Cook meats from start to finish at your picnic site -- partial cooking ahead of time allows bacteria to survive and multiply.

Also, be wary of reheating foods that may have been contaminated. While you may be successful at killing any microorganisms that have proliferated, some bacteria (staphylococci and E. coli 0157:H7) produce heat-resistant toxins that remain behind even after the bacteria are destroyed and can cause severe diarrhea -- or worse.

The good news, as summer arrives, is that Americans from New York to Alaska are becoming more aware of the dangers of food poisoning, and better at preventing it. The most recent CDC statistics show that food-related infections are down by 19%.

So don't be afraid to pack up your picnic basket and celebrate summer with a glorious feast. Just be vigilant when you're handling and preparing food. Whatever you do, don't let Grandma's famous potato salad sit out on the picnic table all day. Grandma is the last person in the world who would want you to get sick.

Originally published May 22, 2000.

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