Just when you thought fat and calories were the biggest restaurant hazards, some new threats have been making headlines lately. Chipotle was recently subpoenaed by the Federal Grand Jury when more than 140 Boston University students contracted norovirus after eating at the Mexican grill near campus. Additional outbreaks have named E. coli and salmonella as the culprits.
How can you tell the difference between these five common foodborne illnesses, and what do you need to know to eat with peace of mind?
According to the Centers for Disease Control and Prevention, norovirus is the leading cause of foodborne illnesses, striking between 10 to 21 million people in the U.S. each year. The highly contagious virus spreads easily: It can live on any surface for weeks, and it only takes a few virus particles to infect someone. The majority of outbreaks originate from restaurant workers who transmit the virus while preparing food, which was the case at the Boston Chipotle.
Symptoms: Norovirus attacks the stomach and intestines, resulting in acute gastroenteritis. Extensive vomiting begins within the first day or two. Other symptoms include nausea, stomach pain, diarrhea, fever, and head and body aches.
Prevention: If there's a chance you've been exposed to norovirus, the best remedy is frequent hand washing, especially before cooking and eating and after using the bathroom. Employees in food service should wash their hands frequently and use disinfecting cleansers on countertops, utensils and other food-prep surfaces. The CDC recommends using a solution of water mixed with five to 25 tablespoons of household bleach.
Recovery: If you've already contracted norovirus and are experiencing symptoms, the best treatment is staying hydrated to offset loss of fluids from vomiting and diarrhea. As norovirus is not a bacterial infection, antibiotics are not effective. In most cases, symptoms start to abate after two or three days. Experts recommend starting with bland foods and slowly easing back into your regular diet.
#2. E. coli
Chipotle has also been under fire for illnesses caused by the foodborne bacteria Escherichia coli (E. coli). In late December, the CDC launched investigations into 52 cases of E. coli contracted at Chipotle locations in nine states.
E. coli is commonly found in rare or raw meats and other undercooked foods, as well as some fruit juices and water. Most strains of E. coli are harmless—in fact, some are essential to our health by acting as a "friendly bacteria" in our intestines, helping to ensure proper digestion—but some types can cause abdominal cramps and diarrhea. The most dangerous strain is E. coli O157:H7, which has been shown to cause kidney failure and can even be fatal.
Symptoms: Although norovirus and E. Coli both have stomach-related symptoms, there are some key differences, starting with the length of the incubation period. While norovirus typically causes vomiting within a day or two, E. coli's symptoms don't kick in for three to four days after infection. The specific symptoms vary, too: Norovirus is characterized by vomiting, with some diarrhea, but E. Coli is marked by bloody diarrhea, fever and abdominal cramping, usually without the vomiting.
Prevention: To avoid dangerous E. Coli infections, the CDC recommends the following:
Salmonella poisoning (salmonellosis) is caused by a bacteria called Salmonella enterica. Like norovirus and E. coli, it is often transmitted via contaminated food--primarily beef, milk, eggs and poultry. It can also be carried by some animals. Recent outbreaks are listed on the CDC site.
Symptoms: Those with salmonella typically experience abdominal pain, diarrhea and fever. Symptoms appear within one to three days of contamination. Young children, elderly people and those with weakened immune systems are at higher risk of severe illness.
Prevention: The best way to prevent the spread of Salmonella is to wash hands frequently with soap and water, especially before preparing food, after using the bathroom and after coming in contact with animals. The FDA also recommends washing fruits and veggies before cooking or consuming them.
Recovery: Symptoms of Salmonella usually diminish within four to seven days, although it may be several weeks or even months before digestion fully returns to normal. A small number of infected people develop Reiter's syndrome, which can lead to chronic arthritis.
#4. Hepatitis A
Although not as common as other foodborne illnesses, Hepatitis A affects up to 50,000 Americans each year. Most cases are spread by food prepared by a contaminated person. In 2013, the CDC reported that 165 people became ill after contracting hepatitis A from pomegranate seeds contained in Townsend Farms Organic Antioxidant Blend.
Symptoms: Hepatitis A has the longest incubation period of any of the illnesses on this list: Symptoms aren’t typically noticeable until around 28 days after infection, although they can appear sooner for some cases. Most infected people experience abdominal pain, headache, muscle aches, fever, appetite loss and general fatigue. In many cases, jaundice occurs a few days later. Approximately 70 percent of children who contract the virus do not develop symptoms.
Prevention: Hepatitis A has the distinction of being the only food-related disease that can be prevented with a vaccine. Starting in 2006, the vaccine has been recommended for all children between the ages of 12 and 23 months old. Many people have not been vaccinated. As with other foodborne illnesses, the CDC recommends frequent hand washing before preparing food and after using the bathroom.
Recovery: The best treatment for Hepatitis A is rest, nourishment and hydration. Most people make a full recovery. Symptoms usually diminish in less than eight weeks, although they can persist for up to six months. Itchy skin can be a lingering side effect for several months. In rare cases, Hepatitis A may develop into a more severe and potentially fatal condition called Fulminant Hepatitis A, which can lead to liver failure.
#5. Listeria (Listeriosis)
Caused by the bacterium Listeria monocytogenes, this potentially deadly illness poses the biggest danger to pregnant women, who are 20 times more likely to contract it. Other vulnerable groups include older adults, newborns and those with weakened immune systems. Listeria is carried by animals and can be spread through consumption of contaminated milk, meat, cheese, cold cuts and vegetables.
The recent listeria outbreaks listed on the CDC website include the contamination of soft cheeses distributed by Karoun Dairies and the contamination of ice cream products from Blue Bell Creameries. Earlier outbreaks in 2015 have involved caramel apples, soy products, cheeses, cantaloupe and more.
Symptoms: Most infected people experience nausea, diarrhea, fever, body aches, headaches, stiff neck and disorientation. In rare cases, listeria can spread to the nervous system and cause severe illness or even death. In pregnant women, the illness can result in a potentially life-threatening fetal infection. In some at-risk groups, listeria can lead to meningitis or septicemia.
Prevention: To avoid contamination, the CDC recommends the following listeria prevention techniques:
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