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Dr K K Aggarwal

Avoid Food Poisoning by thorough washing and proper cooking

By Dr K K Aggarwal
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Thorough washing and proper cooking of fruits and vegetables can eliminate most bacteria that cause food poisoning.

Food-borne illnesses or food poisoning usually occurs due to eating food that is contaminated with bacteria or their toxins. Virus and parasites can also be cause food poisoning. People have known for long that raw meat, poultry and eggs can also harbor diseases causing microbes. But in recent years most outbreaks of food borne illnesses have been due to fresh fruits and vegetables.

Food poisoning can cause abdominal pain, nausea, headache, fatigue, vomiting, diarrhea and dehydration. Symptoms may appear several hours to several days after eating tainted food. For example, Salmonella bacteria will cause illness 12 hours to 3 days after ingestion lasting about 4-7 days.

The most common way to treat food poisoning is to drink plenty of fluids. The sickness usually subsides within a few days.

Food poisoning with rice dishes

By Dr K K Aggarwal
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Staph and Bacillus cereus can cause acute food poisoning within 6 hours of ingestion of food. B. cereus is likely when rice is the culprit.

• B. cereus is able to persist in food processing environments due to its ability to survive at extreme temperatures as well as its ability to form biofilms and spores.

• B. cereus has been recovered from a wide range of foods, including rice, dairy products, spices, bean sprouts and other vegetables.

• Fried rice is an important cause of emetic–type food poisoning associated with B. cereus.

• The organism is frequently present in uncooked rice, and heat–resistant spores may survive cooking.

• Cooked rice subsequently at room temperature can allow vegetative forms to multiply, and the heat-stable toxin that is produced can survive brief heating such as stir frying.

• Two distinct types of toxin-mediated food poisoning are caused by B. cereus, characterized by either diarrhea or vomiting, depending on which toxin is involved. The diarrheal toxin is produced by vegetative cells in the small intestine after ingestion of either bacilli or spores. The emetic toxin is ingested directly from contaminated food. Both toxins cause disease within 24 hours of ingestion.

• The emetic syndrome is caused by direct ingestion of the toxin.

• The number of viable spores and vegetative bacteria that produce diarrheal toxin is reduced by heating, although spores associated with emetic toxin are capable of surviving heat processing.

• Cereulide is heat stable and resistant to gastric conditions.

• The ingested toxin itself may therefore cause disease despite sufficient heating to kill B. cereus.

• The emetic syndrome is characterized by abdominal cramps, nausea, and vomiting. Diarrhea also occurs in about one–third of individuals. Symptom onset is usually within 1 to 5 hours of ingestion, but it can also occur within half an hour and up to six hours after ingestion of contaminated food.

• Symptoms usually resolve in 6 to 24 hours.

• Rice–based dishes in particular have been implicated in emetic toxin mediated disease, usually as a result of cooling fried rice dishes overnight at room temperature followed by reheating the next day.

• The infective dose of cereulide required to cause symptoms is 8 to 10 micrograms per kilogram of body weight.

Do not heat leafy vegetables twice

By Dr K K Aggarwal
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Nitrates in foods such as spinach, beet root and lettuce stimulate the production of nitric oxide in the body. Nitric oxide relaxes blood vessels. Ingested nitrate is reduced by oral, commensal, bacteria to nitrite, which can further be reduced to nitric oxide.

Vegetables are a major source of dietary nitrate. Green leafy and root vegetables, such as spinach and carrots, provide more than 85% of dietary nitrate. Foods in which nitrite are present are bacon, fermented sausage, hot dogs, bologna, salami, corned beef, ham and other products such as smoked or cured meat, fish and poultry. The conversion of dietary nitrate to nitrite has antimicrobial benefits in the mouth and stomach. Some epidemiological studies show a reduced rate of gastric and intestinal cancer in groups with a high vegetable-based nitrate intake.

Nitrate is totally harmless; however, it can be converted to nitrite and some portion of nitrite to nitrosamines, some of which are known to be carcinogenic. Heating increases the conversion rate. The longer the heat treatment, the more nitrosamines will be formed. Hence, the recommendation not to heat leafy vegetables twice.

Adding lemon juice to vegetables will reduce the formation of nitrosamines. It contains vitamin C, which also reacts with nitrite, thereby preventing the nitrosamine formation.

Water Hygiene

By Dr K K Aggarwal
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Safe water is an essential commodity for prevention of most water and food–borne diseases like diarrhea, typhoid and jaundice. These diseases are 100% preventable. All of them can be lethal if not prevented, diagnosed or treated in time. Transmission of parasitic infections can also occur with contaminated water. Here are a few tips:

  1. Travelers should avoid consuming tap water.
  2. Avoid ice made from tap water.
  3. Avoid any food rinsed in tap water.
  4. Chlorination kills most bacterial and viral pathogens.
  5. Chlorination does not kill Giardia cysts.
  6. Chlorination does not kill amoeba cysts.
  7. Chlorination does not kill Cryptosporidium.
  8. Boiled water is safe.
  9. Treated water is safe.
  10. Bottled water is safe.
  11. Carbonated drinks, wine and drinks made with boiled water are safe.
  12. Freezing does not kill the organisms that cause diarrhea. Ice in drinks is not safe unless it has been made from adequately boiled or filtered water.
  13. Alcohol does not sterilize water or ice. Mixed drinks may still be contaminated.
  14. Hot tea and coffee are the best alternates to boiled water.
  15. Bottled drinks should be requested without ice and should be drunk from the bottle with a straw rather than with a glass.
  16. Boiling water for 3 minutes followed by cooling to room temperature will kill bacterial parasites.
  17. Adding two drops of 5% sodium hydrochloride (bleach) to quarter of water (1 liter) will kill most bacteria in 30 minutes.
  18. Adding 5 drops of tincture of iodine to a quarter of water (1 liter) will kill bacteria within 30 minutes.