Of Pathogens and Produce:  Let the salad-lover beware

Of Pathogens and Produce:  Let the salad-lover beware

Until recently, foodborne illnesses have usually been associated with contaminated meat and poultry. Improved surveillance of and practices by those industries, as well as public education about proper handling have helped lower the rates of those sources. But an increase in uncooked vegetables and contamination of these products has developed.

In the International Journal of Environmental Health Research article “Prevalence of multiple antibiotic-resistant Gram-negative bacteria on bagged, ready-to-eat baby spinach,” by S. Walia, et al (Vol. 23, No.2, for April, 2013, pages 108-118), infections caused by pathogens (microorganisms that cause disease) found on uncooked fresh produce are increasing. Perhaps even more concerning is that many of these germs carry the genes for multiple-drug resistance. Thus, if someone consumes these pathogens on their produce, they could get an infection and/or have these dangerous genes passed on to bacteria in their intestines. Antibiotics used in agriculture to increase yield are suspected to have caused the antibiotic-resistant organisms to survive and even thrive. There has been an increase in serious intestinal infections in the most vulnerable – children, the elderly, and those with a weakened immune system.

The study reported in this article noted that pathogens are found even in bagged, ready-to-eat baby spinach. Other studies found pathogens on other produce. High-risk produce includes green onions, spinach and other leafy greens, cilantro, tomatoes, peppers, and alfalfa sprouts.

The CDC’s “Burden of Foodborne Illness:  Findings” which were last updated 7/15/2016, states that 1 in 6 Americans develop a foodborne illness every year. Some half of infections are caused by pathogens not yet identified, and the other half are caused by 31 known microorganisms, but 8 account for the majority of cases of foodborne illness. Norovirus causes the most of these. Salmonella is also a common cause and the most likely to lead to hospitalization or death. (http://wwwnc.cdc.gov/eid/article/17/1/p1-1101 article).

In “Vital Signs:  Incidence and Trends of Infection with Pathogens Transmitted Commonly Through Food – Foodborne Diseases Active Surveillance Network, 10 U.S. Sites 1996-2010″ (Morbidity and Mortality Weekly Report for 6/10/2011, Vol. 60, #22) it is noted that most foodborne illnesses occur in people that aren’t included in reported disease outbreaks. Most foodborne illnesses entail mild to severe diarrhea. In the vulnerable such as the elderly, and even in the healthy, severe complications like kidney damage and meningitis can develop.

In Eat, Drink and Be Wary by Charles M. Duncan (Lanham, MD:  Rowman & Littlefield, 2015) it is stated that 20% of our fresh vegetables and 40% of our fruit and nuts are imported. This may be the greatest risk for foodborne infections, but this hasn’t been confirmed. Since fresh produce is the source of about half of foodborne illnesses a year, and since monitoring has decreased the past 5 years, a few precautions are worthwhile:  wash meticulously all fruits and vegetables, even those with a rind you won’t eat, wash 15 seconds and rinse 15 seconds before and after preparing any produce.


The best way to prevent an infection

The best way to prevent infections

Since we’re living in an era when there isn’t an antimicrobial drug for every infection, prevention is critical. Although there have been a lot of advances in medicine, proper hand washing is the best way to prevent picking up or spreading an infection. Proper in italics because this is key, and I would venture to say most people don’t do that. That changed after reading Dr. Frederic Saldmann’s Wash Your Hands! (New York: Weinstein Books, 2008).

It’s no secret that hands carry a lot of germs, and not just those that cause skin infections or gastroenteritis. We cough into our hands, touch computers and elevator buttons, shake hands, touch our face, grab onto the handrails of stairs, touch toilet seats and sink faucets, touch our face, pick up fruits and vegetables at the grocery store, touch our face, and then do a split-second wash that may be giving the germs just the chance they need to start a very big family and also get free housing.

Proper hand washing includes washing every part including the space between fingers and cuticles. In the article “Implementing Infection Prevention and Control Precautions in the Community” by Deborah Ward (British Journal of Community Nursing, March 2017, vol. 22, #3) it’s noted that fingernails and fingertips have the highest number of organisms. The author adds that rings and other jewelry can also be a reservoir for germs. She also notes that alcohol-based sanitizers don’t kill the germs that cause the pseudomembranous colitis, a serious lower GI infection.

Drying is just as important because, per Dr. Saldmann’s book, moist hands carry five hundred times as many pathogens as dry hands! Yet another study found that about a third of hand washers don’t dry their hands. And using a damp towel can contaminate washed hands. The most startling news is that using a warm-air dryer actually leads to a significant increase in the number of germs on hands compared with the number before washing them!

After shaking hands with someone that had a recent trip to the bathroom and didn’t wash their hands, there’s a 33% chance you’ll get some of the bacteria from their feces in your mouth within a couple hours. If you think it’s rare for someone to not wash their hands after using the restroom, guess again. In one study, almost half of the research subjects didn’t wash their hands then if they were alone; that’s five times the rate of those who are in the bathroom with other people around. Proper hand washing takes less than a minute – a worthy investment!