NEW YORK NURSE: July/August 2008
Q.: I work with oncology patients in a clinic setting and have seen an increase in the number of these patients admitted with gastrointestinal infections from food pathogens. What information and resources should I be providing to the patients and their families to help protect them from these illnesses?
A.: Along with summer comes an increased consumption of fresh fruits and vegetables, ready-to-eat picnic foods, and a spike in the number of food-borne illnesses. Anyone can succumb to these infections; however, the elderly, infants, pregnant women, and those with impaired immune systems are more likely to become severely ill. These individuals may require hospitalization for hydration and antibiotic therapy.
Two bacteria often seen in food-borne illness are Salmonella agona and Listeria monocytogenes. These bacteria cause similar symptoms and are both serious infections, but they vary greatly in symptom onset and outcome. Statistics from the Centers for Disease Control (2008) show these infections kill up to 500 people yearly. Salmonella infection usually causes diarrhea, cramping, and fever 12 to 72 hours after infection. An infection with Listeria, which can also present with fever, gastrointestinal symptoms, and muscle aches, can be delayed as long as 90 days from ingestion of contaminated food. Salmonella infection usually lasts 4 to 7 days with most persons recovering without treatment. A Listeria infection is potentially fatal, as it can spread to the blood or nervous system.
Both of these bacteria are contracted by eating contaminated foods but can also be spread by infected individuals. Salmonella is usually associated with uncooked animal-based foods such as beef, pork, poultry, milk, or eggs. More recently, however, vegetables have also been linked to salmonellosis. Listeria is associated with processed foods such as hot dogs, deli meats, certain soft cheeses, shrimp, raw vegetables, and milk.
Contamination or cross-contamination occurs when infected food handlers do not wash their hands and then come into contact with the product. A contaminated food product may also have come into contact with cutting boards or countertops that were not washed properly after being used to prepare uncooked foods.
Similarities between the two bacteria include susceptibility to hand-washing and heat. Listeria is more virulent, however, and can actually increase substantially when foods are stored in refrigerators that are too warm (>40oF).
Remind your patients that hand-washing, avoiding cross-contamination, and proper storage are essential parts of food handling and preparation. Advise them to avoid eating raw or undercooked foods associated with these bacteria. During hot periods in the summer, remind patients to use a thermometer to ensure their refrigerator temperature is always 40o or below. Consume perishable items as soon as possible and dispose of those left out for long periods in hot weather. Do not drink or eat foods containing unpasteurized milk and be sure to cook beef, pork, and eggs thoroughly.
Centers for Disease Control and Prevention, Department of Health and Human Services. (2008). Salmonella. Retrieved June 24, 2008, from www.cdc/gov/salmonella
Centers for Disease Control and Prevention, Department of Health and Human Services. (2008). Listeriosis. Retrieved June 24, 2008, from www.cdc.gov/nczved/dfbmd/disease_listing/listeriosis_gi.html
This is a sample of the questions NYSNA’s experts answer each day. The advice given is specific for the situation described and may not be applicable generally. If you have questions about your own work setting, it is recommended that you contact your NYSNA Nursing Representative or the Education, Practice, and Research Program, 11 Cornell Road, Latham, New York 12110-1499 or call 800-724-NYRN, ext. 282.