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Food Safety and Diabetes. Diabetes Wellness News. 14(1): 1-2, 5. January 2008.

This patient education newsletter article reminds readers of the need to prevent foodborne illness with proper attention to safe food handling and preparation. The author cautions that individuals with diabetes may be more susceptible to foodborne illness for a variety of reasons, including an impaired immune system, gastrointestinal tract differences due to their diabetes, and diabetes-related kidney damage. The article outlines four basic steps that can be used to keep food safe, categorized into these activities: clean, separate, cook, and chill. In each category, practical, simple tips are listed to reduce the spread of bacteria in the kitchen. Readers are referred to a U.S. Department of Agriculture (USDA) food safety guide at www.fsis.usda.gov/PDF/Food_Safety_for_Diabetics.pdf for more information.

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Bacteria and Foodborne Illness. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2007. 8 p.

Foodborne illness results from eating food contaminated with bacteria—or their toxins—or other pathogens such as parasites or viruses. The resulting illnesses range from upset stomach to more serious symptoms, including diarrhea, fever, vomiting, abdominal cramps, and dehydration. This fact sheet reviews the causes, symptoms, risk factors, complications, diagnosis, treatment, and prevention of foodborne illness. People at greater risk for foodborne illness include young children, pregnant women and their fetuses, older adults, and people with lowered immunity. Symptoms usually resemble intestinal flu. Treatment may range from replacement of lost fluids and electrolytes for mild cases of foodborne illness, to hospitalization for severe conditions such as hemolytic uremic syndrome (HUS). Prevention strategies include adequate hand washing; keeping raw meat, poultry and seafood separate from other foods; cooking foods properly; using adequate refrigeration; and cleaning surfaces well before and after using them to prepare foods. One section describes the use of food irradiation as a means of cold pasteurization, which destroys living bacteria, to control foodborne disease A final section considers recent evidence that foodborne pathogens are linked to chronic disorders, including arthritis, inflammatory bowel disease, kidney failure, Guillain-Barre syndrome, and autoimmune disorders. One sidebar reviews common sources of foodborne illness, including the bacteria that are usually responsible. The fact sheet concludes with contact information for nine resource organizations, including government agencies and a brief description of the activities of the National Digestive Diseases Information Clearinghouse (NDDIC). 1 table.

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Bacteria and Foodborne Illness: What You Need to Know. Bacterias y Enfermedades Transmitidas Por Los Alimentos: Lo Que USted Debe Saber. Bethesda, MD: National Digestive Diseases Information Clearinghouse. 2007. 4 p.

This fact sheet familiarizes readers with bacteria and foodborne illness, which are caused by eating food or drinking beverages contaminated with bacteria, parasites, or viruses. Foodborne illness can cause symptoms ranging from an upset stomach to more serious problems including diarrhea, fever, vomiting, abdominal cramps, and dehydration. Harmful bacteria in raw or undercooked food are the most common cause of foodborne illness. Written in a question-and-answer format, the fact sheet describes the symptoms of foodborne illness, other problems caused by foodborne illness, who is most at risk for foodborne illness, and how to protect oneself from foodborne illness. The fact sheet concludes with information about how to contact the National Digestive Diseases Information Clearinghouse (NIDDK) for more information. This fact sheet is from the NIDDK Awareness and Prevention Series. The fact sheet is presented in English and Spanish (2 pages each).

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Food Safety for the Senior Set. Today's Dietitian. 9(6): 24-27. June 2007.

Many foodborne illnesses cause only mild symptoms in the general population. They can, however, be associated with severe infections, serious complications, and death in high-risk populations such as preschool-aged children, older adults, and those with impaired immune systems. This article considers food safety for older adults, focusing on those seniors who are residents in long-term care (LTC) facilities. The author reviews some of the reasons for renewed interest in this topic, including newly identified pathogens and vehicles of transmission, the threat of bioterrorism, changes in methods of food production, and increasingly international sources of the food supply. The author then briefly reviews the 10 most common causes of foodborne illnesses, which include improper cooling, 12 or more hours between preparation and eating, infected people handling food, inadequate reheating, improper hot-holding temperatures, contaminated ingredients, food from unsafe sources, improper cleaning, cross-contamination from raw foods, and inadequate cooking. The author encourages dietitians to familiarize themselves with certain foods that may pose a significant health hazard to older adults in an LTC setting. In addition, dietitians must manage the safety of food by controlling the food supply, maintaining sanitary facilities, and training employees to know how to work safely with food. 5 references.

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Multistate Outbreak of Norovirus Gastroenteritis Among Attendees at a Family Reunion - Grant County, West Virginia, October 2006. Morbidity and Mortality Weekly Report. 56(27): 673-678. July 13, 2007.

This report describes a collaborative, multijurisdictional epidemiological investigation that used a cohort study and laboratory analyses to determine the source of infection and appropriate control measures for a multistate outbreak of Norovirus gastroenteritis among attendees at a family reunion. The reunion was held October 14 at a private residence in Grant County, West Virginia, and the 53 identified attendees included residents from Florida, Maryland, New York, Pennsylvania, Virginia, and West Virginia. The results indicated that a combination of person-to-person and foodborne transmission of two strains of Norovirus, likely introduced by persons from two different states and subsequently at least two food items, was the probable cause of these illnesses. The complexity of this situation highlights the challenge of investigating and controlling Norovirus outbreaks. During periods of peak Norovirus activity, public health officials should emphasize the importance of appropriate handwashing and the exclusion of ill persons from social gatherings. 1 figure. 2 tables. 8 references.

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Food and Water Safety: Potential for Bioterrorist Attack. IN: Buchman, A., ed. Clinical Nutrition in Gastrointestinal Disease. Thorofare, NJ: Slack Incorporated. 2006. pp 139-153.

This chapter about food and water safety is from a comprehensive textbook that compiles available data, clinical experience, and research on the role of nutrition in the management of patients with disorders that affect the gastrointestinal (GI) tract. The author outlines the major sources of foodborne and waterborne disease, as well as the clinical syndromes that result from food or water contamination. The author considers the potential for bioterrorist attack using foodborne or waterborne disease, reviewing reports of incidents in which food has been deliberately contaminated. This section describes the pathogens projected as potential bioterrorism concerns for dissemination by food or water. The author concludes that many foodborne or waterborne diseases remain undiagnosed and, for some illnesses, readily available diagnostic tests do not exist. Therapy is usually directed at maintaining hydration because of GI loss of fluids caused by vomiting and diarrhea. Physicians are encouraged to take an active role in educating patients to assist in prevention of foodborne illness. 2 figures. 8 tables. 89 references.

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Hemolytic Uremic Syndrome. American Family Physician. 74(6): 998. September 15, 2006.

This patient education fact sheet reviews hemolytic uremic syndrome (HUS), a problem usually caused by Escherichia coli bacteria. An uncommon problem in the United States, the illness is usually one of bloody diarrhea following ingestion of contaminated hamburger meat. Children with HUS usually present with gastroenteritis complaints such as abdominal pain or tenderness, nausea or vomiting, fever, and anemia; adults may be asymptomatic. The fact sheet reviews how people can get HUS, the symptoms of the syndrome, the diagnostic tests that may be done to confirm the condition, treatment strategies, and how to prevent getting HUS. The fact sheet concludes with the contact information for the National Kidney Foundation and the National Kidney and Urologic Diseases Information Clearinghouse.

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Hemolytic Uremic Syndrome: An Emerging Health Risk. American Family Physician. 74(6): 991-996. September 15, 2006.

This article discusses hemolytic uremic syndrome (HUS), a problem caused primarily by Shiga toxin-producing Escherichia coli bacteria O157:H7. HUS is the most common cause of acute kidney failure in children but can also occur in adults. The author reviews the etiology, pathophysiology, epidemiology, clinical characteristics, differential diagnosis, laboratory evaluation, patient management, complications, and prognosis of HUS. The syndrome is characterized by microangiopathic anemia, thrombotic thrombocytopenia, and renal failure. The illness is usually one of bloody diarrhea following ingestion of hamburger meat contaminated with E. coli O157:H7. Children with HUS usually present with gastroenteritis complains such as abdominal pain or tenderness, nausea or vomiting, fever, and anemia; adults may be asymptomatic. Complications from HUS can include intussusception, chronic kidney failure, and, in severe cases, seizures. There is an incubation period of approximately 1 week between the start of diarrhea and the onset of HUS; physicians should maintain a high index of suspicion. Early laboratory testing, including a complete blood count, stool culture, and Shiga toxin testing, is important to diagnose and manage the syndrome. 5 tables. 30 references.

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Vibrio Vulnificus Fact Sheet for Food and Health Educators. Athens, GA: University of Georgia Marine Extension Service. 2006. 2 p.

Vibrio vulnificus is a gram-negative bacterium that is considered the most lethal of the vibrios inhabiting brackish and salt water. This bacterium occurs naturally in warm, coastal areas and is found in higher concentrations from April through October, when coastal waters are warm. This fact sheet helps food and health educators understand the risks of V. vulnificus infection. Readers are encouraged to remember that seafood is an important part of a healthy diet and that any education about risk factors should be clear and specific, so consumers are not confused and avoid all seafood as a result. The bulk of the fact sheet focuses on prevention strategies, targeting groups of consumers with weakened immunity; telling consumers to seek immediate medical treatment for any symptoms of Vibrio infection; providing information about the risk of V. vulnificus infection in any general food safety education activities; stressing that thorough cooking kills harmful bacteria; urging readers to obtain free consumer brochures from the Interstate Shellfish Sanitation Conference (www.issc.org; 803-788-7559); and asking physicians and other health care professionals to place ISSC consumer brochures in their waiting rooms. One chart lists the health conditions that increase risk of serious infection with V. vulnificus. One section offers additional educator resources. 1 figure. 1 table.

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How to Generate Awareness of Vibrio Vulnificus in Raw Oysters within the Hispanic Community: A Media Relations and Community Outreach Health Education Kit. Rockville, MD: Food and Drug Administration, 2004. 41 p.

Vibrio vulnificus is a gram-negative bacterium that is considered the most lethal of the vibrios inhabiting brackish and salt water. This bacterium occurs naturally in warm, coastal areas and is found in higher concentrations from April through October, when coastal waters are warm. This media relations and community outreach health education kit is designed to generate awareness about potential dangers of eating raw Gulf oysters contaminated with V. vulnificus when other health conditions are present; educate the Hispanic community (particularly Hispanic males) about the safe way to eat oysters; inform on how to avoid or eliminate risks of eating raw oysters; create an association between risk and specific medical conditions, including liver disease, blood disorders, diabetes, and cancer; and raise awareness of medical and health resources available within the Hispanic community regarding V. vulnificus. Materials are presented in both English and Spanish and include a sample public relations letter and sample press releases, a feature article on the dangers of eating contaminated raw oysters, a sample public service announcement, a fact sheet from the Food and Drug Administration on myths about raw seafood, and three recipes for cooked oyster dishes (baked oysters, fried oysters, spicy oyster soup).

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