Eggs aren’t just for breakfast anymore. Low-carbohydrate diets finds more people consuming eggs, but there can be health risks if eggs are not handled, stored, and prepared safely.

Eggs – just like raw meat, poultry and fish – must be properly stored, handled and cooked – to be safe. Eggs that appear normal can contain a germ called Salmonella that can make you sick, especially if you eat raw or lightly cooked eggs. Eggs are safe when you handle and cook them properly.

Some unbroken fresh shell eggs may contain Salmonella enteritidis bacteria that can cause foodborne illness. While the number of eggs affected is quite small, there have been some scattered outbreaks in the last few years.

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What are the symptoms of a Salmonella infection?

Symptoms typically appear 6 to 48 hours after eating  contaminated food, though this period is sometimes much longer.  Some people can have diarrhea many times a day for several days and the sick person may need to be hospitalized.

In most cases, Salmonella illness lasts 4–7 days and people recover without antibiotic treatment. Symptoms include:

• Diarrhea
• Fever
• Abdominal cramps

Contact your doctor or healthcare provider if you have:

• High fever (temperature over 101.5°F).
• Diarrhea for more than 3 days that is not improving.
• Bloody stools.
• Prolonged vomiting that prevents you from keeping liquids down.
• Signs of dehydration, such as:
  • Making very little urine.
  • Dry mouth and throat.
  • Dizziness when standing up.

How can I reduce my chance of getting a Salmonella infection?

• Consider buying and using pasteurized eggs and egg products, which are widely available.
• Keep eggs refrigerated at 40°F (4°C) or colder at all times. Only buy eggs from stores and suppliers that keep them refrigerated.
• Discard cracked or dirty eggs.

Groups Vulnerable to FoodIllness

Older adults, infants, and people with weakened immune systems, such as those with HIV/AIDS, diabetes, or an organ transplant, may get a more serious illness that can even be life-threatening.

Salmonella can cause intestinal infections that can be serious (or even fatal) especially for people who are at higher risk of foodborne illness such as young children, elderly, and those who have a weakened immune system.

Storing, Handling and Cooking Eggs

Knowing how to safely buy, store, handle and cook eggs, and the foods that contain eggs, is important. Read on for a quick review of egg handling, preparation, storage and safety.

Storage Tips

• Refrigerate at 45°F or below. Do not freeze.
• Store shell eggs in their case and away from foods with strong odors, such as fish, cabbage, or onions.
  Rotate: first in, first out.
• Eggs can be kept refrigerated in their carton for at least four to five weeks beyond the pack date.

Handling Tips

• Always wash hands when handling eggs.
• Take out only as many eggs as needed for immediate use.
• Do not stack egg trays near the grill.
• Use only clean, un-cracked eggs.
• Eggs should not be washed before using. They are washed and sanitized before they are packed.
• Never mix the shell with the internal contents of an egg.
• Do not re-use a container after it has had a raw egg mixture in it. Clean and sanitize it thoroughly before using it again.

Cooking Tips

It’s not necessary to cook eggs until hard or rubbery in order to kill any bacteria that may be present. Always cook eggs until both the white and yolk are firm. Casseroles and other dishes containing eggs should be cooked to a safe minimum internal temperature of 160°F.

Summary

Eggs – just like raw meat, poultry and fish – must be properly stored, handled and cooked – to be safe. Eggs that appear normal can contain a germ called Salmonella that can make you sick, especially if you eat raw or lightly cooked eggs. Eggs are safe when you handle and cook them properly.

#NationalEggDay is observed annually on June 3 . It is not only the perfect time to celebrate by trying a new egg recipe, but also to refresh you food safety knowledge and procedures on eggs.

References

1. USDA (2006, August). Egg Products and Food Safety.
   http://www.fsis.usda.gov/Fact_Sheets/Egg_Products_and_Food_Safety/index.asp
2. Food Safety and Inspection Service (2006, May). Shell Eggs from Farm to Table.
   http://www.fsis.usda.gov/Fact_Sheets/Focus_On_Shell_Eggs/index.asp

Norovirus is a highly contagious virus and the most common viral foodborne illness. According to the CDC, every year in the United States, norovirus leads to as many as 71,000 hospitalizations and 800 deaths. Likewise, each year, foodborne norovirus illness costs about $2 billion, mainly due to lost productivity and healthcare expenses.

Biological Foodborne Contamination

Food contamination refers to food that has been defiled by a harmful microorganism, toxin, substance, or object.

A food contaminant is any harmful or poisonous agent (biological, chemical, or physical) – that is not naturally inherent to the food itself – in an amount that has the potential to pose a threat to human health or cause illness.

Because food becomes hazardous by contamination, food contaminants are also referred to as food hazards. A hazard is any source of potential damage, harm, or adverse health effects on something or someone.

Biological food hazards are biological agents that can pose a threat to human health. Biological hazards are the main causes of foodborne illness.

Biological food hazards are also called foodborne pathogens – or infectious organisms that are capable of causing human disease. These pathogenic organisms include bacteria, viruses, and parasites. With the exception of certain parasites, most biological foodborne pathogens are microscopic.

How do people become infected with Norovirus?

Anyone can get norovirus. Young children, the elderly, and anyone who already has other illnesses may experience longer, more serious illness, and rarely, death.

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Only a few norovirus particles can make people sick and the infection can be acquired a few different ways:

• Consuming water – or produce (fruit and vegetables) irrigated with water – contaminated with human or animal feces.
• Consuming shellfish (oysters, clams, mussels, scallops), crustaceans (shrimp, crabs, and lobsters), and their products – that are farmed or harvested in water contaminated with human sewage.
• Consuming food handled by a person infected with the virus – or an uninfected person transfers the virus to food with contaminated hands.
• In direct contact with an object, surface, or person that has been infected with the virus and then touches their nose, mouth, or eyes.

Symptoms of Norovirus Infection

Symptoms of norovirus infection typically begin 12 to 48 hours after exposure, last for 1 to 3 days, and cause acute gastroenteritis (diarrhea, vomiting, and abdominal pain) along with fever, headache, and body aches.

2018 Contaminated Oyster Norovirus Outbreak

The FDA reported a 2018 multi-state outbreak of Norovirus illnesses that was associated with contaminated oysters harvested in Baynes Sound, British Columbia, Canada,  and were distributed to AK, CA, FL, HI, IL, MA, NY, and WA. The contamination was determined to be human sewage in the marine environment.

According to the the Public Health Agency of Canada, a total of 176 cases of gastrointestinal illness linked to oyster consumption were reported in three provinces: British Columbia (137), Alberta (14), and Ontario (25). No deaths were reported. Individuals became sick between mid-March and mid-April 2018.

The California Department of Public Health (CDPH) reported approximately 100 individuals reported illness after they consumed raw British Columbian oysters sold by restaurants and retailers throughout the state.

Although the outbreak appears to be over, this outbreak is a reminder that oysters are a known risk for causing food-related illness if consumed as a raw product.

Norovirus Prevention – How can I stay safe?

Because norovirus is highly contagious, infection outbreaks occurs most frequently in closed and crowded environments such as restaurants, hospitals, nursing homes, child care centers, schools and cruise ships.

Maintaining good hygiene is the first line of defense. In addition to washing with soap and water after using the bathroom or eating, it is also recommended using alcohol-based sanitizers as an additional safety measure.

Follow these tips to reduce your chances of getting a norovirus infection:

• Don’t eat raw or undercooked oysters or other shellfish. Fully cook them before eating, and only order fully cooked oysters at restaurants.
• Safe cooking and food preparation is also essential – by thoroughly disinfecting kitchen surfaces, washing all produce, and cooking all food to adequate temperatures.

• Separate cooked seafood from raw seafood and its juices to avoid cross contamination.
• Wash your hands with soap and water after handing raw seafood.
• Cover any wounds if they could come into contact with raw seafood or raw seafood juices or with brackish or salt water.
• Wash open wounds and cuts thoroughly with soap and water if they have been exposed to seawater or raw seafood or its juices.

References

• Centers for Diseases prevention and Control (CDC) – Norovirus
  https://www.cdc.gov/norovirus/trends-outbreaks/burden-US.html
• Mayo Clinic – Noroviros Infection
  https://www.mayoclinic.org/diseases-conditions/norovirus/symptoms-causes/syc-20355296
• CDC – Food Safety
  https://www.cdc.gov/foodsafety/foodborne-germs.html
• U.S. FDA – Foodborne Illnesses
  https://www.fda.gov/food/consumers/what-you-need-know-about-foodborne-illnesses
• U.S. FDA – Foodborne Pathogens
  https://www.fda.gov/food/outbreaks-foodborne-illness/foodborne-pathogens
• FDA – Fish and Fishery Products Hazards and Controls Guidance
  https://www.fda.gov/food/seafood-guidance-documents-regulatory-information/fish-and-fishery-products-hazards-and-controls-guidance-4th-edition

While many people enjoy fresh raw oysters – raw shellfish (e.g. oysters, clams, mussels) can pose an increased risk to be contaminated  – as they are filter feeders and become contaminated when their waters are polluted with raw sewage and bacteria.

Oysters can be contaminated with a variety of foodborne pathogens such as E. coli, norovirus, hepatitis A, and Vibrio vulnificus – which can put anyone at risk for infections.

August 5 is National Oyster Day! To ensure you’ll have shuckin’ good time – don’t gamble on your chances of getting sick with raw contaminated shellfish. Always eat cooked shellfish – i.e., by baking, grilling, or broiling.

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Norovirus

Norovirus is a highly contagious virus that can cause viral gastroenteritis, often called “food poisoning” or the “stomach flu.” Eating raw or partially cooked shellfish can cause norovirus infection.

Norovirus makes its way into the marine environment through untreated human sewage (poop) and vomit. This may come from leaky septic systems, faulty waste water treatment plants, boaters, or beach-goers. Shellfish are filter feeders, which means they filter seawater through their bodies to get food floating in the water. When norovirus particles are in the water, shellfish can accumulate the virus in their bodies.

Vibrio and Vibriosis

About a dozen Vibrio species can cause human illness, known as vibriosis. The most common species causing human illness in the U.S. are Vibrio parahaemolyticus, Vibrio vulnificus, and Vibrio alginolyticus.

The CDC estimates 80,000 people become sick with vibriosis, and 100 people die from their infection, in the United States every year. Most of these illnesses happen from May through October when water temperatures are warmer. However, you can get sick from eating raw or undercooked oysters during any month of the year, and raw oysters from typically colder waters also can cause vibriosis.

Remember, you can’t tell if a raw oyster contains Vibrio germs from the way it looks, smells, or tastes. Always make sure oysters are fully cooked to stay safe from food poisoning.

Most Vibrio infections from oysters, such as Vibrio parahaemolyticus infection, result in only diarrhea and vomiting.

However, people with a Vibrio vulnificus infection can get very sick. Some people can even get infected through an open wound when swimming or wading in brackish or salt water.

This is because the infection can result in bloodstream infections, severe blistering skin lesions, and limb amputations. If you develop symptoms of vibriosis, tell your medical provider if you recently ate or handled raw shellfish.

Anyone can get sick from vibriosis, but you may be more likely to get an infection or severe complications if you:

• Have liver disease, alcoholism, cancer, diabetes, HIV, or thalassemia.
• Receive immune-suppressing therapy for the treatment of disease, such as for cancer.
• Have an iron overload disease, such as hemochromatosis.
• Take medicine to lower stomach acid levels, such as Nexium and Pepcid.
• Have had recent stomach surgery.

How can I stay safe?

Follow these tips to reduce your chances of getting an infection when eating or handling shellfish and other seafood:

• Don’t eat raw or undercooked oysters or other shellfish. Fully cook them before eating, and only order fully cooked oysters at restaurants. Hot sauce and lemon juice don’t kill Vibrio bacteria and neither does alcohol.
  • Some oysters are treated for safety after they are harvested. This treatment can reduce levels of vibrios in the oyster but it does not remove all harmful germs. People who are more likely to get vibriosis should not eat any raw oysters.
• Separate cooked seafood from raw seafood and its juices to avoid cross contamination.
• Wash your hands with soap and water after handing raw seafood.
• Cover any wounds if they could come into contact with raw seafood or raw seafood juices or with brackish or salt water.
• Wash open wounds and cuts thoroughly with soap and water if they have been exposed to seawater or raw seafood or its juices.

Safety Tips for Cooking Shellfish

Before cooking, throw out any shellfish with open shells.

For oysters in the shell, either:

• Boil until the shells open and continue boiling 3–5 more minutes, or
• Steam until the shells open and continue steaming for 4–9 more minutes.
• Only eat shellfish that open during cooking. Throw out shellfish that do not open fully after cooking.

For shucked oysters, either:

• Boil for at least 3 minutes or until edges curl;
• Fry for at least 3 minutes at 375°F;
• Broil 3 inches from heat for 3 minutes; or
• Bake at 450° F for 10 minutes.

Additional information

• Take a look at CDC’s questions and answers about Vibrio and vibriosis
• Listen to CDC podcast on the dangers of eating raw oysters
• Be food safe – learn how you can protect yourself from food poisoning
• Read more guidance on FoodSafety.gov for preventing Vibrio infections
• Learn more about aquaculture: http://www.fisheries.noaa.gov/aquaculture/index.htm
• Learn more about Pacific and Eastern oysters from FishWatch: http://www.fishwatch.gov/profiles/search/oyster

Bacteria are a member of a large group of unicellular microorganisms – some of which can cause human disease. Although most bacteria are harmless or often beneficial, some bacteria are pathogenic, or those that can pose a threat to human health or cause illness.

Bacteria and viruses are responsible for most foodborne illnesses and are the biggest threat to food safety.

Bacteria grow more favorably in foods that are warm, moist, protein-rich, and low in acid. Under the right conditions, bacteria can double every 10 to 30 minutes. A single bacterium can become billions in 10 to 12 hours. Bacteria grow fastest in the temperature range between 40°F and 140°F, which is known as the Temperature Danger Zone.

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Most Common Types of Pathogenic Food Bacteria

Bacteria are a category of food hazards called biological food hazards – or infectious microorganisms that are capable of causing human disease – including bacteria, viruses, and parasites.

More than 90 percent of the cases of food illness are caused by a few types of pathogenic bacteria:

• Bacillus cereus – A toxin-producing bacteria that is one of the most common causes of food illness. However, the vast majority of cases go unreported, because the symptoms are generally mild and short-lived (up to 24 hours) and subside on their own. The bacteria are present in foods (particularly pasta, rice, as well as sauces and soups) and can multiply quickly at room temperature. If cooked food is allowed to cool, slowly the spores can germinate and reheating or lightly cooking the food will not destroy this toxin.
• Campylobacter – A bacteria causing food illness associated with eating raw or undercooked poultry or from other foods contaminated by raw poultry. Symptoms include diarrhea (often bloody), fever, and abdominal cramps accompanied with nausea and vomiting. Causes an estimated 1.3 million illnesses each year.
• Clostridium perfringens – A spore-forming bacterium found naturally in many environmental sources, in the intestines of humans and animals, and on beef, poultry, gravies, and dried or precooked foods. Illness commonly occurs when cooked food contaminated with the bacteria is left out at incorrect temperatures, which allows rapid multiplication and results in toxin production. Symptoms are mild and include diarrhea and abdominal cramps (not fever or vomiting).
• Escherichia coli – Commonly referred to as E. coli, they are bacteria commonly found in the digestive tracts of animals and humans, where they assist with normal digestive processes. While some strains produce toxins that are responsible for gastroenteritis, others are responsible for urinary tract infections and respiratory illness. Symptoms include abdominal cramps and diarrhea, which may be bloody. Fever and vomiting may also occur.
• Listeria monocytogenes – Also referred to as Listeria, this bacterium bacteria is found in the soil and water and in some animals, including poultry and cattle. It can also be present in unpasteurized (raw) milk and dairy products. Pasteurization, cooking, and most disinfecting agents kill L. monocytogenes. Symptoms include fever and chills, headache, upset stomach and vomiting. Treatment is with antibiotics. Unlike most bacteria, L. monocytogenes can grow and multiply at low temperatures, making the bacteria a potential problem even in properly refrigerated food. Compared to other foodborne illnesses, listeriosis is rare but very serious. Even with adequate antibiotic treatment, the disease has a high mortality rate of 20 to 30 percent. Over 90 percent of people with listeriosis are hospitalized.
• Salmonella – Bacteria that are commonly found in the digestive tracts of animals and humans and are shed through feces. Salmonella infection is usually caused by eating raw or undercooked meat, poultry, eggs or egg products. Symptoms are generally typical of gastroenteritis (diarrhea, vomiting, abdominal pain) along with fever, chills, and headache.
• Shigella – Genetically closely related to E. coli, Shigella causes disease in humans and primates, but not in other mammals. Infection is cause by consuming water or food supplies that been contaminated with feces from humans or animals. Also, from touching the mouth after caring for an infected person or changing the diaper of an infected child. Gastroenteritis – diarrhea, fever, and stomach cramps start a day or two after they are exposed to the bacteria.
• Staphylococcus aureus – Also referred to as “Staph”, this type of bacteria is commonly found on the skin and hair as well as in the noses and throats of humans and animals. People who carry Staph can contaminate food if they don’t wash their hands before touching it. A staph infection in food usually doesn’t cause a fever. Signs and symptoms you can expect with this type of Staph infection include nausea and vomiting, diarrhea, and dehydration. Although most Staph infections from food are not serious, the bacteria can cause serious infections when entering the bloodstream.
• Vibrio parahaemolyticus – Commonly called Vibrio, are bacteria that occur naturally in warm coastal areas, such as the Gulf of Mexico. These bacteria are found in higher concentrations in the summer months when water gets warmer and and most commonly causes gastroenteritis. A Vibrio infection can be acquired by eating raw or undercooked shellfish or drinking contaminated water. Eating raw oysters is the most common way the infection is spread as the organism naturally lives in the warm tidal waters where oysters grow. Eating raw or undercooked fish and crustaceans, such as crabs and lobsters, has also been associated with foodborne outbreaks of this infection. Symptoms are generally typical of gastroenteritis (diarrhea, vomiting, abdominal pain) along with fever and headache.
• Yersinia enterocolitica – A bacterial infection caused most often by eating contaminated food, especially raw or inadequately cooked pork products. Drinking contaminated unpasteurized milk or untreated water can also transmit the infection. The bacteria causes a condition called enterocolitis, which is an inflammation of the small intestine and colon that occurs, but also symptoms such as diarrhea and a fever, mostly in young children.

References

• FoodSafety.gov – Bacteria and Viruses
  https://www.foodsafety.gov/poisoning/causes/bacteriaviruses/index.html
• The National Institute of Diabetes and Digestive and Kidney Diseases Health Information Center
  https://www.niddk.nih.gov/health-information/digestive-diseases/foodborne-illnesses
• CDC – Food Safety
  https://www.cdc.gov/foodsafety/foodborne-germs.html
• U.S. FDA – Foodborne Illnesses
  https://www.fda.gov/food/consumers/what-you-need-know-about-foodborne-illnesses
• U.S. FDA – Foodborne Pathogens
  https://www.fda.gov/food/outbreaks-foodborne-illness/foodborne-pathogens
• U.S. National Library of Medicine – Medline Plus – Bacterial Infections
  https://medlineplus.gov/bacterialinfections.html