Foodborne Illness United States


Foodborne Illness United States get help at

Foodborne Illness United States

1. Read and construct 10 questions with Correct answers on food safety below

The questions and answers that you provide should be written in the correct “jeopardy” format-answers first and questions second. The purpose of the assignment is to demonstrate an understanding of the course content.

Foodborne Illness in the United States

When certain disease-causing bacteria, viruses or parasites contaminate food, they can cause foodborne illness. Another word for such a bacteria, virus, or parasite is “pathogen.” Foodborne illness, often called food poison- ing, is an illness that comes from a food you eat.

• The food supply in the United States is among the safest in the world— but it can still be a source of infection for all persons. Foodborne Illness United States

• According to the Centers for Disease Control and Prevention, 48 million persons get sick, 128,000 are hospitalized, and 3,000 die from foodborne infection and illness in the United States each year. Many of these people are children, older adults, or have weakened immune systems and may not be able to ght infection normally.

Since foodborne illness can be serious—or even fatal—it is important for you to know and practice safe food-handling behaviors to help reduce your risk of getting sick from contaminated food.


• Your gastrointestinal tract, when functioning properly, allows the foods and beverages you consume to be digested normally. Diabetes may damage the cells that create stomach acid and the nerves that help

Food Safety:

It’s Especially Important for You Foodborne Illness United States

As a person with diabetes, you are not alone—there are many people in the United States with this chronic disease. Diabetes can affect various organs and systems of your body, causing them not to function properly, and making you more susceptible to infection. For example:

• Your immune system, when functioning properly, readily ghts off harmful bacteria and other pathogens that cause infection. With diabetes, your immune system may not readily recognize harmful bacteria or other pathogens. This delay in the body’s natural response to foreign invasion places a person with diabetes at increased risk for infection.

your stomach and intestinal tract move the food throughout the intestinal tract. Because of this damage, your stomach may hold on to the food and beverages you consume for a longer period of time, allowing harmful bacteria and other pathogens to grow.

Additionally, your kidneys, which work to cleanse the body, may not be functioning properly and may hold on to harmful bacteria, toxins, and other pathogens. Foodborne Illness United States

A consequence of having diabetes is that it may
leave you more susceptible to developing infections—like those that can be brought on by disease-causing bacteria and other pathogens that cause foodborne illness. Should you contract a foodborne illness, you are more likely to have a lengthier illness, undergo hospitalization, or even die.

To avoid contracting a foodborne illness, you must be vigilant when handling, preparing, and consuming foods.

Make safe food handling a lifelong commitment to minimize your risk of foodborne illness. Be aware that as you age, your immunity to infection naturally is weakened.


Major Pathogens That Cause Foodborne Illness

Symptoms and Potential Impact

• Fever, headache, and muscle pain followed by diarrhea (sometimes bloody), abdominal pain, and nausea. Symptoms appear 2 to 5 days after eating and may last 2 to 10 days. May spread to the bloodstream and cause a life-threatening infection.

Symptoms and Potential Impact

• Watery diarrhea, dehydration, weight loss, stomach cramps or pain, fever, nausea, and vomiting; respiratory symptoms may also be present.

• Symptoms begin 7 to 10 days after becoming infected, and may last 2 to 14 days. In those with a weakened immune system, including people with diabetes, symptoms may subside and return over weeks to months.

Symptoms and Potential Impact Foodborne Illness United States

Associated Foods

• Untreated or contaminated water

• Unpasteurized (“raw”) milk

• Raw or undercooked meat, poultry, or shell sh

Associated Foods/Sources

• Swallowing contaminated water, including that from recreational sources, (e.g., a swimming pool or lake)

Eating uncooked or contaminated food

Placing a contaminated object in the mouth

Soil, food, water, and contaminated surfaces

Associated Foods/Sources

• Many outbreaks result from food left for long periods in steam tables or at room temperature and time and/or temperature abused foods.

• Meats, meat products, poultry, poultry products, and gravy

Associated Foods Foodborne Illness United States

• Improperly reheated hot dogs, luncheon meats, cold cuts, fermented or dry sausage,
and other deli-style meat and poultry

Unpasteurized (raw) milk and soft cheeses made with unpasteurized (raw) milk

Smoked seafood and salads made in the store such as ham salad, chicken salad, or seafood salads

Raw vegetables

• Onset of watery diarrhea and abdominal cramps within about 16 hours. The illness usually begins suddenly and lasts for 12 to 24 hours. In the elderly, symptoms may last 1 to 2 weeks.



Clostridium perfringens

• Complications and/or death occur only very rarely.

Listeria monocytogenes

Can grow slowly at refrigerator temperatures

Symptoms and Potential Impact Foodborne Illness United States

• Fever, chills, headache, backache, sometimes upset stomach, abdominal pain, and diarrhea. May take up to 2 months to become ill.

Gastrointestinal symptoms may appear within a few hours to 2 to 3 days, and disease may appear 2 to 6 weeks after ingestion. The duration is variable.

Those at-risk (including people with diabetes and others with weakened immune systems) may later develop more serious illness; death can result from this bacteria.

Can cause problems with pregnancy, including miscarriage, fetal death, or severe illness or death in newborns.


Associated Foods Foodborne Illness United States

• Undercooked beef, especially hamburger

Unpasteurized milk and juices, like “fresh” apple cider

Contaminated raw fruits and vegetables, and water

Person-to-person contact Associated Foods

• Shell sh and fecally- contaminated foods or water

• Ready-to-eat foods touched by infected food workers; for example, salads, sandwiches, ice, cookies, fruit

Associated Foods

• Raw or undercooked eggs, poultry, and meat

Unpasteurized (raw) milk or juice

Cheese and seafood

Fresh fruits and vegetables

Toxoplasma gondii

Associated Foods/Sources

• Accidentalcontactofcatfeces through touching hands to mouth after gardening, handling cats, cleaning cat’s litter box, or touching anything that has come in contact with cat feces. Foodborne Illness United States

• Raw or undercooked meat.

Vibrio vulni cus

Associated Foods

• Undercooked or raw seafood ( sh or shell sh)

Symptoms and Potential Impact

• Severe diarrhea that is often bloody, abdominal cramps, and vomiting. Usually little or no fever.

• Can begin 1 to 9 days after contaminated food is eaten and lasts about 2 to 9 days.

• Some, especially the very young, may
develop hemolytic-uremic syndrome (HUS), which can cause acute kidney failure, and can lead to permanent kidney damage or even death.

Symptoms and Potential Impact

• Nausea, vomiting, and stomach pain usually start between 24 and 48 hours, but cases can occur within 12 hours of exposure. Symptoms usually last 12 to 60 hours.

• Diarrhea is more prevalent in adults and vomiting is more prevalent in children.

Symptoms and Potential Impact Foodborne Illness United States

• Stomach pain, diarrhea (can be bloody), nausea, chills, fever, and/or headache usually appear 6 to 72 hours after eating; may last 4 to 7 days.

• In people with a weakened immune system, such as people with diabetes, the infection may be more severe and lead to serious complications including death.

Symptoms and Potential Impact

Escherichia coli O157:H7
One of several strains of E. coli that can cause human illness

Noroviruses (and other caliciviruses)

Salmonella (over 2,300 types)

• Flu-like illness that usually appears
10 to 13 days after eating, may last months. Those with a weakened immune system, including people with diabetes, may develop more serious illness.

• Can cause problems with pregnancy, including miscarriage and birth defects.

Symptoms and Potential Impact

• Diarrhea, stomach pain, and vomiting may appear within 4 hours to several days and last 2 to 8 days. May result in a blood infection. May result in death for those with a weakened immune system, including people with diabetes, cancer or liver disease.


Eating at Home: Foodborne Illness United States

Making Wise Food Choices

Some foods are more risky for you than others. In general, the foods that are most

likely to contain harmful bacteria or viruses fall into two categories:

• Uncooked fresh fruits and vegetables

• Some animal products, such as unpasteurized (raw) milk; soft cheeses made with raw milk; and raw or undercooked eggs, raw

meat, raw poultry, raw sh, raw shell sh and their juices; luncheon meats and deli-type salads (without

added preservatives) prepared on site in a deli-type establishment.

. . . about Particular Foods:


If you are not sure about the safety of a food in your refrigerator, don’t take therisk.

Interestingly, the risk these foods may actually pose depends on the origin

or source of the food and how the food is processed, stored, and prepared. Follow these guidelines (see chart at right) for safe selection and preparation of your favorite foods.

If You Have Questions . . .
. . . about Wise Food Choices:

Be sure to consult with your doctor or health care provider. He or she can answer any speci c questions or help you in your choices.

When in doubt, throw it out!

Wise choices in your food selections are important. Foodborne Illness United States

All consumers need to follow the Four Basic Steps to Food Safety:
Clean, Separate, Cook, and Chill.

Check your steps at











Common Foods: Select the Lower Risk Options

Type of Food Higher Risk Lower Risk

Meat and • Raw or undercooked • Meat or poultry cooked to a


meat or poultry safe minimum internal tem- perature (see chart on p. 10) Foodborne Illness United States

Tip: Use a food thermometer to check the internal temperature on the “Is It Done Yet?” chart on page 10 for speci c safe minimum internal temperature.


• Any raw or undercooked sh, or shell sh, or food containing raw or undercooked seafood e.g., sashimi, found in some sushi or ceviche. Refrigerated smoked sh

• Partially cooked seafood, such as shrimp and crab

• Previously cooked seafood heated to 165 °F

• Canned sh and seafood • Seafood cooked to 145 °F


• Unpasteurized (raw) milk

• Pasteurized milk

Eggs Foods that contain raw/undercooked eggs, such as:

At home:

• Homemade Caesar salad dressings* • Homemade raw cookie dough*
• Homemade eggnog*

• Use pasteurized eggs/egg products when preparing recipes that call for raw or undercooked eggs Foodborne Illness United States

When eating out:

• Ask if pasteurized eggs were used

*Tip: Most pre-made foods from grocery stores, such as Caesar dressing, pre-made cookie dough, or packaged eggnog are made with pasteurized eggs.


• Raw sprouts (alfalfa, bean, or any other sprout)

• Cooked sprouts


• Unwashed fresh vegetables, including lettuce/salads

• Washed fresh vegetables, including salads

• Cooked vegetables


• Soft cheeses made from unpasteurized (raw) milk, such as: — Feta
— Brie
— Camembert
— Blue-veined
— Queso fresco

• Hard cheeses
• Processed cheeses
• Cream cheese
• Mozzarella
• Soft cheeses that are

clearly labeled “made from pasteurized milk” Foodborne Illness United States

Hot Dogs and • Hot dogs, deli meats, and

• Hot dogs, luncheon meats, and deli meats reheated to steaming hot or 165 °F

Tip: You need to reheat hot dogs, deli meats, and luncheon meats before eating them because the bacteria Listeria monocytogenes grows at refrigerated temperatures (40 °F or below). This bacteria may cause cause severe illness, hospitalization, or even death. Reheating these foods until they are steaming hot ho destroys these dangerous bacteria and makes these foods safe for you to eat.

Deli Meats

luncheon meats that have not been reheated


• Unpasteurized, refrigerated pâtés or meat spreads

• Canned or shelf-stable pâtés or meat spreads


Taking Care:

Handling and Preparing Food Safely

Foodborne pathogens are sneaky. Food that appears completely ne can contain pathogens—disease-causing bacteria, viruses, or parasites—that can make you sick. You should never taste a food to determine if it is safe to eat.

As a person with diabetes, it is especially important that you—or those preparing

your food—are always careful with food handling and preparation. The easiest way to do this is to Check Your Steps – clean, separate, cook, and chill – from the Food

Safe Families Campaign.

Four Basic Steps to Food Safety 1. Clean: Wash hands and surfaces often

Bacteria can spread throughout the kitchen and get onto cutting boards, utensils, counter tops, and food.

To ensure that your hands and surfaces are clean, be sure to: Foodborne Illness United States

Wash hands in warm soapy water for at least 20 seconds before and after handling food and after using the bathroom, changing diapers, or handling pets.

Wash cutting boards, dishes, utensils, and counter tops with hot soapy water be- tween the preparation of raw meat, poultry, and seafood products and preparation of any other food that will not be cooked. As an added precaution, sanitize cut- ting boards and countertops by rinsing them in a solution made of one tablespoon of unscented liquid chlorine bleach per gallon of water, or, as an alternative, you may run the plastic board through the wash cycle in your automatic dishwasher.

Use paper towels to clean up kitchen surfaces. If using cloth
towels, you should wash them often in the hot cycle of the washing machine.

Wash produce. Rinse fruits and vegetables, and rub rm-skin fruits and vegetables under running tap water, including those with skins and rinds that are not eaten.

With canned goods: remember to clean lids before opening.


2. Separate: Don’t cross-contaminate

Cross-contamination occurs when bacteria are spread from one food product to another. This is especially common when handling raw meat, poultry, seafood, and eggs. The key is to keep these foods—and their juices—away from ready-to-eat foods.

To prevent cross-contamination, remember to: Foodborne Illness United States

• Separate raw meat, poultry, seafood, and eggs from other foods in your grocery shopping cart, grocery bags, and in your refrigerator.

• Never place cooked food on a plate that previously held raw meat,
poultry, seafood, or eggs without rst washing the plate with hot soapy water.

• Don’t reuse marinades used on raw foods unless you bring them to a boil rst.

• Consider using one cutting board only for raw foods and another only for ready-to-eat foods, such as bread, fresh fruits and vegetables, and cooked meat.

3. Cook: Cook to safe temperatures

Foods are safely cooked when they are heated to the USDA-FDA recommended safe minimum internal temperatures, as shown on the “Is It Done Yet?” chart (see next page).

To ensure that your foods are cooked safely, always:

• Use a food thermometer to measure the internal temperature of cooked foods. Check the internal temperature in several places to make sure that the meat, poul- try, seafood, or egg product is cooked to safe minimum internal temperatures.

Cook ground beef to at least 160 °F and ground poultry to a safe minimum internal temperature of 165 °F. Color of food is not a reliable indicator of safety or doneness.

Reheat fully cooked hams packaged at a USDA-inspected plant to 140 °F. For fully cooked ham that has been repackaged in any other location or for leftover fully cooked ham, heat to 165 °F.

Cook seafood to 145 °F. Cook shrimp, lobster, and crab until they turn red and the esh is pearly opaque. Cook clams, mussels, and oysters until the shells open. If the shells do not open, do not eat the seafood inside. Foodborne Illness United States

Cook eggs until the yolks and whites are rm. Use only recipes in which the eggs are cooked or heated to 160 °F.

Cook all raw beef, lamb, pork, and veal steaks, roasts, and chops to 145 °F with a 3-minute rest time after removal from the heat source.


3. Cook: Cook to safe temperatures (cont.)

Bring sauces, soups, and gravy to a boil when reheating. Heat other leftovers to 165 °F.

Reheat hotdogs, luncheon meats, bologna, and other deli meats until steam- ing hot or 165 °F.

When cooking in a microwave oven, cover food, stir, and rotate for even cooking. If there is no turntable, rotate the dish by hand once or twice during cooking. Always allow standing time, which completes the cooking, before checking the internal temperature with a food thermometer. Food is done when it reaches the USDA-FDA recommended safe minimum internal temperature.

Is It Done Yet?

Use a food thermometer to be most accurate. You can’t always tell by looking.

4. Chill: Refrigerate promptly

Cold temperatures slow the growth of harmful bacteria. Keeping a constant refrigerator temperature of 40 °F or below is one of the most effective ways to reduce risk of foodborne illness. Use an appliance thermometer to be sure the refrigerator temperature is consistently 40 °F or below and the freezer temperature is 0 °F or below.

To chill foods properly: Foodborne Illness United States

• Refrigerate or freeze meat, poultry, eggs, seafood, and other perishables within 2 hours of cooking or purchasing. Refrigerate within 1 hour if the temperature outside is above 90 °F.

Never thaw food at room temperature, such as on the counter top. It is safe to thaw food in the refrigerator, in cold water, or in the microwave. If you thaw food in cold water or in the microwave, you should cook it immediately.

Divide large amounts of food into shallow containers for quicker cooling in the refrigerator.

Follow the recommendations in the abridged USDA-FDA Cold Storage Chart (see page 11). The USDA-FDA Cold Storage Chart in its entirety may be found at

USDA-FDA Recommended Safe Minimum Internal Temperatures

Beef, Pork, Veal, Lamb Steaks, Roasts & Chops 145 °F with 3-minute

rest time


145 °F

Beef, Pork, Veal, Lamb Ground

160 °F

Egg Dishes

160 °F

Turkey, Chicken & Duck Whole, Pieces & Ground Foodborne Illness United States

165 °F


USDA-FDA Cold Storage Chart

These time limit guidelines will help keep refrigerated food safe to eat. Because freezing keeps food safe inde nitely, recommended storage times for frozen foods are for quality only.


Refrigerator (40 °F)

Freezer (0 °F)


Fresh, in shell

3 to 5 weeks

Don’t freeze

Hard cooked

1 week

Don’t freeze well

Liquid Pasteurized Eggs, Egg Substitutes


3 days

Don’t freeze well


10 days

1 year

Deli and Vacuum-Packed Products Foodborne Illness United States

Egg, chicken, ham, tuna, & macaroni salads

3 to 5 days

Don’t freeze well

Hot Dogs

Opened package

1 week

1 to 2 months

Unopened package

2 weeks

1 to 2 months

Luncheon Meat

Opened package

3 to 5 days

1 to 2 months

Unopened package

2 weeks

1 to 2 months

Bacon & Sausage


7 days

1 month

Sausage, raw—from chicken, turkey, pork, beef

1 to 2 days Foodborne Illness United States

1 to 2 months

Hamburger and Other Ground Meats

Hamburger, ground beef, turkey, veal, pork, lamb, & mixtures of them

1 to 2 days

3 to 4 months

Fresh Beef, Veal, Lamb, Pork


3 to 5 days

6 to 12 months


3 to 5 days

4 to 6 months


3 to 5 days

4 to 12 months

Fresh Poultry

Chicken or turkey, whole

1 to 2 days Foodborne Illness United States

1 year

Chicken or turkey, pieces

1 to 2 days

9 months


Lean sh ( ounder, haddock, halibut, etc.)

1 to 2 days

6 to 8 months

Fatty sh (salmon, tuna, etc.)

1 to 2 days

2 to 3 months


Cooked meat or poultry

3 to 4 days

2 to 6 months

Chicken nuggets, patties

3 to 4 days

1 to 3 months


3 to 4 days

1 to 2 months Foodborne Illness United States

Check Your Steps

Check “Sell-By” date

Put raw meat, poultry, or seafood in

plastic bags
• Buy only pasteurized milk, soft cheeses

made with pasteurized milk, and pasteurized or juices that have been otherwise treated to control harmful bacteria.

• When buying eggs:
– Purchase refrigerated shell eggs
– If your recipe calls for raw eggs, purchase

pasteurized, refrigerated liquid eggs

• Don’t buy food displayed in unsafe or unclean conditions

Is It Done Yet?

You can’t tell by looking. Use a food thermometer to be sure.

USDA-FDA Recommended Safe Minimum Internal Temperatures

Beef, Pork, Veal, Lamb Steaks, Roasts & Chops 145 °F with 3-minute

rest time


145 °F

Beef, Pork, Veal, Lamb Ground Foodborne Illness United States

160 °F

Egg Dishes

160 °F

Turkey, Chicken & Duck Whole, Pieces & Ground

165 °F

Ordering “Smart” When Eating Out

Higher Risk:

✘ Cheese made from unpasteurized (raw) milk.

✘ Raw or undercooked seafood.

✘ Cold hot dogs.

✘ Sandwiches with cold deli

or luncheon meat.

✘ Raw or undercooked fish,

such as sashimi or some

kind of sushi.

✘ Soft-boiled or “over-easy”

eggs, as the yolks are not fully cooked.

Lower Risk:

✔Hard or processed cheeses. Soft cheeses only if made from pasteurized milk.

✔Fully cooked smoked fish or seafood. ✔Hot dogs reheated to steaming hot. If the Foodborne Illness United States

hot dogs are served cold or lukewarm, ask to have the hot dogs reheated until steaming, or else choose something else.

✔Grilled sandwiches in which the meat or poultry is heated until steaming.

✔Fully cooked fish that is firm and flaky; vegetarian sushi.

✔Fully cooked eggs with firm yolk and whites.

Clip out these handy Info Cards and carry them for quick reference when shopping, cooking, and eating out!

In the Know:

Becoming a Better Shopper

Follow these safe food-handling practices while you shop.

• Carefully read food labels while in the store to make sure food
is not past its “sell by” date. (See Food Product Dating

• Put raw packaged meat,
poultry, or seafood into a
plastic bag before placing it
in the shopping cart, so that
its juices will not drip on—
and con taminate—other foods. Foodborne Illness United States
If the meat counter does not offer plastic bags, pick some up from
the produce section before you select your meat, poultry, and seafood.

Buy only pasteurized milk,
cheese, and other dairy products
from the refrigerated section. When buying fruit juice from the refrigerated section of the store, be sure that the juice label says it is pasteurized.

Purchase eggs in the shell from the refrigerated section of the store. (Note: store the eggs in their original carton in the main part of your refrigerator once you are home.) For recipes that call for eggs that are raw or undercooked when the dish is served—homemade Caesar salad dressing and ice cream are two examples—use either shell eggs that have been treated to destroy Salmonella by pasteurization, or pasteurized egg products. When consuming raw eggs, using pasteurized eggs is the safer choice.

• Never buy food that is displayed in unsafe or unclean conditions.

When purchasing canned goods, make sure that they are free of dents, cracks, or bulging lids. (Once you are home, remember to clean each lid before opening the can.)

Purchase produce that is not bruised or damaged.

When shopping for food,
it is important to read the label carefully.

on page 13)


Food Product Dating

Read the “Safe Handling Label” for food safety information on raw foods. Foodborne Illness United States

Types of Open Dates

Open dating is found primarily on perishable foods such as meat, poultry, eggs, and dairy products.

A “Sell-By” date tells the store how long to display the product for sale. You should buy the product before the date expires.

A “Best If Used By (or Before)” date is recommended for best avor or quality. It is not a purchase or safety date.

A “Use-By” date is the last date recommended for the use of the product while at peak quality. The date has been determined by the manufacturer of the product.



270567 005093


1.99 2.56 lb





“Closed or coded dates” are packing numbers for use by the manufacturer. “Closed” or “coded” dating might appear on shelf-stable products such as cans and boxes of food. Foodborne Illness United States

Transporting Your Groceries

Follow these tips for safe transporting of your groceries:

• Pick up perishable foods last, and plan to go directly home from the grocery store.

Always refrigerate perishable foods within 2 hours of cooking or purchasing.

Refrigerate within 1 hour if the temperature outside is above 90 °F.

In hot weather, take a cooler with ice or another cold source to transport foods safely.


10 NOV 06

Eating out can be lots of fun—so make it an enjoyable experience by following some simple guidelines to avoid food-

borne illness. Remember
to observe your food
when it is served, and
don’t ever hesitate to ask
questions before you order.
Waiters and waitresses can
be quite helpful if you ask how a
food is prepared. Also, let them know you don’t want any food item containing raw meat, poultry, sh, sprouts, or eggs. Foodborne Illness United States