Bacteria and Foodborne Illness: NIDDK
Article title: Bacteria and Foodborne Illness: NIDDK
Main condition: Foodborne illness
Conditions: Foodborne illness
- Risk Factors
- Food Irradiation
- Links to Other Disorders
- Common Sources of Foodborne Illness
- Points To Remember
- For More Information
Foodborne illness results from eating food contaminated with bacteria (or their toxins) or other pathogens such as parasites or viruses. The illnesses range from upset stomach to more serious symptoms, including diarrhea, fever, vomiting, abdominal cramps, and dehydration. Although most foodborne infections are undiagnosed and unreported, the Centers for Disease Control and Prevention estimates that every year about 76 million people in the United States become ill from pathogens in food. Of these, up to 5,000 die.
When food is cooked and left out for more than 2 hours at room temperature, bacteria can multiply quickly. Most bacteria grow undetected because they do not produce an "off" odor or change the color or texture of the food. Freezing food slows or stops bacteria's growth but does not destroy the bacteria. The microbes can become reactivated when the food is thawed. Refrigeration may slow the growth of some bacteria, but thorough cooking is needed to destroy the bacteria.
- Abdominal cramps
In some people, especially children, hemolytic uremic syndrome (HUS) can result from infection by a particular strain of bacteria, E. coli O157:H7, and can lead to kidney failure and death. HUS is a rare disorder that affects primarily young children between the ages of 1 and 10 years and is the leading cause of acute renal failure in previously healthy children. The child may become infected after consuming a contaminated food, such as meat (especially undercooked ground beef), unpasteurized apple cider or apple juice, or raw sprouts.
The most common symptoms of infection are vomiting, abdominal pain, and diarrhea, which may be bloody. In 5 to 10 percent of cases, HUS develops about 2 to 6 days after the onset of illness. This disease may last from 1 to 15 days and is fatal in 3 to 5 percent of cases. Symptoms of HUS include fever, lethargy, irritability, and pallor. In about half the cases, the disease progresses until the kidneys are unable to remove waste products from the blood and excrete them into the urine (acute renal failure). A decrease in circulating red blood cells and blood platelets and reduced blood flow to organs may lead to multiple organ failure. Seizures, heart failure, inflammation of the pancreas, and diabetes can also result. However, most children recover completely.
You need to see a doctor right away if you have any of the following symptoms, with or without gastrointestinal symptoms:
- Signs of shock, such as weak or rapid pulse; shallow breathing;
cold, clammy, pale skin; shaking or chills; or chest pain.
- Signs of severe dehydration, such as dry mouth, sticky saliva,
decreased urine output, dizziness, fatigue, sunken eyes, low blood
pressure, or increased heart rate and breathing.
- Confusion or difficulty reasoning.
In the most severe situations, such as HUS, the patient may need hospitalization in order to receive supportive nutritional and medical therapy. Maintaining adequate fluid and electrolyte balance and controlling blood pressure are important. Doctors will try to minimize the impact of reduced kidney function. Early dialysis is crucial until the kidneys can function normally again, and blood transfusions may be needed.
To prevent harmful bacteria from growing in food, always
- Refrigerate foods promptly. If you let prepared food stand at room
temperature for more than 2 hours, it may not be safe to eat. Set your
refrigerator at 40°F or lower and your freezer at 0°F.
- Cook food to the appropriate temperature (145°F for roasts, steaks,
and chops of beef, veal, and lamb; 160°F for pork, ground veal, and
ground beef; 165°F for ground poultry; and 180°F for whole poultry).
Use a thermometer to be sure! Foods are properly cooked only when
they are heated long enough and at a high enough temperature to kill the
harmful bacteria that cause illness.
- Prevent cross-contamination. Bacteria can spread from one food
product to another throughout the kitchen and can get onto cutting
boards, knives, sponges, and countertops. So keep raw meat, poultry,
seafood, and their juices away from other foods that are ready to eat.
- Handle food properly. Always wash your hands before touching food
and after using the bathroom, changing diapers, or handling pets, as
well as after handling raw meat, poultry, fish, shellfish, or eggs.
Clean surfaces well before preparing food on them.
- Keep cold food cold and hot food hot.
- Maintain hot cooked food at 140°F or higher.
- Reheat cooked food to at least 165°F.
- Refrigerate or freeze perishables, prepared food, and leftovers
within 2 hours.
- Never defrost food on the kitchen counter. Use the refrigerator,
cold running water, or the microwave oven.
- Never let food marinate at room temperature; refrigerate it.
- Divide large amounts of leftovers into small, shallow containers for
quick cooling in the refrigerator.
- Remove the stuffing immediately from poultry and other meats and
refrigerate it in a separate container.
- Do not pack the refrigerator. Cool air must circulate to keep food
- Inflammatory bowel disease
- Kidney failure
- Guillain-Barré syndrome
- Autoimmune disorders
Symptoms: Abdominal pain, diarrhea, nausea, and vomiting.
Bacteria: Campylobacter jejuni, E. coli O157:H7, L. monocytogenes, Salmonella.
Source of illness: Raw (unpasteurized) milk and dairy products, such as soft cheeses.
Symptoms: Nausea and vomiting, fever, abdominal cramps, and diarrhea.
Bacteria: L. monocytogenes, Salmonella, Shigella, Staphylococcus aureus, C. jejuni.
Source of illness: Raw or undercooked eggs. Raw eggs may not be recognized in some foods such as homemade hollandaise sauce, caesar and other salad dressings, tiramisu, homemade ice cream, homemade mayonnaise, cookie dough, and frostings.
Symptoms: Nausea and vomiting, fever, abdominal cramps, and diarrhea.
Bacteria: Salmonella enteriditis.
Source of illness: Raw or undercooked shellfish.
Symptoms: Chills, fever, and collapse.
Bacteria: Vibrio vulnificus, Vibrio parahaemolyticus.
Source of illness: Improperly canned goods, and smoked or salted fish.
Symptoms:Double vision, inability to swallow, difficulty speaking, and inability to breathe. (Seek medical help right away!)
Bacteria: C. botulinum.
Source of illness: Fresh or minimally processed produce.
Symptoms: Diarrhea, nausea, and vomiting.
Bacteria: E. coli O157:H7, L. monocytogenes, Salmonella, Shigella, Yersinia enterocolitica, viruses, and parasites.
- Foodborne illness results from eating food that is contaminated with
bacteria, viruses, or parasites.
- People at greater risk for foodborne illness include young children,
pregnant women and their fetuses, the elderly, and people with lowered
- Symptoms usually resemble intestinal flu. See a doctor immediately
if you have more serious problems, or if you do not seem to be improving
as you'd expect.
- Treatment may range from replacement of lost fluids and electrolytes
for mild cases of foodborne illness, to hospitalization for severe
conditions such as hemolytic uremic syndrome.
- You can prevent foodborne illness by taking the following
- Wash your hands with hot, soapy water before preparing food and
after using the bathroom or changing diapers.
- Separate raw meat, poultry, or seafood from other foods to keep
these foods and their juices away from ready-to-eat foods.
- Cook foods properly and at a high enough temperature to kill
- Refrigerate foods within 2 hours or less after cooking because
cold temperatures will help keep harmful bacteria from growing and
- Clean surfaces well before using them to prepare foods.
- Wash your hands with hot, soapy water before preparing food and after using the bathroom or changing diapers.
14th & Independence Avenue, SW.
Washington, DC 20250
Meat and Poultry Hotline:
U.S. Department of Health and Human Services
200 Independence Avenue, SW.
Washington, DC 20201
U.S. Environmental Protection Agency (EPA)
401 M Street, SW.
Washington, DC 20460-0003
Phone: (202) 260-2090
U.S. Food and Drug Administration
5600 Fishers Lane
Rockville, MD 20857
Center for Food Safety & Applied Nutrition
Food and Drug Administration
200 C Street, SW.
Washington, DC 20204
Food Information Line:
Centers for Disease Control and Prevention
1600 Clifton Road
Atlanta, GA 30333
Phone: (404) 639-3534 or 1-800-311-3435
Gateway to Government Food Safety Information
Partnership for Food Safety Education
American Dietetic Association
216 West Jackson Boulevard
Chicago, IL 60606-6995
Consumer Nutrition Hotline:
National Digestive Diseases Information Clearinghouse
2 Information WayThe National Digestive Diseases Information Clearinghouse (NDDIC) is a service of the National Institute of Diabetes and Digestive and Kidney Diseases (NIDDK). The NIDDK is part of the National Institutes of Health under the U.S. Department of Health and Human Services. Established in 1980, the clearinghouse provides information about digestive diseases to people with digestive disorders and to their families, health care professionals, and the public. NDDIC answers inquiries, develops and distributes publications, and works closely with professional and patient organizations and Government agencies to coordinate resources about digestive diseases.
Bethesda, MD 20892-3570
Publications produced by the clearinghouse are carefully reviewed by both NIDDK scientists and outside experts. This fact sheet was reviewed by Dr. Howard Trachtman of the Long Island Jewish Medical Center, Dr. Peter McNally of the American College of Gastroenterology, and Howard Sutter of the Food and Drug Administration.
This e-text is not copyrighted. The clearinghouse encourages users of this e-pub to duplicate and distribute as many copies as desired.
NIH Publication No. 01-4730
Posted: May 2001
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