The Telegraph
You wouldnít think it’s possible that three bites of a hamburger from a fast-food restaurant would be fatal or that ordering a glass of fresh-squeezed orange juice could result in a miscarriage — but it has happened.
A 6-year-old California girl died several years ago when she ate a burger contaminated with E. coli bacteria. The orange juice made a Washington woman ill because it was not pasteurized.
Dining out is so commonplace — nearly one in two American adults eats out every day — and itís an experience that often is taken for granted.

Maura DeYoung, environmental health services manager with the Madison County Health Department, said protecting the health of the community was one of the main reasons that the county started its food sanitation program more than a decade ago. Until then, there were only a few communities that conducted inspections, such as Alton and Granite City, at popular eateries and food establishments.
“Many people do not think about food safety until a food-related illness affects them or a family member,” DeYoung said.
She said the county has come a long way during the past 10 years in fighting the battle and protecting consumers.
Restaurants are responsible for ensuring that the food they serve is safe and wholesome. Thus, the reason for inspections, because without access to an establishmentís kitchen, customers canít be sure whether conditions are clean and that food is being stored and prepared properly.
“Itís our job to protect the public,” DeYoung said.
While the food supply in the United States is one of the safest in the world, the national Centers for Disease Control and Prevention estimates that 76 million Americans get sick, more than 300,000 are hospitalized and 5,000 Americans die each year from foodborne illness.
Understanding the nature of foodborne illness-causing bacteria and the common types of foodborne illness helps consumers and food handlers take preventive measures. The majority of illness cases occur from May to September.
There are more than 30 types of foodborne illness, which usually cause flu-like symptoms. Cold foods have to be held below 41 degrees, hot foods above 140 degrees. Anything in between creates an environment in which bacteria can grow.
In recent years, salmonella has been the leading foodborne illness-causing bacterium. Clostridium, staphylococcus, shigella and campylobacter have also been responsible for many outbreaks. Other bacteria implicated in foodborne illness are bacillus, escherichia coli, listeria, streptococcus, vibrio and yersinia.
These bacteria can cause two types of food illness — food infection and food poisoning.
Eating food containing the living bacteria causes food infection. Eating foods in which bacteria such as staphylococcus or clostridium botulinum have lived and produced a poison, or toxin, causes food poisoning. The toxin, not the bacteria, causes the illness.
Food infections are caused when microbes, bacteria and protozoa invade the body and begin attacking, usually the digestive system. Viruses are caused when particles enter the body through food or water, and common ones affect the digestive tract or the liver.
Viruses have been identified as the cause of a number of foodborne disease outbreaks in recent years, and they likely also are responsible in many of the instances where no agent has been identified in a foodborne outbreak.
Most food illnesses are of short duration, lasting one to three days, and are usually not life-threatening. Symptoms include: the onset of severe vomiting or diarrhea without any upper respiratory symptoms, diarrhea lasting several days along with a fever, diarrhea with blood or excessive mucus, and jaundice.
DeYoung said the onset of symptoms depends on the bacteria and may occur as soon as one to three hours or up to seven days or longer after ingestion. Duration of the illness is also dependent on the bacteria and can be from about eight hours to 30 days.
“Knowing the illness symptoms and when they occurred are critical to being able to determine the cause,” she said.
She said if someone reports a food illness, nurses then take a three-day food history of the individual.
“Knowing what and where you ate for the three days before you became ill will help us determine the cause of the illness,” she said. “There is a common misconception that the last food item that you ate made you sick.”
She said while this can be true, most bacteria and viruses require longer incubation periods.
“Some persons are also more susceptible than others to foodborne illness,” DeYoung said.
Infants, the elderly, pregnant women and persons already ill from other causes may be more vulnerable. Also, persons whose immune system is suppressed, such as patients undergoing treatment for cancer or recovering from organ transplants, should take special precautions to avoid foodborne illness.
The majority of outbreaks occur because of mishandling of food, DeYoung said. Foods most commonly involved include meat, poultry, fish, eggs, dairy products and raw vegetables.
Once health officials determine there is a foodborne illness outbreak, then preventative measures are taken to extinguish it.
Enforcement may involve the proper destruction of food where safety issues are compromised. A general lack of effort or imminent health threat would dictate the need for an establishment to close operations.
“We would ask that an establishment voluntarily close its doors until the situation is resolved,” DeYoung said.
Food service workers, managers and owners should consider all reports of possible foodborne illness legitimate and notify the health department immediately.
The Centers for Disease Control estimates that fewer than one in 10 people tell the health department about their illness.
People often will report the problem to the food establishment rather than the health department as a way of circumventing an investigation, or to try to get the owner or manager to pay the individualís medical bills.
DeYoung said the risk of foodborne illness can be controlled by proper sanitation practices in the kitchen, correct cooking temperatures and times, and safe food storage conditions that do not allow spoilage organisms to grow.
“While there are many species of bacteria, viruses, yeasts and molds that can turn a delicious meal into a vehicle for disease, careful emphasis on three broad areas of safe food-handling is the most reliable way to reduce possible problems,” she said.
DeYoung said the best methods in the fight against contamination are “keep it clean, keep it hot and keep it cold.”
She said those preparing meals should keep raw and cooked foods separate, practice good personal hygiene and use clean utensils during food preparation.
Potentially hazardous foods should be heated rapidly and cooked thoroughly and held above 140 degrees. Foods that are refrigerated should be chilled rapidly to 40 degrees or less.
“Foodborne illnesses are preventable,” DeYoung said.
She said that if someone suspects unsanitary conditions at an establishment, they should contact their local health department. Jersey, Greene, Calhoun and Macoupin counties all conduct sanitary inspections of food establishments, and investigations are conducted on reported foodborne illnesses.
TUESDAY: What restaurants say about the health inspection process.