Understanding Food Poisoning, Healthcare Professionals’ Role in Prevention

What Is Food Poisoning? 

Caused by ingesting harmful bacteria, viruses, parasites, or toxins, food poisoning affects millions of people worldwide annually. The symptoms and severity of food poisoning can vary based on the specific bacteria or virus that has contaminated the food. 

In the United States, the bacteria and viruses that cause the highest number of illnesses, hospitalizations, or deaths include the following: 

• Campylobacter 
• Clostridium perfringens 
• Escherichia coli 
• Listeria 
• Norovirus 
• Salmonella 

Some other significant bacteria and viruses can cause foodborne illnesses: 

• Bacillus cereus 
• Botulism 
• Hepatitis A 
• Shigella 
• Staphylococcus aureus (also known as Staph Food Poisoning) 
• Vibrio species that cause vibriosis 

According to the World Health Organization (WHO), an estimated 600 million cases of foodborne illnesses are reported yearly, resulting in approximately 420,000 deaths. Such alarming statistics underscore the need for increased awareness and preventative measures. 

Recent Outbreaks 

So far this year, there have been at least eight instances where food had to be recalled due to potential contamination. Here are the details of each recall: 

1. Enoki mushrooms: Three recalls were made because enoki mushrooms might have been contaminated with Listeria monocytogenes. No illnesses were reported, and consumers were advised against consuming the mushrooms. 
2. Alfalfa sprouts: Fullei Fresh recalled alfalfa sprouts due to Shiga toxin-producing E. coli. No illnesses were reported, but consumers were warned not to consume the sprouts. 
3. Infant formula: Batches of infant formula were recalled due to the possibility of cross-contamination with Cronobacter sakazakii bacteria. No illnesses were reported, and consumers were instructed to return the products for a refund. 
4. Canned shrimp: Geisha canned shrimp was recalled because of signs of Clostridium botulinum contamination. No illnesses were reported, and consumers were strongly advised not to consume the damaged cans. 
5. Cocktail shrimp: Lidl US voluntarily recalled Tapas-branded cocktail shrimp due to concerns over L. monocytogenes contamination. No illnesses were reported, and customers were instructed to return the products for a refund. 
6. Strawberry granola and yogurt parfait bars: Clio Snacks recalled Strawberry Granola & Greek Yogurt Parfait bars because they were found to contain L. monocytogenes. The source of contamination is being investigated, and consumers were advised not to eat the bars. 
7. Frozen fruit: Scenic Fruit Company recalled frozen organic strawberries because they may have been contaminated with Hepatitis A. Consumers were instructed to return the products to the retailer. 
8. Smoked salmon: Biltmore Smoked Wild Sockeye Salmon was voluntarily recalled due to L. monocytogenes contamination. No illnesses were reported, and consumers were advised against consuming the product. 

Frozen Fruit Recalls 

According to the CDC, an outbreak of hepatitis A infections was caused by frozen organic strawberries. The first of five cases was reported on November 24, 2022. 

The FDA also issued an announcement recalling various types of frozen fruit from Willamette Valley Fruit Co. The recall included Great Value sliced strawberries, mixed fruit, antioxidant blend, and Radar Farms' organic fresh start smoothie blend and organic berry trio. 

Based in Salem, OR, the company announced the recall on January 12, 2023, stating that the leading cause was potential hepatitis A contamination in strawberries grown in Mexico.  

On Friday, March 17, 2023, the FDA announced that Scenic Fruit Company has voluntarily recalled some frozen fruit sold at Aldi, Trader Joe’s, and Costco. This announcement was just one day behind a recall notice issued by California Splendor, another manufacturer of frozen fruit, for the same reason. 

On June 12, 2023, the FDA announced that Willamette Valley Fruit Co recalled multiple kinds of frozen fruit. The company recalled the Great Value sliced strawberries, mixed fruit, and antioxidant blend. Additional recalls included Radar Farms’ organic fresh start smoothie blend and organic berry trio. 

Later in the month, the Scenic Fruit Company issued a voluntary recall on frozen pineapple and fruit blends, including frozen pineapple, due to potential contamination with L. monocytogenes. This recall adds to the FDA’s growing list of frozen fruit recalls that previously contained strawberries. 

Salad Recalls 

On April 4, 2023, Revolution Farms in Caledonia, Michigan, issued a voluntary recall on multiple salads and raw greens packaged between March 3, 2023, and March 11, 2023. According to the recall notice, the Michigan Department of Agriculture and Rural Development identified L. monocytogenes during a random sample text. The products were sold in Michigan, Ohio, Indiana, Illinois, Kentucky, and Wisconsin. 

Two days later, on April 6, 2023, Revolution Farms expanded the recall in an updated notice published by the FDA. The update added food service products to the recall, noting that many 3 lb bulk bags of greens may also be contaminated. 

Infant Formula Recalls 

In May 2022, a baby formula shortage surged nationwide, with about 31% of stores running out of stock. Abbott Laboratories, responsible for 43% of domestic production, recalled powdered infant formulas due to illnesses and deaths linked to C. sakazakii.  

Then, in February 2023, Reckitt voluntarily recalled over 140,000 cans of its Enfamil 12.9 oz ProSobee Simply Plant-Based Infant Formula due to potential contamination with C. sakazakii.  

Causes of Contamination 

Food can become contaminated with foodborne pathogens through various sources and mechanisms: 

• Raw ingredients: Foodborne pathogens can be present in raw ingredients such as meat, poultry, seafood, fruits, and vegetables. If these ingredients are contaminated at their source, the pathogens can be introduced into the food production process. 
• Cross-contamination: This occurs when pathogens from one food item are transferred to another. For example, if a cutting board used for raw meat is not adequately cleaned before cutting vegetables, the pathogens can be transferred from the meat to the vegetables. 
• Poor hygiene practices: Contamination can occur when food handlers, such as chefs or kitchen staff, do not follow proper hygiene practices. This includes inadequate handwashing, not wearing gloves when necessary, or working while sick. 
• Improper storage temperatures: Foodborne pathogens can multiply rapidly in the temperature danger zone, which is between 40°F (4°C) and 140°F (60°C). If perishable foods are not stored at proper temperatures, it can lead to bacterial growth and contamination. 
• Improper cooking: Insufficient cooking temperatures or cooking times may not kill pathogens in the food. Consuming undercooked or raw food can lead to foodborne illness. 
• Contaminated water: Water used in food preparation and irrigation can carry pathogens. If contaminated water comes into contact with food, it can result in contamination. 
• Poor sanitation: Inadequate cleaning and sanitation of food preparation surfaces, utensils, and equipment allow pathogens to persist and contaminate food. 
• Improper food processing: If food processing methods, such as canning or pasteurization, are not performed correctly, they can fail to eliminate or destroy pathogens in the food. 

Preventing contamination and ensuring food safety requires following proper food handling practices, maintaining hygienic conditions, following appropriate cooking and storage temperatures, and conducting regular inspections and testing to detect and prevent contamination. 

Because current US farm policies promote a centralized food system that heavily relies on imported food, fresh produce must travel long distances before reaching the end consumer — increasing the chances of contamination as food passes through multiple stages of transportation.  

Additionally, large-scale grain usage in cattle production, aimed at promoting rapid growth, can affect the acidity of their digestive systems and make them more susceptible to pathogenic strains of E. coli. Inadequate manure treatment practices and contaminated fields, water sources, or slaughtered livestock are often linked to outbreaks of foodborne pathogens.  

Each year in the US, these pathogens cause approximately 76 million illnesses, 325,000 hospitalizations, and 5,000 deaths. 

Preventative Action 

Healthcare professionals are uniquely positioned to address this public health concern by disseminating accurate information and best practices to patients and communities. By educating the public about safe food handling, proper cooking temperatures, and appropriate storage techniques, healthcare providers can help reduce the incidence of food poisoning. 

Recognizing the symptoms of foodborne illnesses is vital for early detection and appropriate treatment. Common symptoms include nausea, vomiting, diarrhea, abdominal pain, fever, and in severe cases, dehydration or even organ failure. By promptly identifying these symptoms, healthcare professionals can initiate necessary interventions and prevent complications. 

Preventing food poisoning requires a comprehensive approach involving both individuals and regulatory bodies. Healthcare professionals should encourage patients to adopt safe food practices, as noted above. They should also advise individuals with compromised immune systems, pregnant patients, young children, and older adults to be especially cautious due to their increased vulnerability to foodborne pathogens. 

In addition to personal preventive measures, healthcare professionals should advocate for and support robust food safety regulations and policies. Collaboration with local health departments, food producers, and regulatory agencies can help ensure that foodborne outbreaks are swiftly identified, investigated, and contained. 

Effective communication is critical to reaching a broader audience. Healthcare professionals should leverage various platforms, such as public health campaigns, social media, and community events, to disseminate educational materials and raise awareness about food safety practices. Empowering the public through knowledge equips them to make informed decisions about food choices and handling, reducing the risk of food poisoning. 

Furthermore, healthcare providers should stay informed about emerging foodborne pathogens and outbreaks. By staying updated on current research, clinical guidelines, and public health advisories, they can provide accurate information and appropriate treatment to their patients. 

Food poisoning is a preventable public health concern that requires a collective effort. Healthcare professionals have a significant role to play in educating and empowering the public to prevent, recognize, and manage cases of foodborne illnesses.