Preventing Foodborne Illnesses

One of the major necessities for a human being to survive and thrive is food. The nutrients from consuming food give us the energy and nourishment for sustaining our daily activities and thus remain healthy. It has a great role in society, and our culture, and gives a certain identity to a community. Consuming food brings different experiences through the sensations and flavors it provides.

It has been estimated that over 200 diseases are caused by consuming contaminated food. The contamination ranges from bacteria, viruses, parasites, or to chemical substances such as heavy metals (WHO, 2023). A foodborne illness results from the consumption of foods or beverages contaminated with harmful pathogens such as bacteria, viruses, or fungi or their toxins. Food poisoning is a type of foodborne illness caused by ingesting toxins present in foods. 

Symptoms 

Depending on the pathogens or severity, foodborne illnesses may resolve within days or months. Symptoms such as diarrhea and/or vomiting are common and typically last for 1 to 7 days. Other symptoms range from abdominal cramps, nausea, fever, joint/back aches, and fatigue. These illnesses are often treated with a combination of at-home remedies and over-the-counter or prescription medications. Foodborne illnesses range from mild to severe and can even lead to deaths if left untreated.

The world is facing a burden in terms of foodborne illnesses besides food insecurity. The World Health Organisation (2022) has estimated that at least 600 million people all over the world suffered from foodborne illnesses after consuming unsanitary food. Of these people, at least 420,000 people are estimated to die every year, and that accounts for the loss of 33 million healthy life years (DALYs). Children under five account for 40 per cent burden of foodborne illnesses. Among them, countries in South-East Asia Region account for 150 million illnesses, 175 000 deaths, and 12 million disability-adjusted life-years (DALYs) (WHO, 2022).

Economic progress is thus hindered by productivity loss and medical expenses as a result of a foodborne disease burden. A total of US$ 110 billion is lost each year due to foodborne illnesses from productivity and medical expenses in low- and middle-income countries alone. The majority of food safety issues are associated with pathogenic microorganisms such as bacteria that cause food poisoning or food intoxication. The effects range from mild to fatal health consequences such as watery diarrhea, vomiting, abdominal pain, or even debilitating infections and long-term diseases. 

Foodborne illnesses may result from bacteria that may present in raw and undercooked meat, fish, and poultry; unpasturised dairy products; contaminated fruits and vegetables; and contaminated drinking water. Viruses are usually transmitted through food contaminated by viral particles. Similarly, contaminated water and soil transmit harmful parasites to fresh produce, meat, poultry, and other foods.

Naturally occurring toxins in mushrooms, staple foods such as corn and cereal, and mold on grains may cause long term health complications. Environmental pollutants such as byproducts of plastic production and waste management, as well as heavy metals such as lead and mercury found in water and soil, can contaminate foods and lead to foodborne illnesses.

The emergence of zoonotic diseases has been linked to intensive farming. The growing need for additional space for farming can diminish the natural buffers that protect humans from viruses and other pathogens circulating among wild animals. It is a known fact that pathogens can spread even more rapidly among intensively farmed flocks and herds with genetic similarities particularly as they are kept in close proximity.

At the same time, antimicrobials are often used to accelerate livestock growth, which can lead to resistance in microorganisms that makes antimicrobials less effective as medicine for humans. Currently, about 700,000 people die of resistant infections every year and by 2050, those diseases may cause more deaths than cancer and are estimated to account for up to 10 million deaths every year worldwide. 

Approaches

The prevention of foodborne illness is an important public health endeavor. It has been recommended to wash hands often and thoroughly with warm, soapy water for at least 20 seconds before and after handling raw or cooked foods, using the bathroom, and handling pets. Also important is to clean food surfaces, utensils, and cutting boards with hot, soapy water after each use. It is essential to keep raw meat, poultry, seafood, and eggs separate from cooked and ready-to-eat foods, including fruits and vegetables, to avoid cross-contamination. Similarly, cook foods to a safe internal temperature to avoid undercooking and reduce foodborne illness risk. 

Moreover, avoiding drinking raw and unpasturised dairy and juice products results in the reduction of the risk of foodborne illnesses. Moreover, foods should be kept out of the temperature danger zone of 5–600C by thawing frozen food safely in the refrigerator and refrigerating foods within 2 hours of cooking. It is equally important to stay at home after feeling unwell and avoid preparing food for others during an illness period that may be even for several days after symptoms have subsided.

The bottom line is that the burden of foodborne illnesses is enormous and the government needs to formulate policies and guidelines for food safety at different levels of food production from farmers, dealers, and manufacturers to restaurants.

(Dr. Lohani is the clinical director at the Nepal Drug and Poison Information Centre. lohanis@gmail.com)