Foodborne Illness Outbreaks: Determining Their Cause and Effects on Consumer Health
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By Dr. Sheri Hernandez
Program Director, Hospitality Management, American Public University
Most of us have experienced it. A few hours after eating at a restaurant, your stomach starts protesting and griping about whatever it was that you put in it. You spend the next day or two mostly in the bathroom, fighting off a terrible gastrointestinal reaction.
Most likely, your symptoms involve nausea, vomiting and diarrhea. You may even blame it on that recent restaurant meal, thinking, “I must have had a bad serving of eggs, salad, fish, turkey, etc.”
Foodborne Illnesses Aren’t Always a Restaurant’s Fault
It is human nature to automatically blame your suffering on whatever you ate last. Maybe you’ll tell your friends and family to avoid the restaurant that obviously poisoned you. But be careful! You probably should not blame the restaurant so quickly. Here’s why:
Most foodborne illnesses take well over an hour after consumption to trigger symptoms. If your symptoms include diarrhea, it’s safe to assume they are NOT caused by something you just ate. Instead, the cause may be from a meal you consumed earlier or even a couple of days previously.
According to the FDA, the only foodborne illness with very sudden onset of symptoms (one to six hours) is staphylococcal food poisoning. This type of food poisoning is caused by the bacteria staphylococcus aureus, commonly found in meat, potatoes and egg salads, as well as in cream-filled pastries that were improperly refrigerated.
The onset for some of the more commonly known illnesses is six to 48 hours for salmonellosis and 24 to 72 hours for E. coli infection.
Human Behavior Complicates Investigation of Foodborne Illnesses
Some people do not understand how difficult it is trace the source for a foodborne illness. In general, victims are not much help.
Despite being aware of when the symptoms began, it is human nature to blame whatever and wherever you just ate. That practice is not always fair and can permanently damage a restaurant’s reputation or even lead to a lawsuit by the establishment against the accuser who became ill. The last thing most people will think of is that something they prepared or their own poor hygiene may have caused their illness.
Restaurant Warnings Often Appear in Social Media and Websites
In addition to people posting warnings about “bad restaurants” on their personal social media accounts, there are websites where people can post warnings about specific restaurants. Some sites list restaurants by name and address, and users blame these restaurants for their illnesses without necessarily having proof. Several sites list specific restaurants and meals, including symptoms of diarrhea within an hour or two of eating, and as was stated earlier, these symptoms would not develop that quickly.
Submitted posts are reportedly reviewed and blatantly false accounts are not posted. Several of these sites claim they report back to restaurants and governmental authorities to help identify “clusters” of foodborne illnesses. Such reporting can aid in tracing the cause of those illnesses.
In fact, what you SHOULD do if you suspect you have food poisoning is to call your doctor and if you truly suspect it came from a particular food or restaurant, contact your local health department so as not to delay the investigation process and save others from the same fate.
Quickly Tracing Serious Foodborne Illness Outbreaks Is Difficult and Complicated
Most people will suffer through a “belly bug,” and not head to the doctor for a diagnosis unless the illness becomes severe. That makes it difficult for health officials to quickly trace and stop the source of a foodborne illness outbreak.
Tracing the actual cause of an outbreak is a difficult and complicated process. The process does not start when one people reports an illness. It’s when several victims come forth and report their condition that investigators begin the process of finding the point of contamination and what may have caused the illness. Contamination can occur anywhere in the food supply chain.
Foods with Multiple Ingredients Affect Illness Traceability
Tracing the source of an illness becomes even more complicated when multiple ingredients are involved in several food items. Examples include tomatoes, onions and peppers used in in salsa, guacamole, salads and tacos.
In 2016, there was a widespread outbreak of illnesses caused by the bacteria salmonella. The outbreak affected 32 people in nine states.
The traceback investigation was complicated. The initial suspected source was tomatoes, the most common food that victims ate in the week before the onset of symptoms. Seventy-one percent of those affected reported having had tomatoes.
However, the other items that were commonly eaten were guacamole and jalapeno peppers. After conducting additional interviews across several states, officials concluded that with the combination of foods eaten by all who were affected, the common link was likely not tomatoes, but some type of pepper.
Investigators had to review recipes from several different restaurants, check invoices to find the sources of the ingredients and conduct multiple open-ended interviews with the victims. The complicated traceback investigation ultimately named one pepper supplier as the source of the contamination.
Victim interviews can be complicated too. Imagine yourself as one of the interviewees. Would you be able to list everything you ate last week, especially if you were sick enough to visit a doctor?
Produce will commonly be consolidated from several different growers or locations. As a result, tracking is not an easy process.
Adding to the investigation’s difficulty was the fact that the fresh peppers were technically called Anaheim peppers, a variety of hot pepper. However, most people were not familiar with that variety of pepper. If you are eating salsa or guacamole, it’s not likely you would know if you were eating jalapenos or some other variety of hot pepper.
Why Do Illness Investigations Take So Long?
If you ever wondered why it sometimes takes so long to find the source of a foodborne illness outbreak like the recent one associated with romaine lettuce, just think of the entire food chain involved from farm to fork, seed to stomach. Think about growing conditions on farms and how many hands and equipment that fresh produce comes into contact with.
Also, consider the different types of data needed to determine the source of an outbreak, such as epidemiologic, traceback, food and environmental data.
In addition, think about the likelihood that you would be able to remember a week’s worth of meals and their ingredients. Before you blast that restaurant on social media because you felt queasy soon after your shrimp dinner, consider what you ate over your last few meals.
Be sure to check a reliable source of information that might clue you in to whether or not you truly are a victim of a foodborne illness. Your illness may have a simpler cause, such as not washing your hands thoroughly before you dropped a slice of lemon into your tea last Tuesday.
About the Author
Sheri Hernandez has been the Hospitality Management Program Director for American Public University’s School of Business since 2012. She holds a bachelor’s degree in business administration and management from Kutztown University of Pennsylvania, a master of business administration degree from Lehigh University and a doctoral degree in education from Capella University.