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"It must have been something I ate!" How many times do people
say this following a bout with nausea, upset stomach, cramps,
diarrhea, or vomiting?
Indeed, these can be the symptoms of food poisoning--illness
caused by eating food on which harmful bacteria have grown. The
bacteria that cause food poisoning are difficult to detect by a
food's appearance, taste or smell. But they can cause illness
ranging from mild to very severe and even life-threatening. The
human body ordinarily is well-equipped to deal with these bacteria,
but individuals with weakened immune systems--such as those with
acquired immune deficiency syndrome (AIDS) and those infected with
the human immunodefiency virus (HIV)--can be far greater risk of
serious illness. Because of their weakened immune systems, these
individuals are more susceptible to contracting a foodborne
illness. Once contracted, these infections, with their severe
vomiting and diarrhea, can be difficult to treat and they can come
back again and again. This can further weaken the immune system and
hasten the progression of HIV infection and be fatal for person
with AIDS.
Since most foodborne illnesses result from improper handling
of food, person with AIDS or HIV infection can help themselves by
following basic food safety guidelines. Applying these guidelines
when buying, preparing and storing food, along with having a basic
knowledge of the most common harmful bacteria and the foods on
which they are found or can grow, can allow persons with AIDS to
eat defensively while choosing a nutritious diet.
People cannot get AIDS from food. The food safety advice in
this brochure is intended to help persons with HIV infection to
reduce the risk of food poisoning, thereby avoiding an illness that
could worsen their condition or even cause death. While many kinds
of bacteria can cause food poisoning, three are the most prevalent
threat to persons with AIDS and HIV infections. These are:
Campylobacter, Listeria and Salmonella.
The symptoms of Campylobacter infection (campylobacteriosis)
include acute abdominal pain, diarrhea (which can be watery and
contain blood), nausea, headache, muscle pain, and fever. Symptoms
can begin 2 to 5 days after eating contaminated food and generally
lasts 7 to 10 days. Campylobacter bacteria are most commonly found
in raw or undercooked poultry, unpasteurized milk, and
non-chlorinated water.
Listeriosis, the disease caused by Listeria, is characterized
by flu-like symptoms of chills, fever and headache, sometimes
accompanied by nausea and vomiting. These early symptoms can appear
2 to 30 days after exposure and can be followed by bacteremia (a
bloodstream infection), meningitis (an inflammation of the
membranes covering the spinal cord and brain), or encephalitis (an
inflammation of the membranes of the brain itself). Foods found to
contain Listeria are unpasteurized milk and cheeses, raw or
undercooked meat, poultry, and fish.
Salmonellosis is the illness that can develop from eating
foods containing Salmonella bacteria. It is characterized by flu-like
symptoms, possibly accompanied by nausea, vomiting, abdominal
cramps, and diarrhea. Symptoms can develop 6 to 48 hours after
exposure and last up to a week. Foods most often associated with
salmonellosis include raw or undercooked meat, poultry, fish, and
eggs.
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For persons with AIDS, it is especially important to read food
labels to select foods that pose the least risk of food poisoning.
For example, all milk and cheese products should have the word
"pasteurized" on the label. Products that contain any raw or
undercooked meat or dairy products should be avoided, as well as
products with a "sell by" or "best used by" date that has passed.
It is a good idea to put packaged meat, poultry or fish into
plastic bag before placing it in the shopping cart. This prevents
drippings from coming in contact with other foods and thus reduces
the risks of cross-contamination--bacteria from one food
contaminating another food.
The sale of food products with damaged packaging, the unsafe
displaying of products (such as cooked shrimp on the same bed of
ice as raw seafood), workers with poor personal hygiene, and
unsanitary store conditions can add to the risk of foodborne
illness. Not only should consumers avoid purchasing food products
sold under such conditions, but the conditions should be reported
to local health authorities.
After shopping, get chilled and frozen foods into refrigerator
or freezer as soon as possible. Storing them in a warm car or
office or even just carrying them around for a couple of hours can
raise the foods' temperature enough to allow bacteria to grow.
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Most cases of food poisoning are caused by improper food
handling or preparation in the home. Keeping shelves, counter tops,
refrigerators, freezers, utensils, sponges, and towels clean is one
of the best ways to prevent bacterial contamination of food at
home. It is especially important to wash all utensils and your
hands with soap and hot water after handling one food and before
handling another. This helps prevent cross-contamination in which,
for example bacteria in raw meat could be transferred to other
foods, such as salads or vegetables. For the same reason, wooden
cutting boards should not be used for cutting raw meat, poultry or
fish. Plastic boards are easier to clean and sanitize. Fresh fruits
and vegetables should be thoroughly washed with water and
refrigerated to reduce spoilage. the temperature in a refrigerator
should be maintained at or below 40 deg F and food should be stored in
covered containers.
Properly cooking food is another important guard against food
poisoning. Heat kills bacteria. Most cookbooks give appropriate
cooking times and temperature for different foods. A meat
thermometer should be used to ensure complete cooking. Cook red
meat until it is well done and poultry until the juices run clear.
Thoroughly reheat leftovers (165 deg F).
Never eat raw eggs or foods that contain them. Pasteurized
eggs should be used in place of shell eggs when making homemade ice
cream, eggnog and mayonnaise. If you can't obtain pasteurized eggs,
then you must omit the egg ingredient when making homemade ice
cream. When cooking eggs, make sure that the yolk and white are
firm, not runny. Here are cooking times and temperatures:
Microwave cooking requires special precautions. Most microwave
recipes include a "standing time" after the cooking period to
ensure that a proper temperature is reached throughout the food.
Also, many microwave dishes must be removed from the oven and
stirred from time to time-again, ensuring thorough cooking. It is
particularly important to heat pre-cooked foods or leftovers
thoroughly, whether in a microwave or conventional oven.
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Restaurants, like grocery stores, are required to follow
sanitation guideline established by state and local health
departments to ensure cleanliness and good hygiene. Persons with
AIDS need to avoid the same foods in restaurants that they would at
home. Always order food well-done; if it served medium to rare,
send it back. A good way to determine doneness is to cut into the
center of a steak, hamburger, or other piece of meat. If it is the
least bit pink or bloody, it needs more cooking. Fish should be
flaky, not rubbery, when cut.
Order fried eggs cooked on both sides instead of sunny side
up, and avoid scrambled eggs that look runny. Caesar salad should
also be avoided since it contains raw eggs. If unsure about the
ingredients in a particular dish, ask before ordering.
Raw seafood poses a serious risk of food poisoning for persons
with AIDS. Raw shellfish, like raw meat and poultry, should be
assumed to harbor harmful bacteria. Oysters on the half shell, raw
clams, sushi and sashimi should not be eaten. Lightly steamed
seafood, such as mussels and snails, should be avoided.
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Not all countries have the same high standards of hygiene and
sanitation as the United States, so persons with AIDS should take
additional precautions when traveling abroad.
Boil all water before drinking. Drink only beverages made with
boiled water or canned or carbonated bottled drinks. Ice, too,
should be made only from boiled water. Avoid uncooked vegetables
and salads. All fruit should be peeled. Eat cooked foods while they
are still hot.
A good rule of thumb is "Boil it, cook it, peel it, or forget
it."
While food poisoning can usually be treated with rest and
plenty fluids until solid food can be eaten again, persons with
AIDS or HIV infection may experience prolonged and more serious
symptoms requiring a doctor's care.
If a consumer or doctor believes that an attack of food
poisoning was related to a particular food or restaurant, the local
health department or the Food and Drug Administration should be
contacted. Reporting the incident to health officials can help
others avoid serious illness. The telephone number for FDA's
Emergency Operations Branch is 301-443-1240 (this number is staffed
24 hours a day).
These food safety guidelines for persons with AIDS and HIV
infection are no different than those recommended for anyone. But,
in the case of persons with AIDS or HIV infection, contaminated
food can have more serious consequences.
There are other high-risk groups--such as cancer patients,
diabetics, transplant recipients, infants, pregnant women, and the
elderly--who should also give special attention to those
guidelines. For individuals in these high-risk groups, maintaining
a nutritious diet is of great importance. Cooking and eating
defensively need not interfere with a nutritious diet. But not
being aware of the hazards and not taking appropriate steps to
reduce the risk food poisoning can be life-threatening.
Source: U. S. Food and Drug Administration
FDA Brochure: 1992
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Bacteria and Food Poisoning
Shopping for Food
Food Safety At Home
Eating Out
Traveling Abroad
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