Is it the flu or your food?

When 82-year-old Lila Christman started feeling ill, she thought it was the flu. Then, as she grew worse, she worried it was another bout with pneumonia, for which she had been hospitalized twice in the previous year.When Christman slipped into a coma, her family feared the worst. As she lay unconscious in a hospital bed hooked up to life support for more than a week, her children and grandchildren made pilgrimages to her bedside, all the while asking what had happened.

“We thought that she’d suffered a heart attack or stroke. The doctors were stumped, too,” says her son Don Baker, 60.

When the doctors told her family she was effectively brain-dead, they consented to taking her off life support and she died a mere five hours later.

It wasn’t until a lab test result-received, sadly, after she died-revealed what had killed her: a piece of soft cheese from her own refrigerator.

30 deas a year
Every year, an estimated 2 million Canadians are reported to suffer side effects from foodborne illness and 30 people die.

Millions more go unreported because many cases aren’t recognized as food poisoning.

“In fact, I would say the reported cases of food poisoning are only the tip of the iceberg,” says Dr. Joseph Odemeru, senior research scientist in microbiology at the University of Guelph’s department of food science.

While dying from eating food contaminated with bacteria is a rare occurrence, it does happen and it’s the young and the old who are affected most severely.

With symptoms ranging from a few hours of fever and vomiting to days of diarrhea and stomach cramps to weeks of weight loss and fatigue ending, in some cases, in death, people tend to ride out the minor cases and be confused about the reasons for the more severe ones.

Next page: Flu or food?

Flu or food?
One of the major reasons that so many cases of foodborne illness go unreported is that those who develop diarrhea or vomiting think they’re suffering from the flu.

“People use the term flu to refer to vomiting and diarrhea but, in actual fact, the flu is a respiratory illness, not gastrointestinal at all,” explains Dr. Dan Cass, director of emergency services at St. Michael’s Hospital in Toronto.

Regardless of what you call it, it can be hard to tell exactly what is causing your aches and pains. If you’re suffering from a sore throat or cough, it’s safe to assume it’s not a foodborne illness but other symptoms can make the diagnosis confusing.

According to Odemeru, one way to find out is to ask around: “With the flu, someone will have it one day and then, the next day, someone else will have it. With food poisoning, everyone experiences symptoms at the same time. Everyone who ate the same food is contaminated.”

Persistent symptoms
Also, if your symptoms don’t go away on their own over a reasonable amount of time or if they intensify after a couple of days, it’s probably food poisoning.

“A lot of people with viral infections will have diarrhea but specific things like blood or mucus in the stools is an indication of something a bit more alarming,” advises Cass.

One of the other complicating factors is the belief that food poisoning symptoms are felt immediately after a tainted meal. Not so.

While bacteria such as staphylococcus, which can be transmitted through milk, water and meat products, can occur as quickly as an hour after contact, other bacteria such as Listeria monocytogenes, transmitted through soft cheeses, ice cream, hot dogs and luncheon meats, can take up to six weeks to do their damage.

“When you’ve ingested the salmonella organism, it has to multiply to cause the effect,” explains Odemeru. “That can take a day or two before you start feeling ill. But in the case of botulism, the effects are severe and quick because the organism doesn’t have to multiply. It’s already producing a toxin which hits in a matter of hours.”

Next page: When to get help

When to get help
In most cases of food poisoning, the symptoms will resolve themselves, depending on the type of bacteria you’ve ingested and the amount. Some can take a few hours, others a few weeks to fully clear your system.

Indications that you should see your doctor for help include:

• An inability to keep food or fluids down, especially if you are on medication of any kind
• Blood or mucus in your stools
• Dehydration from vomiting or diarrhea (dehydration usually results in dizziness when walking and a dry mouth)

If the amount of diarrhea increases or if you experience severe abdominal pain, then you should definitely make an appointment with your physician or go to the emergency room.

Tracking and treatments
Determining whether you have food poisoning is usually done through a stool sample. There are no specific blood tests for most of the organisms that cause foodborne illness.

If the cause of the illness is bacterial, which includes organisms like salmonella, shigella and campylobacter; it can be treated with a three- to five-day course of antibiotics.

Public health departments, which are notified whenever tests are done for food poisoning, usually track the culprit.

 “Public health will say ‘okay, today we had 10 cases of salmonella’ and they’ll contact the patients and try to work back to determine the common source,” Cass explains.

If your symptoms are mild, should you take over-the-counter medications? According to Cass, it’s preferable to let the symptoms run their course.

“What I tell people is that if they can put up with the symptoms, it’s better to let it run its course. Your body is trying to get rid of whatever toxin is there anyway. The faster it does that, the faster you’ll feel better,” he explains.

But if the symptoms are disrupting your workday with frequent trips to the bathroom or you’re finding it hard to get any sleep at night, Cass says taking an over-the-counter medication such as Immodium will do no harm “but only if you don’t have symptoms that we would want you to go to emergency for, including a high fever or bloody diarrhea.”

Next page: Expert advice

Expert advice
So, what can you do to protect yourself? A lot, according to experts in the field of nutrition and food safety. Here are their suggestions:

• Wash and thoroughly dry your hands. This is job one. “Wet them first, get some friction going with soap and rub for a good 20 seconds. Rinse them in warm water and dry them thoroughly,” says Bonnie Lacroix, a dietitian and spokesperson for the Canadian Partnership for Consumer Food Safety Education.
• Avoid cross-contamination. Store all juicy foods in metal or glass containers, which won’t leak on other food in your fridge. Clean your cutting board thoroughly between uses and never put cooked food back on a dish that previously held raw food.
• Pay attention to best-before dates. Once you open a package, the best-before date no longer applies. Use it within a few days.
• Use your leftovers within a day or two and reheat them until steaming hot.
• Wash all fruits and vegetables with warm water and scrub the rind of any fruit or vegetable with a brush-even if you don’t eat the rind. Bacteria can go from the outside to the inside of a piece of produce the minute it’s cut.
• Always use a thermometer to ensure meat is cooked.
• Use bleach or a chlorine-based cleanser regularly to clean your sink, cutting board, countertops and dishcloths.

Take extra caution
According to the experts, if you are on medication or receiving medical treatments that impair your immune system, take extra caution when buying, storing and preparing your food.

In Lila Christman’s case, once the lab tests showed that listeria caused her death-a bacteria that is particularly deadly because it can grow on foods that are refrigerated and can lead to septicemia, encephalitis and meningitis-the public health department came to her house to play detective.

“When we finally knew the reason for her death, it seemed even more senseless and unnecessary, and that made it that much harder to deal with for all of us,” says Baker.

“Maybe if we had known what to look for or we had an inkling that it was related to something she ate, we could have done something for her before it was too late.”