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Tuesday, July 16, 2013
Dear Dr. Camardi:
We were the family who all got sick last year at my brother’s pool party when we were still in Roanoke.
Five of us landed in the emergency room so sick to our stomachs that it was horrible. Dad gave us a terrible fright. He was so sick from the vomiting and diarrhea that he passed out.
When we got to the hospital they said he had “no blood pressure” because he lost so much body fluid and that he was already “dry” being on a diuretic for his blood pressure. He stayed in the hospital for three days before they let him out.
When I saw you those times in the clinic with my father, you had to adjust all his medications a few times just to get him back in balance again. During one of the visits you said that it was probably either the mac-'n'-cheese or the slaw that did us in. And you made me think that it was probably the four-hour car trip with the food in the back seat that did it.
It took Dad about two weeks to get right again, and it took us a good week to get close to feeling better.
When you saw me, you gave me a sheet of paper about what to do with the food during the summer but I lost it. Would you be so kind as to talk about it again?
We have since moved to West Virginia, but we all still read your column on the Internet every month. Thanks for taking the time.
— Wheeling, W.Va.
Well, it is that time of year when it’s great to be outdoors enjoying the fresh air, sunshine (more about sunshine next month!) and those parties with family and friends.
But there is a lurking danger in those picnic baskets and homemade treats that with a little forethought and some precautions need not ruin our summer fun.
Sadly many of us have been victims of food poisoning of one form or the other, but the number of cases spikes during summer months because of lax hygiene and not adhering to food safety precautions.
Let’s stay ahead of the curve this year by going over some fundamental measures to protect our health. This is even more important in geriatric patients as food poisoning poses a deadlier risk to seniors.
The Centers for Disease Control and Prevention has estimated that as many as 1 in 5 people nationwide in any given year have been made sick by food, resulting in an average of some 50 million food-borne infections across all age ranges. This results in about 130,000 hospitalizations and some 3,000 deaths. These deaths tend to aggregate in the very young and the very old.
Many drugs seniors use to treat conditions such as blood pressure and diabetes tend to increase the risk of mortality and morbidity by the very nature of their medicinal action before also being hit by food poisoning.
This makes the onset of the disease insidious and, once it strikes, more debilitating. This results in more severe dehydration because of both the infection and the aforementioned drugs. Add to this the electrolyte imbalance that accompanies fluid loss, and one can begin to see the scope of the problem.
The symptoms typically start two to eight hours after eating contaminated food. We all seem to recall the nausea, vomiting, abdominal cramps, weakness, diarrhea, fever, chills and headache that tell us “the party’s over.” The good news is that with rest, fluids and a gentle diet, all this will pass in two to three days.
Food poisoning has many causes, but it all boils down to dirty hands and rotting food. Following these simple steps can make your life easier:
1. Before handling food or beverages of any kind, wash your hands.
2. Make sure cooking utensils, cutting boards and anything that comes in contact with what may be swallowed is first properly cleaned.
3. Don’t underestimate the risk of cross-contamination of raw meats, fish and poultry with raw foods such as carrot sticks and celery.
4. Don’t eat raw chicken, poultry or fish — period. Now what constitutes “raw”? It is a matter of temperature and time.
The only way to be sure about temperature is with a food thermometer. Refer to your cookbooks to find safe temperatures for different meats.
5. Leaving food on the table for more than two hours at room temperature or even one hour if the environment is higher than 90 degrees (such as certain areas of a car) will put you at risk. Use an abundance of caution with dairy products.
6. Thawing food at room temperature just gives organisms time to grow. Thaw food in the refrigerator or microwave to be safe.
7. Do not taste food to see if it has gone bad. If you have to do that, consider it bad, dispose of it and do a better job next time. I once had a patient who told me that all she had done was “take a little taste the egg salad to see if it was OK.” She was telling me her history from an ICU bed . The egg salad wasn’t OK.
8. Wash vegetables thoroughly.
9. When in doubt, throw it out.
Dr. Michael Camardi is a geriatrician at the Carilion Center for Healthy Aging and an assistant professor of medicine of the Virginia Tech Carilion School of Medicine. His column runs monthly in Extra.
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