In response to my question about his gastro symptoms, Mr. Dooley replied, “About three weeks ago my son — he’s about 40 years old — anyways, he started getting some abdominal cramps, a lot of gas, and man did it stink. His bowels were loose too … still are in fact. So, a couple days later I start having all the same symptoms. We’ve both had them for over two weeks and neither of us is getting better. It’s not like it’s going to kill us, but it sure makes you feel puny.”

With some more questions, it turned out the son had been on a hike a couple days before the symptoms started. He drank out of the streams without filtering or boiling the water. And, as a thoughtful gesture to his dad, he had brought home a water bottle of stream water for his dad to enjoy. After a couple of stool tests came back, our suspicions were confirmed: the two men had Giardia, often called, hikers’ diarrhea. Giardia is a frequent contaminant of mountain streams and causes the symptoms we have mentioned.

That year, as is true every year, they were not alone in their misery. The Center for Disease Control estimates that each year about 1 in 6 Americans (approximately 50 million people) get sick, 128,000 are hospitalized, and 3,000 die of foodborne diseases.

What are the most frequent bad guys? Number one by far is Norovirus, causing over half of the foodborne illnesses. It is highly contagious from aerosol droplets from infected persons or poorly washed hands, and stays infectious for days on surfaces such as counters.

No wonder it occasionally decimates cruise ships, adult living facilities, prison populations and other enclosed groups of people. Generally, it passes after 2-3 days, but by its very commonness it is still one of the top causes of foodborne deaths, usually from electrolyte imbalance or severe dehydration.

The gnarly virus is followed by bacterial bad guys with hard-to-pronounce names such as Salmonella, Clostridium, Campylobacter and Staphylococcus, in order of frequency. Common sources of these bacteria include undercooked chicken or eggs, unpasteurized milk, meats and gravies left at room temperature and any food handled by a contaminated person with unwashed hands.

Unfortunately, the list goes on. There is the rarer, but more deadly, botulism, found in improperly home-canned foods or in small amounts in honey (an adult will not have a problem with the latter but the gut of infants under one year old can’t yet handle it).

More common but less deadly is the parasite, Toxoplasmosis. It is estimated that about 60 million Americans carry this parasite, but only those with a lowered immune system exhibit the symptoms of fatigue, muscle pains and swollen lymph nodes. It is usually picked up by eating undercooked meat, especially pork, lamb and venison, or by coming in contact with cat feces and not washing hands well before eating.

One last player worth mentioning is hepatitis A. This is the hepatitis that generally is not deadly but still makes you miserably sick for weeks.

It is picked up in contaminated water or food, such as inadequately washed fruits or vegetables, or that which has been handled by an infected food handler. Hepatitis A is one of the only serious foodborne illnesses for which there is a preventive vaccine.

A lot of gastro illnesses are picked up by person-to-person contact, but as we’ve seen, contaminated food and water is another common source. It can be greatly reduced by some common precautions:

• Wash your hands well before eating or handling food

• Cook your meats adequately

• Think twice before drinking unpasteurized milk

• Wash your food well

• After a utensil, cutting board or counter surface has been in contact with raw meat it needs to be washed thoroughly

• Food that is meat-based or made with mayonnaise needs to not be kept out at room temperature for a prolonged time

• If in doubt, throw it out — it’s not worth the consequences if it makes you really sick

• If you travel to a third world country, up all your precautions about ten-fold

• If in spite of your precautions you get gastro symptoms that are beyond mild or are hanging on for days, see your physician.

Hope I didn’t spoil your appetite. I love good food as much as the next person but a few precautions can keep you from paying dearly from a close encounter with one of these food-borne bad guys.

Andrew Smith, MD is board-certified in Family Medicine and practices at 2217 East Lamar Alexander Parkway, Maryville. Contact him at 982-0835.

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