Friday, March 21, 2014


If you ask people to name the most common cause of foodborne illness (“food poisoning”), they would probably say Salmonella or E.coli bacteria. But the most common cause is actually a virus – norovirus (which used to be called “Norwalk-like virus). I am particularly aware of this because I had it last week. Believe me, I am SO glad it is over.

Alright, it was basically only one evening and night of absolute misery, but it took several days for me to get my strength back. And when I finally got to see my doctor yesterday, she said a lot of it was “going around” in our part of California. Believe me, if it hits other people as hard as it hit me, I feel very sorry for them.

According to the U.S. Centers for Disease Control and Prevention (CDC), norovirus causes over half of all cases of food poisoning in the United States. In fact, it causes about five times as many cases as do Salmonella bacteria. But if you look at food poisoning from the point of view of people becoming so sick that they have to be hospitalized, norovirus comes in second – after Salmonella.

Let’s go one step further still – If you then look at causes of food poisoning that have resulted in death, norovirus comes in fourth – after Salmonella, Toxoplasma gondii, and Listeria monocytogenes . Yes, I certainly felt like death with norovirus, but in actual fact, it only kills about 11% of victims of food poisoning.

Norovirus can get into your food such as a salad, sandwich or other ready-to-eat or catered or restaurant items, entering via kitchen workers or food processors. But food isn’t the only way you can catch it. You can also get it from water, from surfaces and from direct contact with someone who is ill with the virus. How did I get it? My guess is from cleaning and opening oysters. Just because I don't eat them, doesn't mean I don't serve them to others.

Let's go back to the numbers again. So if you take all the ways you can catch norovirus into account (not just food) - each year on average 19 to 21 million cases of acute gastroenteritis are caused by noroviruses in the United States. That means about 1 in every 15 Americans will get a bad case of norovirus illness this year and some 570 to 800 of these people will actually die of it.

So what are the symptoms of norovirus? Basically vomiting, diarrhea, stomach cramps and sometimes a headache, fatigue, low-grade fever, and muscle aches. If you get dehydrated, you could also have a dry throat and decrease in urination. It sounds like the flu doesn’t it? But it isn’t. Even though norovirus illness is sometimes called “stomach flu” it is not related to the influenza virus.

Unfortunately there is no vaccine and no treatment for norovirus. Antibiotics do not work with viruses. Just tough it out – as I did, drinking lots of water and once you can tolerate them, beverages that replace your electrolytes such as sports drinks and other drinks or juices without caffeine or alcohol. And rest.

To your good health,


Sunday, March 16, 2014


Many people believe that freezing will kill any bacteria or viruses in food such as fruit or vegetables. Unfortunately, that is not true. Some nasty bugs that cause food poisoning survive freezing quite well.

The huge membership-only warehouse club, Costco, learned that lesson again last week. One of its suppliers - Oregon Freeze Dry, Inc. of Albany, Oregon had to recall almost 60,000 cases of Kirkland Signature Real Sliced Fruit, produced exclusively for Costco Wholesale Stores, after testing showed Salmonella bacteria could be present. The recalled product consists of 20 pouches of freeze-dried, supposedly healthy snacks in a pretty red and white box.

And of course this is not the only U.S. recall of frozen fruit or vegetables we have had over the years, that was caused by a bacterium – usually one of the Salmonella or Listeria monocytogenes. Even such unexpected frozen produce as chili peppers have had to be recalled.

Viruses can also survive freezing. In mid 2013, there was a recall of Scenic Fruit Company’s Frozen Organic Pomegranate Kernels and of Townsend Farms’ Frozen Organic Antioxidant Blend. Both contained pomegranate seeds imported from Turkey that were suspected of carrying a Hepatitis A virus. There was a resulting outbreak of hepatitis in seven U.S. states. Poor Costco also sold this Townsend Farms’ frozen product. The mix contained strawberries, raspberries, blueberries and cherries as well as the pomegranate seeds. Sounds great, doesn’t it?

This is not to say you should stop eating frozen fruit or vegetables. The chances of contamination are actually pretty slim - less than in fresh produce, and if you cook them thoroughly, you will be fine.

To your good health,


Thursday, March 6, 2014


If you suddenly find that you have bumps under the skin or tender lesions that look like those in the photo (Courtesy of the New York City Health Department) and they do not heal, you may want to see a doctor. This is especially the case if you have recently bought fish from one of New York’s fish markets located in Sunset Park, Brooklyn; Flushing, Queens; or Chinatown, in Manhattan.

The cause could be a bacterium called Mycobacterium marinum. This bacterium is common in fish and aquariums but it rarely causes infections in humans – until now. Recently there has been a cluster.

You don’t get ill from eating a fish that carries M. Marinum, but from touching it when you have a cut or abrasion on your hands. If not treated quickly with specific antibiotics, the infection can spread to the soft tissue below the skin and then get into your tendons and muscles. If untreated for a long time, you may even end up having to have surgery to repair damage to those damaged muscles, nerves or tendons.

So which fish is the cause and where did it come from? At the moment, we don’t know, but the investigation is ongoing.

By the way, there is no evidence that eating the fish from any of those markets could make you ill – just touching it. And, it can’t spread to other people if you have an infection. At least, that is the current thinking.

So the advice for now – wear waterproof gloves when preparing your fish. Some cuts on your hands can be so small that you are not even aware of them – but large enough to let bacteria get in.

To your good health,