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January 2000 Issue
Stomach Flu is Rarely "Stomach Flu"
by Michael Fick
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My friend Joe gets what he calls "stomach flu" often, missing a day or two of work every several weeks. I knew him well enough to suspect several contributing factors, among them:
  • Stress. He is a workaholic who hates his job but puts in at least 100 hours a week on his 40-hours/week corporate job.
  • Inadequate sleep (see above).
  • Inadequate salt intake. He eats virtually none, despite its necessity to our immune system. He and his equally busy wife, Jane, have the mistaken idea that salt causes high blood pressure.
  • No medical care. They mistrust doctors, and will consult one only when a life is at stake, literally.
But despite all those reasons to get sick, Joe and Jane could still avoid most of their "stomach flu". Why? One look at their kitchen told me. They rinse and reuse dishes and utensils without proper hot soap and water washing. They let leftovers sit out for hours before putting them in the refrigerator. Their cutting board is visibly dirty. Their dish cloths look more like shop rags. Their kitchen's not like something we'd see on Dateline, or the aftermath of a cattle train plowing through a supermarket, but I'm sure that at the microscopic level their kitchen counter resembles an endless herd of galloping beasts from the bar scene in the original Star Wars movie. It's a jungle down there!

Invaders -- bacteria, viruses, chemicals, and parasites -- lurk everywhere, waiting for the right combination of warmth, moisture, oxygen (or lack of it) and acidity to bloom at rates we cannot comprehend. Food contamination can reach violent, even lethal, levels before showing any changes in smell, color, or taste. When contamination hits a stomach in sufficient quantity to challenge its chemical defenses, we spend the next day or two being very thankful pulmonary and cardiovascular activity are autonomic.

We usually call it "stomach flu", "intestinal flu", or "24-hour flu", and chalk it up to fate and having skipped that flu shot. In fact it's usually one of the countless forms of food poisoning, and it's often avoidable. Some forms can kill children or the elderly or even robust victims; but most merely make us wish our case was fatal ... and the sooner, the better.

In the more common form of food poisoning, bacteria, viruses, or parasites multiply exponentially inside our body in a battle to overwhelm our defenses. This form takes 12 hours to three days to double us over, but seldom threatens our life or long-term health if we have a healthy immune system and force down plenty of fluids. We'll never forget it, but we'll get over it if we're healthy adults. Very young, very old, or otherwise weakened victims can be rapidly and dangerously dehydrated by the resulting loss of fluids, but this form seldom requires hospitalization unless bloody diarrhea -- an emergency --  is present.

Even long after recovering from their nausea, headaches, cramps, fever, and/or diarrhea, victims can be carriers of the causative organisms, especially in their feces. This is a common vector of illness in nurseries and kindergartens, and in food-handlers who do not wash their hands after bathroom visits.

In the more dangerous form of food poisoning, a chemical toxin in the food actually poisons us. Either an invader produced a toxic chemical in the food before we ate it, or a foreign chemical contamination is present, and the chemical makes us wish we could get a whole-body transplant. (You might think I'd choose Arnold's, but on second thought I think I'd opt for Pamela Lee's.) This form can strike within a couple of hours, or can take up to a day to hit us, and can be one of the deadlier forms of food poisoning. It can go way beyond "stomach flu", attacking nervous and brain functions dramatically and irreversibly.

The higher-risk food poisoning vectors are protein-rich products such as red meat, seafood, and dairy products, but bean sprouts, cut melons, and cooked potatoes, beans, or rice are also frequent offenders. They provide an excellent growth medium when between 45 and 140 degrees F -- right where most pot luck or picnic dishes sit. And sit. In that temperature zone, the astounding growth rate of bacteria looks like science fiction under a microscope. Since I began taking a stomach-acid-reducing drug (Prilosec) daily for the rest of my life, I have joined the legion of people more susceptible than average to food borne organism invasion, and have heightened my suspicion of such meals. I'm now even more diligent in observing the following precautions everyone should follow who doesn't enjoy being too sick to eat ice cream or to crawl into -- or out of -- the bathroom.

  • Cook all meats, especially ground meats, until they reach at least 165 degrees at the center. A hamburger patty cooked less than medium is risky business. Its juice, and that of cooked chicken, should run clear, not pink.
  • Keep all prepared food above 140 or below 45 until consumed -- not just until your guests ring the doorbell. The minute a casserole drops below 140 or cole slaw climbs above 45, zoology kicks into high gear.
  • Big batches of food cool slowly even in the freezer, so divide them into more quickly cooled smaller servings so they chill through the breeding range more quickly, or keep them above 140 until eaten.
  • Thaw food in the refrigerator. That turkey's outer layers sit at ambient temperature for many hours before the inside thaws, so ambient should be under 45 degrees.
  • Isolate raw meat. Provide no vector -- utensils, plates, drippings, unwashed hands --¬†from raw meat to any consumed food.
  • Even quality restaurants have occasional problems with sushi, and specially sashimi; I'm not about to eat your amateur attempts at either. As they say, "I like my sushi well done."
  • Keep the danged iguana out of the kitchen. Reptiles skins and scales and shells swarm with salmonella, making them very risky children's pets. If you do let the iguana in the kitchen, at least SERVE HIM WELL DONE and at over 140.
  • Wash your hands thoroughly, especially after going to the bathroom or if you have pimples or other skin infections.
  • Take only scalding hot or icy cold foods at picnics or pot lucks where food has been sitting out for long. That last buffet table raid as most of the guests are leaving could make you swear off food forever.
  • Be vocal about food safety when necessary. A friend got furious when I threw out and replaced the raw hamburger he had thawed in the sink overnight. Better to risk his friendship than threaten the lives of the children he was baby-sitting. And I don't eat at Joe and Jane's anymore.
  • If in doubt, throw it out. It's cheap insurance. Boiling, even for hours, fails to faze the bacterial spores that cause deadly botulism.
Sound like overreaction? Then the next time you lose control of both ends and the middle, or are rushing your infant to the hospital because you fed him some honey, ask yourself, "Could I have avoided this?" Most often, the answer is, "Yes."



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