Eating Dangerously Page 13
Campylobacter is not something you want to get. In a small percentage of cases, a Campylobacter infection leads to the severe, lifelong disease of Guillain-Barré syndrome, a disorder in which the body’s immune system attacks itself. The subsequent nerve damage progresses to muscle weakness and paralysis. “We’re not talking about just a little bit of diarrhea here,” Morris said.
This doesn’t mean people should quit eating poultry. It means they should “treat it with respect,” Morris advises. Don’t cross-contaminate in the kitchen. And cook it, thoroughly. That means 165 degrees on a meat thermometer.
Chicken and turkey rank high on the list of concerns for the CDC, yet the agency often does not differentiate between whole chickens and ground meat when it comes to public reporting. Poultry was the fourth most common food implicated in all outbreaks in 2009 and 2010, according to the CDC’s national food surveillance network. However, the agency tracks it simply by “poultry” without further detail about specifically what kind of poultry consumers should fear most.
Cooked improperly, all poultry is dangerous. But ground turkey has had its share of bad news in the last several years, particularly in 2011, when ground turkey contaminated with Salmonella Heidelberg sickened 136 people in thirty-four states, killing one person.12 Cargill Meat Solutions, which has since revamped its safety protocols and added a high-pressure, elevated-temperature water wash that disrupts bacteria cells in ground turkey and “neutralizes” them, recalled thirty-six million pounds of the stuff.13 That same year, twelve people were struck ill, including three hospitalized, by Salmonella hadar in turkey burgers sold at Sam’s Club.14
Especially worrisome about those outbreaks was that they involved antibiotic-resistant Salmonella. The frequency of such outbreaks is rising, causing concern among consumer groups and food scientists. The Center for Science in the Public Interest petitioned the U.S. Department of Agriculture in 2011 to prohibit the sale of poultry or ground meat containing four strains of Salmonella. At the end of 2012, the USDA implemented stricter pathogen controls for raw ground turkey and chicken, requiring all manufacturers to update their pathogen control plans.15 It wasn’t as stringent as what consumer advocates had asked for, but it was a sign that federal officials were focusing more attention on contaminated poultry.
Banning any poultry with the four antibiotic-resistant strains of Salmonella hasn’t been a popular method of cutting down on foodborne illness. Government regulators and meat processors contend that if meat sold in stores contains the bacteria, proper cooking will destroy it and make the food safe to eat.
A federal surveillance program has been tracking antibiotic-resistant bacteria on meat since 2002. Scientists at state health departments across the country purchase chicken, turkey, beef, and pork at local grocery stores to isolate surface bacteria, which is sent to a federal lab. The Center for Science in the Public Interest analyzed data collected through that U.S. FDA program, called the National Antimicrobial Resistance Monitoring System, before petitioning for tougher regulation.16 While E. coli is considered an “adulterant” in beef, Salmonella and Campylobacter are allowed in chicken as the cost of doing business.
Salmonella that is resistant to commonly prescribed antibiotics is concerning because without effective prescription drugs to treat the illness, there is greater risk of severe health issues and death. Most cases of Salmonella poisoning go untreated, but, especially in the very young, the very old, and those with compromised immunity, the bacteria can spread beyond the gut and invade the body. “You have a consumer who becomes ill and goes to the hospital and is told the roster of antibiotics that would normally be used might not be effective or as effective,” said Klein, with the Center for Science in the Public Interest.
Relying on consumers to kill the bacteria through cooking isn’t a safe policy, some experts have contended. A drop of chicken juice that splashes in your kitchen can land halfway across the room. And most people don’t use a meat thermometer to make sure their ground beef reaches the recommended 160 degrees or their ground turkey reaches 165 degrees.
But the American Association of Meat Processors has warned that consumers will pay the price if the USDA declares the four strains of Salmonella to be “adulterants,” meaning they are a “poisonous or deleterious substance” that makes the meat dangerous to health. “Just declaring something an adulterant doesn’t solve the problem,” said Jay Wenther, executive director of the association. “That is almost a false sense of security. We try to limit any type of pathogens in the product to begin with, but you can’t reduce it down to zero.”17
If the strains of bacteria are banned from raw meat products, ground meat and poultry carcasses found to contain them would have to be either thrown away or cooked before sale. Until then, which is unlikely to come any time soon given the reluctance of the industry, assume the worst about chicken and cook it to 165 degrees.
Deli Meats
Many obstetricians tell pregnant women not to eat deli meat, and for good reason. Listeria—which can kill a fetus—lurks between slices of oven-roasted turkey and black forest ham.
Deli meat consistently ranks near the top of food science lists of the country’s most dangerous foods. Listeria bacteria is stubborn; it survives and multiplies even at cold temperatures—including the refrigerated deli and hot dog section at the supermarket. Food scientists call it a “production pathogen,” meaning it creeps into a factory, probably on the meat slicing machines, and is difficult to kill off. Listeria can contaminate deli meats after the cooking process and before the packaging. “It requires scrupulous attention in a plant to keep Listeria out,” said Dr. Morris at the University of Florida. “It’s a big problem.”
The only way to kill Listeria is to heat the meat to steaming first, which is a pain and not all that appetizing. Zap it in the microwave before making a sandwich, especially if you are pregnant or have a compromised immune system. On average, about 104 people die each year in this country because their deli meat was contaminated with Listeria. Nearly six hundred are so sick they are hospitalized, and thousands more are struck with gastrointestinal illness.18
Whether the USDA’s zero-tolerance policy for Listeria is effective is a source of debate. Zero tolerance sounds like a good thing—if any Listeria is found on a sample of deli meat headed out of the factory, the entire lot is not fit for sale and must be destroyed. But here’s the problem: the stakes are so high that manufactures avoid doing any testing other than the minimum required. Don’t ask, don’t have to throw it out, is sometimes the operating procedure. Some in the food industry and the FDA have argued federal regulation should allow for low levels of Listeria in certain products so that manufactures would not fear testing.
If you think you are safer standing in line at the deli counter to have turkey or ham sliced while you wait instead of buying pouches of prepackaged meat, you are wrong. Data from the USDA’s FSIS shows the risk of contamination is five times higher in meat sliced at the grocery store counter.19 Once a slicing machine becomes infected, it’s nearly impossible to clean. And, say, food scientists, retail grocery stores are less likely to undergo frequent scrutiny from inspectors who would swab slicing machines for bacteria. Without proper sterilization techniques, Listeria could hang out on a grocery store slicing machine for days or weeks. In a 2010 study, the USDA’s FSIS reported that among illnesses and deaths caused by Listeria in deli meat, 83 percent were linked to meat sliced and packaged at the grocery store.20
Several deli meat health scares in the late 1990s and early 2000s sparked change. Since then, some manufacturers began adding bacterial growth inhibitors to prepackaged meat.
The CDC has long recommended that older people, children, expectant mothers, and those with compromised immunity avoid deli meats unless they’ve heated them to steaming first, or more precisely, 165 degrees. The federal agency also recommends throwing them away sooner than most people probably do. Don’t keep
meat sliced at the grocery store more than three to five days. As for prepackaged meat, keep it for up to two weeks if it’s still sealed. But once it’s opened, toss it within three to five days. Hot dogs, also prone to Listeria contamination, shouldn’t be kept longer than a week once the package is opened.
Here’s another important tip: don’t let the juices from a package of hot dogs or deli meat drip on the kitchen counter. Don’t cross-contaminate your kitchen by touching a raw hot dog with the same fork you are about to use for macaroni and cheese. And wash your hands after touching raw hot dogs or making a sandwich.
And if you are a mustard fan, slather it on. A study from Washington State University showed a slight reduction in pathogen growth when meat came in contact with mustard.21
Raw Milk
It’s all the rage to buy farm-fresh food, to seek out free-range eggs and organic vegetables delivered to the door or grown in the backyard. That’s all great—but don’t take the back-to-nature way of life all the way to raw milk. It’s not worth it.
“Raw milk is horrifically dangerous. I would never advise anyone under any circumstances to drink it,” said Klein, with the Center for Science in the Public Interest. Food poisoning due to unpasteurized dairy products is among the top four most common foods linked to outbreaks. An average of eight outbreaks are reported each year, and children are particularly susceptible to severe illness and kidney failure. Nearly 80 percent of all raw milk outbreaks reported to the CDC involve at least one child.
Raw milk—meaning unpasteurized or not heated to kill bacteria—that is contaminated with E. coli or Campylobacter can cause a healthy child to fall desperately ill within a matter of days.
In 2010, an outbreak traced to a Colorado dairy goat cooperative sickened about thirty people, including two young children. At first, Mary Pierce thought her two-year-old couldn’t stop throwing up because she had a typical stomach virus.22 A few days later, she watched in terror as the lethargic young girl was rushed by helicopter to the Children’s Hospital Colorado, her little kidneys shutting down. Then Nicole’s five-year-old brother, Aaron, fell ill, following her into the hospital and onto a dialysis machine. The cause of their potentially deadly illness: drinking raw goat’s milk from a local dairy. “We were just trying it because my son is allergic to dairy. We’re not going near it anymore,” Pierce said soon after their recovery.
The two kids spent three weeks in the hospital as doctors worked to get their kidneys functioning again. Nicole and Aaron had been drinking raw goat’s milk about two or three months before they were infected with a virulent strain of E. coli, O157. The bacteria is found in animal manure and likely got into the milk because manure was near the goats’ teats. Pasteurization would have cooked out the danger. The kids developed hemolytic uremic syndrome, which causes blood vessels to break up, become meshed with blood platelets, and then damage filters in the kidneys. Nicole and Aaron were anemic and pale and had almost no kidney function, meaning they were not urinating. They spent weeks on dialysis machines to filter their blood and to regain kidney function.
Mary Pierce and her husband, Mike, did research online before deciding to try raw goat’s milk because their son was allergic to pasteurized milk. The parents didn’t drink any of the goat’s milk. “It was so healthy, I was saving it for them,” Mary Pierce said. She knew there was a risk of E. coli but figured it was highly unlikely. “It’s not worth it,” she said. “You can’t understand until it’s your kid lying in the bed.”
Kids younger than five and older people are most susceptible to illness from unpasteurized food, said Alicia Cronquist, the epidemiologist with the Colorado Department of Public Health and Environment who played a key role in solving the Listeria cantaloupe outbreak. The vitamins killed during pasteurization—thiamine, B12, and C, to name a few—are present in milk in small amounts in the first place, Cronquist said. Any minuscule vitamin gain is overshadowed by the bacterial risk of raw dairy. “I do not drink raw milk. I don’t want to play roulette with my health in that way,” she said.
Raw-milk proponents say “cooking” milk destroys not only vitamins and “healthy-gut” bacteria but also the enzymes that help digest milk, which is why people who are lactose intolerant can usually drink it without allergic reaction.
Many states ban the sale of unpasteurized milk, yet they allow people to join a farm co-op and buy raw milk directly from “their” farm. CDC officials said a spike in raw milk outbreaks in recent years is likely due to state laws that make it easier for people to buy the raw product.
It’s not just raw milk, but all unpasteurized dairy products that people should avoid. The CDC recommends that certain people—the young, old, pregnant, and immune compromised—avoid any cheese that does not say “made with pasteurized milk.” The cheese most often blamed is Mexican-style queso fresco, a white cheese. But other soft, unpasteurized cheeses are also suspect, including feta and brie, which are allowed to be made with raw milk because of the aging process.
Leafy Greens
In terms of the sheer number of outbreaks, these guys are number one, and many consumers still have trouble believing it. Leafy greens—spinach, kale, chard, cabbage, endive, baby greens, and the rest of the lettuces—were responsible for 2.1 million illnesses in a decade’s worth of tallying by the CDC.23
For eighty-seven people involved in those outbreaks, it was fatal.
Here’s the problem, to summarize: leafy greens are eaten raw, and, too often, they are dirty. About half of the outbreaks linked to leafy greens from 1998 to 2008 were caused by norovirus, transmitted into salads and sandwiches by food handlers who didn’t wash their hands or let greens touch dirty countertops. Many others were due to E. coli that landed on spinach during the growing or packaging process, likely because the greens touched manure, wild animals, or contaminated water.
If you buy a package of salad mix or plastic tub of spinach that’s been contaminated with E. coli, there’s not much you can do about it. “Washing pre-washed greens isn’t going to remove contamination because the bacteria can actually be inside the leaves and stems. You may even make it worse by contaminating it with stuff from your sink,” Klein said.
Food safety experts, though, aren’t suggesting people stop eating spinach and salads. For the majority of people, the overall health benefits outweigh the risk. Leafy greens help fight cancer, heart disease, and diabetes. “We should be eating a lot of servings of fruits and vegetables per day,” said Dr. Patricia Griffin, chief of enteric diseases at the CDC’s epidemiology office.24
The year 2006 was a bad one for leafy greens. Bagged baby spinach—the kind you would like to assume has been prewashed and is healthy for you—killed three people and sent more than one hundred to the hospital with E. coli poisoning.25 As people were succumbing to illness in twenty-six states and federal investigators were trying to determine which farm was responsible, the FDA warned Americans not to eat any bagged spinach. That outbreak was traced back to Earthbound Farm.
The same year, the dreaded E. coli O157:H7 was found in two other outbreaks traced back to leafy greens. In one major outbreak, iceberg lettuce served by Taco John’s sickened more than eighty people in Iowa, Minnesota, and Wisconsin.26
Once greens are contaminated with bacteria, it’s difficult if not impossible to sterilize them without cooking. A chlorine wash after harvest can reduce some of the pathogens, but it doesn’t make greens completely safe—even the “prewashed” kind. Since leafy greens appeared on the FDA’s national watch list in 2006,27 farms have improved safety protocols and the seriousness of outbreaks has declined. Still, leafy greens remain one of the riskiest foods.
Many of the leafy-green outbreaks were linked specifically to spinach, and university researchers have found that spinach is more likely than lettuce to harbor bacteria on its leaves, although the reasons are unclear. Measured by the amount consumed, spinach is more often linked to outbreaks and r
ecalls than lettuce. Think about this the next time you line up in the salad shop lunch line: food researchers have found 1 percent of unprocessed spinach, on average, is contaminated with bacteria. Now think about how often you eat it raw. The odds are in your favor, at least. Eating raw spinach has become much more common in the last several years, its popularity climbing on the praise of nutritionists and raw food enthusiasts. A few decades ago, most people ate spinach cooked, killing any harmful bacteria. “Spinach has a higher likelihood of contamination than what we see with lettuce,” said Dr. Michael Doyle, director of the Center for Food Safety at the University of Georgia. “I like spinach. My grandmother made a very good spinach dish. She cooked it with vinegar and bacon. We never thought about eating raw spinach—that was for the rabbits. I avoid raw spinach. I eat it cooked.”
Improving the safety of spinach and other greens must happen at the farm because if they are contaminated when they show up in your refrigerator, there is not much to do about it, besides cook it. That said, experts recommend keeping it refrigerated, throwing it away by its expiration date, and washing it to remove any dirt on the leaves. If it’s prewashed, however, go ahead and eat it straight out of the bag. Washing it again only increases the chances that the spinach will pick up bacteria in your kitchen sink.
Eggs
Reconsider ordering your eggs sunny side up. Don’t eat raw eggs, even if it’s just in a little dab of cake batter. Or runny ones. Or eggs that have been sitting under a heat lamp for hours on a buffet table. Eggs contaminated with Salmonella inside their shells kill more than thirty people in this country on average each year and sicken an estimated seventy-nine thousand.28
In the late 1980s, CDC researchers discovered how it was that thousands of people were becoming ill after eating raw eggs that were clean on the surface of the shell and had no cracks. Hens infected with the bacteria in their ovaries laid eggs that carried Salmonella enteritidis on the inside of the shell. One might think the FDA and USDA sprung into action to make sure farmers would no longer be allowed to let contaminated chickens lay contaminated eggs that were killing people. But it was not until 2009—twenty years slipping by as the FDA and USDA pointed fingers at each other—that the federal government instituted the “egg rule.”29