Do you know if your waiter sings in the bathroom? Or if the lady who whipped up the icing on your cake wore false fingernails? When was the last time you microwaved your dishcloth, or put your cutting board in the dishwasher? Is your orange juice pasteurized? Do you know if the shallots you ate in the restaurant were properly washed? Was the chicken thoroughly cooked? Let me tell you, these are more important questions than whether you eat fresh or farmed salmon, whether there is acrylamide in your French fries, whether genetically modified foods should be labeled, or whether fruits and vegetables harbor traces of pesticides. Why? Because we are not talking about theoretical risks; we are talking about real ones. The kind that can land you in a hospital, and potentially even destroy your life. We are talking about what microbes can do.
They rule the world, you know. We may think that we are in charge, but we’re not. Microbes are. Without them, we would have no oxygen to breathe, no beer or wine to drink, no cheese or yogurt to eat. They help us digest our food, decompose our garbage, bake our bread, and synthesize our medications. And they also can make us sick. Very sick.
It often starts with a little tingling in the fingertips and toes. Then the sensation progresses up the arms and legs. Weakness sets in. Next comes paralysis and the inability to move anything except the eyelids. With luck, symptoms resolve within a couple of months. But a small percentage of patients die, and about 20 percent suffer permanent nerve damage. This is Guillain-Barré Syndrome (GBS)! And it can be caused by something as seemingly trivial as eating undercooked chicken.
Most cases of GBS occur after a bout with a bacterium or a virus. Somehow, the infection kicks the body’s immune system into overdrive, causing it to attack the protective sheathing (myelin) around the nerves that connect the brain and spinal cord to the rest of the body. Often the culprit is Campylobacter jejuni, the bacterium that probably causes more food-borne infections in North America than any other. Most infections are associated with eating undercooked poultry or unpasteurized dairy products and result in nausea, vomiting, fever, diarrhea, and abdominal pain—the usual unpleasant symptoms of gastroenteritis. But in roughly one in a thousand cases, Campylobacteriosis progresses to life-altering Guillain-Barré Syndrome. And that’s not all. Sometimes, just like Salmonella infections, Campylobacter can cause “reactive arthritis,” which may or may not resolve. Fortunately, thorough cooking readily destroys Campylobacter.
But how can we be sure that in a restaurant the poultry is thoroughly cooked, or that the cutting board used for poultry was adequately cleaned before slicing vegetables? There is not much we can do except rely on government inspectors to assure our safety. At home, though, we can do something. Statistics show that about a quarter of consumers do not clean their cutting boards after using them for chicken. Whether wood or plastic, they should either be washed in the dishwasher or cleaned with a dilute bleach solution. Washcloths are another problem. Microwaving a dry cloth for thirty seconds, or a wet one for three minutes, kills all bacteria.
Bacterial infections can sometimes come about in the most unusual fashion. Who would ever think that having breakfast with Mickey, Donald, and Pluto at Walt Disney World would send dozens of people to their physician with Salmonella infection? How could this happen at a theme park that prides itself on being squeaky clean? Well, it seems the plant where the unpasteurized orange juice served at the “character breakfast” was squeezed was not so squeaky clean. After the Salmonella outbreak was traced to the orange juice, inspection of the plant revealed cracks and holes in the ceilings and walls. And the toads that were found cavorting outside those walls turned out to be contaminated with Salmonella. They were likely responsible for the guests’ misery. Walt Disney World restaurants now serve only pasteurized orange juice.
Even producers who use only pasteurized products can run into trouble because total control over suppliers is virtually impossible. One of the largest outbreaks of Salmonella poisonings in North America was caused by ice cream made from pasteurized ingredients. It turned out that the trucking company that delivered the pasteurized ice-cream mix also hauled liquid unpasteurized eggs. Of course, the trucks were supposed to be completely sanitized between loads, but to save costs, it wasn’t always done. Salmonella from the eggs contaminated the mix and made thousands of people ill.
By contrast, the green onions served in a Mexican restaurant in Pennsylvania made only a few hundred people ill. This time, the contaminant was the hepatitis A virus. We can only guess at how the virus came to infect the onions, but given that it is usually transmitted via the fecal-oral route, there are some disturbing possibilities. Perhaps the irrigating water used on the Mexican farm where the onions originated was contaminated with manure, or maybe one of the farm workers handled the produce with dirty hands, or maybe a waiter didn’t wash his hands properly after answering nature’s call. It takes soap and effort to wash hands properly. The whole process should take as long as it takes to sing a couple of choruses of “Happy Birthday!”
And what about the fingernails? An outbreak of gastroenteritis that affected over 200 people in Georgia was traced to a colony of Norwalk-like virus growing under the false fingernails of an employee who had prepared icing for a cake. It seems even scrupulous washing doesn’t remove all the microbes under these appendages. Obviously, we can’t control every aspect of our food supply. But at home, at least, we can make sure that we keep our counters, cutting boards, and dishrags clean, that we thoroughly wash our vegetables and cook our chicken. And a couple of rousing choruses of “Happy Birthday,” while washing hands can help to ensure more happy birthdays in the future.