Who Is at High Risk for Foodborne Illness

  • Pregnant women
  • Young children
  • Older adults
  • People with weakened immune systems or certain chronic illnesses

If you're at high risk, follow general advice for food safety and take extra precautions:

  • Do not eat or drink unpasteurized juice, raw sprouts, raw (unpasteurized) milk, and products made with unpasteurized milk.
  • Do not eat raw or undercooked meat, poultry, eggs (or foods made with them), fish, and shellfish (clams, oysters, scallops, and mussels).
  • Avoid soft cheeses such as feta, Brie, Camembert, blue-veined, and Mexican-style cheeses.
  • Eat only certain deli meats and frankfurters, reheated to steaming hot.

New information on food safety is constantly emerging. Recommendations and precautions for people at high risk are updated as scientists learn more about preventing foodborne illness. If you are among those at high risk, be aware of and follow the most current information on food safety. For the latest information and precautions, talk to your healthcare provider, check the government's food safety Web site (http://www.foodsafety.gov), or call the government information numbers listed in the Appendices. Source: Dietary Guidelines for Americans (2005).

If you or someone you know is at high risk and needs help with meals, find out about services such as home-delivered meals in your community. Check to be sure that the service follows food safety regulations. To find services in your community, see "To Find Food and Nutrition Services" in chapter 24.

death, especially in young children and the elderly.

To combat all strains of E. coli, cook and reheat meat thoroughly. Be especially careful of ground meat—for example, hamburgers—because bacteria on the surface of the meat get mixed into the center of the meat, which takes longer to cook. Keep cutting surfaces clean. Avoid cross-contamination of raw food, or transferring bacteria from one food to another with dirty utensils, cutting boards, plates, and hands. Raw milk and produce also may be sources.

Listeria monocytogenes can cause a less common but potentially fatal foodborne illness called listeriosis. Pregnant women, infants, older adults, and those with weakened immune systems are more susceptible. Listeria are part of your everyday surroundings, including places where food is processed. It can grow even under proper refrigeration.

Because Listeria is common in unpasteurized milk and in cheese made from unpasteurized milk, avoid unpasteurized milk products. Listeria also can be found in raw and undercooked meat, poultry, seafood, and eggs, and in produce. As with any packaged food product, follow the "keep refrigerated" advice on the label, the "use by" date on the package, and the reheating instructions.

To avoid Listeria, high-risk individuals are advised by the U.S. Food and Drug Administration to avoid soft cheeses (such as Brie, Camembert, feta, and Mexican-style cheeses); refrigerated pâtés and meat spreads; and smoked seafood (such as lox, jerky, or nova-style) that require refrigeration. When they haven't been reheated to a safe internal temperature, frankfurters and deli meat (except for very salty ham or hard salami) are considered very high risk for lis-teriosis.

Shigella, one source of bacterial diarrhea, is transmitted from improper handling of either food or water. It originates in the feces of infected humans and easily passes from one person to another through improper hand washing. Proper cooking eliminates it; uncooked food such as potato, tuna, or chicken salad is more likely the source.

Vibrio vulnificus, a bacterium in shellfish, especially in mollusks, can be fatal within two days of developing the condition. Symptoms include sudden chills, fever, nausea, vomiting, and stomach pain. Although this bacterium is destroyed in the intestinal tract or in the immune system of most healthy people, this form of foodborne illness can be very serious, even fatal for high-risk individuals. These bacteria multiply even during refrigeration. Thoroughly cooking shellfish destroys them.

Yersinia enterocolitica is most often found in contaminated raw or undercooked pork products (including chitterlings, or pork intestines). The most common symptoms: for young children, fever, abdominal pain, and diarrhea, often bloody, and for older children and adults, fever and abdominal pain that feels like appendicitis. Unpasteurized milk or untreated water also may transmit this bacterium. In most cases the body can handle a yersiniosis infection without antibiotics. As prevention, avoid eating raw or undercooked pork and unpasteurized dairy foods, wash hands well, avoid cross-contamination, and dispose of animal feces in a sanitary way. If you're making chitterlings, have someone else care for your children. For cooking pork, see "Safe Internal Temperatures" in this chapter.

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