Food safety is a concern at all stages of life but food poisoning in older adults is of particular interest. Here’s why. Seniors aged 65 or older are especially vulnerable and make up the largest portion of the 128,000 hospitalizations and 3,000 deaths that happen every year as a result of foodborne illnesses.
Even if they don’t die, seniors are more vulnerable to long-term complications and disabilities as a result of food poisoning cases.
Why Are the Elderly More Vulnerable to Food Poisoning?
A few different factors contribute to why older adults are more at risk from foodborne pathogens. The most direct is that the immune system loses potency as we age and becomes less capable of fighting off intruders. Another element is how stomach acid production tends to decrease in older individuals. Since stomach acid is the first line of defense against foodborne pathogens, decreased production means it’s easier for intruders to survive ingestion. Lastly, elderly individuals are more likely to have chronic illnesses, recover from major surgeries, suffer from malnutrition or immobility, and other factors that increase susceptibility to infection.
A large variety of diseases can be transmitted through food and the most common ones fall into the categories of bacteria or viruses. What follows is not an exhaustive list, merely a compilation of the most common causes.
Bacterial Foodborne Illnesses in Adults and the Elderly
- Botulism: Botulism is a rare disease caused by the spectacularly toxic Clostridium botulinum bacteria. The typical symptoms include double vision, blurred vision, drooping eyelids, slurred speech, difficulty swallowing, dry mouth, and muscle weakness that can advance to paralysis and death. Botulism tends to crop up in cases where food with low acid content is improperly canned.
- E. coli: E. coli is one of the more common forms of food poisoning. E. coli causes stomach cramps, diarrhea, vomiting, and low grade fever. In the elderly these symptoms can result in life-threatening dehydration if not addressed. Unpasteurized milk, contaminated water, and eating food handled by someone who didn’t wash their hands properly after using the bathroom are all possible sources of infection.
- Salmonella: This disease is spread similarly to E. coli and causes similar symptoms; however, it is less common. The main difference is salmonella can potentially spread to the bloodstream and cause life-threatening infections across the entire body. The elderly, infants, and those with compromised immune systems are most vulnerable to this side-effect.
Common Viral Foodborne Illnesses in Older Adults
- Hepatitis A: This is a short-lived type of the hepatitis liver infection. Hepatitis A is not chronic and is spread by contact with food, drinks, or objects contaminated with even microscopic amounts of infected fecal matter. Not everyone with hepatitis A will show symptoms but those who do can experience fever, fatigue, loss of appetite, nausea, vomiting, abdominal pain, dark-colored urine, clay-like bowel movements, joint pain, and a yellowing of the skin called jaundice. Hepatitis A is not normally fatal even among the elderly, but is known to cause liver failure in rare cases. This is more common if the person has other liver diseases, which the elderly are more likely to have.
- Norovirus: The most common cause of foodborne illness outbreaks in the U.S., norovirus is extremely easy to spread. It causes a condition called gastroenteritis, which means that it inflames the stomach and intestines. This results in stomach pain, nausea, diarrhea, and vomiting and can be deadly in young children and older adults. Drinking and eating contaminated foods, touching contaminated surfaces, and contact with an infected person can all spread the disease.
Sources of Foodborne Illnesses
The above summaries mentioned a few ways that food poisoning can be transmitted but there are others. Speaking broadly, food can be contaminated in any of the following ways:
- Meat becomes contaminated during slaughter by contact with intestinal content.
- Fruit and vegetables can be irrigated with tainted water.
- Salmonella can be transmitted through eggs.
- Norovirus circulates in the sea through sewage dumping and can infect seafood.
- Contamination by workers who don’t wash their hands thoroughly.
- Cross-contamination by using the same knife, surface, or utensil to cook meat and fruit or vegetables.
- A food product that is left in a warm, moist environment overnight.
- Food that is not cooked thoroughly enough.
It is worth noting that freezing or refrigerating a food does not kill the pathogens but often places them in a sort of suspended state. Since most microbes require building up to a certain level to pose as a health risk, refrigeration is often enough to prevent infection. Similarly, microbes can’t survive well in acidic or salty environments, which is why salted meat or pickled vegetables are typically considered safe. High levels of heat, even for a few seconds, can also kill off many microbes.
There are, of course, exceptions to every rule. Listeria bacteria, for instance, can grow even when refrigerated and the staphylococcus toxin can survive high temperatures.
How to Protect Yourself From Food Poisoning
- Refrigerate or freeze all perishable foods.
- Always thaw frozen food either in the fridge, cold water, or microwave. Cook the food as soon as possible after thawing.
- Wash hands with warm, soapy water before preparing food. Wash hands, utensils, and work surfaces after contact with raw meat.
- Don’t leave perishable food out for more than two hours, or one hour in case of room temperatures over 90 degrees Fahrenheit. This includes takeout or delivery meals as well.
- If dealing with a pre-made hot meal, eat or refrigerate it within two hours of receiving the food.
- Pre-made cold foods should be eaten or refrigerated immediately.
- Thoroughly cook raw meat, poultry, and fish. Meat should be cooked to an internal temperature of at least 160 degrees Fahrenheit (ground) or 145 degrees Fahrenheit (whole), poultry should be cooked to a minimum of 165 degrees Fahrenheit, fish to 145 degrees Fahrenheit, and egg dishes to 160 degrees Fahrenheit. Use a meat thermometer to confirm temperature.
Food poisoning in older adults is something that we all need to be aware of. Remember that there’s no need to take risks and erring on the side of caution can be important for safety. When in doubt, throw it out!
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Sources for Today’s Article:
“A New Fact Sheet On Foodborne Illnesses In Older Adults,” Healthinaging.org, November 10, 2014; http://www.healthinaging.org/news/press-releases/article:11-10-2014-12-00am-a-new-fact-sheet-on-foodborne-illnesses-in-older-adults/.
“Botulism – General Information,” Centers for Disease Control and Prevention web site, April 25, 2014; http://www.cdc.gov/nczved/divisions/dfbmd/diseases/botulism/.
“E. Coli – General Information,” Centers for Disease Control and Prevention web site, November 6, 2015; http://www.cdc.gov/ecoli/general/index.html.
“Foodborne Germs and Illnesses,” Centers for Disease Control and Prevention web site, September 24, 2015; http://www.cdc.gov/foodsafety/foodborne-germs.html.
“Hepatitis A Questions and Answers for the Public,” Centers for Disease Control and Prevention web site, September 2, 2015; http://www.cdc.gov/hepatitis/hav/afaq.htm#causesymptoms.
“Norovirus Overview,” Centers for Disease Control and Prevention web site, July 26, 2013; http://www.cdc.gov/norovirus/about/overview.html.
“Older Adults and Food Safety,” United States Department of Agriculture web site, http://www.fsis.usda.gov/wps/wcm/connect/ab56957a-3f3c-4b67-aece-44ef1890b0fd/Older_Adults_and_Food_Safety.pdf?MOD=AJPERES, last accessed November 18, 2015.
“Salmonella,” Centers for Disease Control and Prevention web site, March 9, 2015; http://www.cdc.gov/salmonella/general/index.html.