This article was medically reviewed by Dr. Francisco De Jesus.
The holidays are a time for family gatherings, preparing food, and enjoying festive meals together. But with those activities comes the risk of foodborne illnesses that can cause severe and even life-threatening conditions if safety measures are not taken. Knowing how to prevent a foodborne illness outbreak is covered in this article — “A Guide to Holiday Food Safety” — with helpful tips from Dr. Francisco De Jesus, an infectious disease doctor at ID Care.
It is important to know that a foodborne illness is an infection caused by the consumption of food or drinks contaminated by a disease-causing pathogen. Such pathogens, which can be viral, bacterial, or parasitic, can cause symptoms including nausea, vomiting, and diarrhea.
To ensure holiday food safety, you need to understand that a foodborne illness outbreak occurs when:
- Meat and fish are not cooked to recommended temperatures.
- Perishable foods are left unrefrigerated for too long.
- Raw fruits and vegetables are contaminated by raw meat during the preparation process.
- Unpasteurized milk and/or eggs are used in dishes served uncooked.
- Cooks fail to frequently wash hands, countertops, cutting boards, and utensils in hot, soapy water.
Identifying the Leading Causes of Foodborne Illness
The biggest causes of foodborne illness involve consuming food or beverages contaminated by bacteria, viruses, and/or parasites, which can be acquired through drinking water, contact with animals or their environment, or person-to-person spread. For instance, a cook who has nausea and vomiting due to an infection and doesn’t engage in proper hand washing can pass an illness through prepared food. That’s why food safety tips for the holiday season focus around avoiding or eradicating such pathogens.
The most common infectious germs that can live in food include the bacteria campylobacteriosis, cryptosporidiosis, giardiasis, listeriosis, and salmonella, as well as two viruses, norovirus and hepatitis A.
Are Food Poisoning and Foodborne Illness the Same?
Although the terms are often used interchangeably, there is a difference between foodborne illness and food poisoning. Foodborne illness occurs when infection arises from food contaminated with live microorganisms or their toxins, while food poisoning is the result of eating preformed toxins, such as Clostridium botulinum, which causes botulism, Dr. De Jesus said.
“Pathogens can be introduced into food at any point from farm-to-table and crop up in any setting, from home to restaurants and cruise ships or while traveling abroad, and that’s why safety precautions are crucial when preparing and serving dishes to guests,” Dr. De Jesus said. “Consulting a guide to holiday food safety can be helpful in serving food safely and to avoid an infectious disease.”
Top Tips for Preparing Food Safely
When it comes to meal preparation, the following holiday food safety tips can help everyone stay healthy:
- Wash your hands. Cooks should wash their hands often: before and after eating and after handling pets or their food, using the bathroom, changing diapers, or taking out the garbage. Kitchen surfaces should also be washed and sterilized often.
“Wash your hands for 20 seconds with soap and water before, during, and after preparing food, and before eating,” says Dr. De Jesus.
- Wash surfaces. Dr. De Jesus recommends that cooks regularly wash their utensils, cutting boards, and countertops with hot, soapy water. They should also rinse fresh fruits and vegetables thoroughly under running water.
- Separate food items. Raw meats, poultry, seafood, and eggs can spread germs, so they should always be kept separate from foods that are ready to eat. In fact, cooks should assign raw meat and poultry their own cutting boards and preparation areas, Dr. De Jesus advises. The same rules about separation apply even during grocery shopping and storage of ingredients prior to food preparation.
- Be mindful of food temperatures. An important holiday food safety tip that many people aren’t aware of is that frozen food is most safely thawed in the refrigerator, cold water (which should be changed every 30 minutes), or the microwave. “You should never thaw food on the counter, because bacteria tend to multiply quickly there and can reach any food that is nearby,” Dr. De Jesus said.
When items are ready to cook, he advises, always make sure they reach their ideal final temperature using a food thermometer, as it’s impossible tell if food is safely cooked simply by its color or texture.
Likewise, food that isn’t going to be served immediately should be refrigerated. “There’s something called the danger zone in perishable food, which is when conditions are right for bacteria to grow: between 40 degrees and 140 degrees Fahrenheit,” Dr. De Jesus said. “As a result, a guide to holiday food safety is to never leave perishable foods unrefrigerated for more than two hours, or one hour if your room or car temperature is above 90 degrees. To further avoid hitting that danger zone, keep your refrigerator at 40 degrees Fahrenheit or below and your freezer at a maximum of 0 degrees Fahrenheit, and know when to throw food out.”
- Be vigilant with holiday leftovers. An important food safety tip for the holiday season is that it’s safe to freeze or eat leftovers if they have been refrigerated within two hours of being put on the table for guests, and then are reheated to adequate temperatures.
Which Foods Are Most Likely to Cause Foodborne Illness?
Although many foods can transmit illnesses if they are handled improperly, certain favorites are mentioned in this guide to holiday food safety because they are often at the center of foodborne illness outbreaks. According to Dr. De Jesus, these include:
- Salads and sliced fruit. “Any food touched by a person who is ill and vomiting or has diarrhea can become contaminated, and when these foods items are not subsequently cooked, they can pass the illness to other people,” Dr. De Jesus said. “Another source of illness from fresh fruits and vegetables is cross-contamination from utensils used in the preparation of meat without being properly washed.
- Raw milk and soft cheeses. “Unpasteurized milk and other raw milk products, including soft cheeses such as queso fresco, brie and camembert, ice cream, and yogurt can harbor harmful germs such as E. coli, salmonella, and campylobacter,” Dr. De Jesus said. “When pasteurized, these products usually sustain enough heat, for just long enough, to kill these germs.”
- Raw eggs. Even if they look clean, but especially if they are cracked, raw eggs can contain salmonella. “There are a lot of holiday dishes that contain raw eggs, including eggnog, tiramisu, and Caesar dressing,” Dr. De Jesus said. “If you’re going to go this route, a good food safety tip for the holiday season is to consider using pasteurized eggs.”
- Meats, including chicken, beef, pork, and turkey. “Most raw poultry contain campylobacter, and you may also see salmonella associated with chicken,” Dr. De Jesus said, adding that “Yersinia can live in raw or undercooked meats, and canned meat can harbor Clostridium perfringens and other bacteria.”
- Seafood and raw fish. “Raw or cooked oysters can contain the bacteria Vibrio, which can lead to a pretty severe infection, especially if you have liver conditions,” Dr. De Jesus said. “In addition, ceviche, sushi, and sashimi can contain bacteria or viruses that can cause foodborne illnesses.”
- Raw cookie dough. Children often clamor for raw cookie batter, but no one should eat it because it can contain germs like E. coli and salmonella. “Some companies have edible cookie dough made with heat-treated flour and pasteurized eggs or no eggs,” Dr. De Jesus said. “If you want to taste the dough, see if you can find those.”
Holiday Tips for COVID Food Safety
Can the COVID virus live on food? Fortunately, there is no evidence to suggest that handling or eating food is associated with the spread of COVID-19. However, those hosting holiday gatherings can help prevent other methods of spread — for instance, guests sharing utensils or standing too close together around food tables without masks. To help you accomplish this, Dr. De Jesus offers a quick COVID-19-related guide to holiday food safety.
He recommends discouraging congregation by limiting the food or beverage service in areas where people are most likely to gather; cleaning and disinfecting frequently touched surfaces; and promoting social distancing around buffet tables by providing physical guides, such as tape on the floor or signs on the walls, to encourage guests to remain 6 feet apart. In addition, Dr. De Jesus suggests using gloves to wash dishes and utensils or providing disposable ones, as well as encouraging hand washing among guests for 20 seconds at a time both before and after eating.
What are the Most Common Symptoms of Foodborne Illness?
The symptoms of foodborne illnesses mainly affect the gastrointestinal tract and can range from mild to very serious. In rare cases, they can be deadly. The severity of this kind of illness can be dependent on its source and the person’s age and other health conditions, Dr. De Jesus said. Although some people may not experience all the possible signs of foodborne illness, the most common symptoms are:
- Nausea
- Vomiting
- Diarrhea
- Abdominal cramps
- Fever
- Dehydration
“You may want to see a healthcare provider, like the infectious disease doctors at ID Care, if you’re having bloody diarrhea, fever of 102 degrees or higher, or frequent vomiting that doesn’t let you keep liquids down. Other issues of concern would be signs of dehydration, such as little or no urination, dry mouth or throat, feeling dizzy when you stand up, or diarrhea that lasts more than three days, because this could lead to kidney problems that could affect you longer-term,” Dr. De Jesus said.
Who is at the Highest Risk for Foodborne Illnesses?
The U.S. Food and Drug Administration estimates that about 48 million people per year are sickened by foodborne illnesses, with about 128,000 of them needing hospitalization and about 3,000 dying. But who among us is the most susceptible? No guide to holiday food safety would be complete without a discussion of the individuals who face the highest risk of contracting foodborne illnesses:
- People over age 65: As people age, their immune systems and organs work less efficiently to get rid of harmful germs. “Half the people over 65 who have a foodborne illness such as salmonella, campylobacter, listeria, or E. coli end up hospitalized for treatment,” states Dr. De Jesus.
- Children under age 5: “Because their immune systems are still developing,” Dr. De Jesus said, “children under age 5 can’t fight germs as well, and if they contract a foodborne illness, it can be rather dangerous because the symptoms can lead to dehydration. Children in this age group are three times more likely to be hospitalized if they get these illnesses, and they can actually have kidney failure when they contract infections such as E. coli.”
- People with weakened immune systems: “Whether living with diabetes, liver or kidney disease, alcoholism, HIV, or chemotherapy or radiation treatment, people with these conditions simply can’t make an effective defense against germs or sickness,” Dr. De Jesus said. “For individuals on dialysis, the risk of contracting a listeria infection is heightened by about 50 times compared with the average American.”
- Pregnant women: Specific foodborne germs are particularly dangerous to pregnant women. “The one you often hear about is listeria infection, so these women may want to limit their consumption of soft cheeses, deli meats, and hotdogs, in which this pathogen has been known to linger,” Dr. De Jesus said.
How Does ID Care Diagnose and Treat Foodborne Illnesses?
ID Care doctors investigate possible foodborne illnesses by getting a health history from patients, conducting a physical examination, and testing stool or blood for certain bacteria, viruses, and parasites.
Infectious disease doctors typically recommend supportive care for foodborne illnesses, such as keeping hydrated and controlling fever. However, some organisms and parasites require antibiotics, and in the case of hepatitis A, vaccination is needed.
Often, ID Care’s patients are referred by other doctors who are finding a diagnosis challenging. “Sometimes the culprit is not the typical bacteria or virus but instead something picked up during recent international travel,” Dr. De Jesus said. “On the other hand, sometimes gastroenterologists refer to us simply to make sure that their patients are adequately treated with antiparasitic or antimicrobial medications when needed.”
Infectious disease doctors are the specialists best prepared to help you through a bout with foodborne illness during the holidays or at any time. In addition to diagnosing and treating these infectious diseases, ID Care experts teach patients how to prevent recurrences, as they have in this guide to holiday food safety. Through this advice, you can prevent foodborne illness by following their expert tips.
To schedule an appointment with an ID Care infectious disease expert today, call 908-281-0610 or visit idcare.com.