Ahna A. Patterson, PA-C
Food poisoning affects nearly 50 million people annually. While most cases resolve without the intervention of a healthcare provider, food poisoning can be serious – the CDC estimates that each year 128,000 people are hospitalized and 3,000 people die from food poisoning.1 There are many different bacteria and viruses that can cause food poisoning. The five most common are Norovirus, Salmonella, Clostridium perfringens, Campylobacter, and Staphylococcus aureus.2 You may have heard of other bacteria such as E. coli and Clostridium botulinum (which causes botulism); these are not as common, but they do lead to severe illnesses and often hospitalization.3
Certain germs that can lead to food poisoning tend to grow in certain common food sources:4
- Shellfish, prepared foods, vegetables and fruit (Norovirus)
- Poultry, eggs, fresh produce, meat, fish, unpasteurized milk or juice, nut butters, and spices (Salmonella)
- Meat, poultry, gravy, and home-canned goods (Clostridium perfringens)
- Poultry, meat, and unpasteurized milk (Campylobacter)
- Meat, dairy, and bakery products (Staphylococcus aureus)5
Food poisoning symptoms can include diarrhea (watery or bloody), vomiting, abdominal pain, fever, headache, and nausea.Symptoms may begin minutes to days after ingesting food that contains a virus or bacteria and the average onsets are:6
- 12–48 hours (Norovirus)
- 6 hours – 4 days (Salmonella)
- 6–24 hours (Clostridium perfringens)
- 2–5 days (Campylobacter)
- 30 minutes – 6 hours (Staphylococcus aureus)
The most important treatments include replacing fluid losses, preventing dehydration, and maintaining appropriate nutrition. Diluted fruit juices, flavored soft drinks, saltine crackers, broths, and soups are all appropriate for mild cases of food poisoning.Over-the-counter anti-diarrheal medications can help with stomach cramping and persistent diarrhea. However, caution should be used when taking over-the-counter medications to treat food poisoning symptoms, as they may hide the actual amount of fluid losses, causing people to think they do not need to drink more fluids; people taking anti-diarrheal medications should not decrease their fluid intake.7
Individuals that have bloody diarrhea or a high fever should seek immediate medical attention. If there are signs of severe disease (for example, fever, more than 6 stools a day, dehydration, severe abdominal pain, or bloody diarrhea), healthcare providers often collect stool samples for laboratory testing and may prescribe antibiotics.8
The CDC recommends four steps that can be performed at home to prevent food poisoning.9 These include:
- Clean – Wash your hands for at least 20 seconds with soap and water when preparing food and prior to eating. Wash surfaces and eating utensils with hot water and soap. Fruits and vegetables should be rinsed under running water.
- Separate – Use separate cutting boards for raw poultry, seafood, and meat. Keep the juices from these raw foods away from other food items when grocery shopping.
- Cook – Use a food thermometer to ensure that food is cooked to the right temperature. You cannot tell if food is safely cooked by only monitoring the color and texture.
- Chill – Never leave perishable food outside of the refrigerator for more than 2 hours or more than 1 hour if it is warmer than 90 degrees outside. Never thaw food on the counter as bacteria can multiply quickly. In order to safely thaw food, use the refrigerator, cold water, or the microwave.
When eating out, use the following safety tips:10
- Check inspection scores.
- Order food that is cooked properly and do not consume undercooked meat, poultry, seafood, or eggs.
- Do not eat food that is served lukewarm. Ensure that buffet and salad bar items are appropriately hot or chilled.
- Place leftovers in the refrigerator within 2 hours of eating out and eat them within three to four days.
1 Centers for Disease Control and Prevention, “Food Borne Illnesses and Germs,” https://www.cdc.gov/foodsafety/foodborne-germs.html
4 Regina LaRocque and Jason Harris, “Causes of acute infectious diarrhea and other foodborne illnesses in resource-rich settings,” UptoDate, updated January 10, 2019.
5 Peter V. Chin-Hong and B. Joseph Guglielmo, “Problems in Infectious Diseases & Antimicrobial Therapy,” in Current Medical Diagnosis and Treatment 2018, (McGraw-Hill Education, 2018): 1314-1317.
6 Centers for Disease Control and Prevention, “Food Poisoning Symptoms,” https://www.cdc.gov/foodsafety/symptoms.html
7 Regina LaRocque and Jason Harris, “Approach to the adult with acute diarrhea in resource-rich settings,” UptoDate, updated June 14, 2019.
9 Centers for Disease Control and Prevention, “Four Steps (Clean, Separate, Cook, Chill) to Food Safety,” https://www.cdc.gov/foodsafety/keep-food-safe.html
10 Centers for Disease Control and Prevention, “Food Safety and Eating Out,” https://www.cdc.gov/foodsafety/communication/eatingout.html