You admire the holiday turkey sitting on the sideboard, but food safety experts look at it and wonder if it might be contaminated with salmonella.
You expect to pig out at the lavish buffet on your winter cruise. The experts aren't surprised if the food contains everything from E. coli to a generous helping of Norovirus.
To celebrate the season, Americans are entertaining, dining out in restaurants and taking holiday vacations. They are also getting food poisoning in record numbers, particularly this time of year when party food is left out at room temperature and frequent eating out increases the risk of exposure to stomach bugs. Be warned. That cream-filled pastry could be toxic - and not just to your thighs.
Even savvy cooks may not realize where danger lurks. Robin Spence, a registered dietitian at Union Memorial Hospital, had friends who properly thawed their turkey in the refrigerator, not on the kitchen counter, but some of the juices dripped down into the vegetable bin and onto the salad ingredients.
Everyone got sick.
"I'm a huge 'fraidy cat when it comes to any raw poultry," Spence says. She now uses Clorox wipes or her own mild bleach solution to clean cutting boards and knives when she's preparing raw chicken or turkey. And she thaws her frozen turkey on a platter in the refrigerator.
As for holiday feasts, "It makes me crazy when I see food sitting out," says Spence. "Snap it up there, folks! Clean up before the football game.
"And it's scandalous what people do with leftovers," she says. "They should be kept three or four days max." When in doubt, she adds, throw it out.
Food-borne infections will cause 76 million people to get sick and 325,000 to be hospitalized in the United States this year, the federal Centers for Disease Control and Prevention estimates. Most of these will be uncomfortable but relatively minor gastrointestinal illnesses, lasting one or two days.
Still, one or two days of vomiting, abdominal cramping and diarrhea can ruin a holiday.
One reason food-borne illnesses are on the increase is that busy Americans are eating out more than they used to.
Dr. Neil Goldberg, chief of gastroenterology at St. Joseph Medical Center in Towson, experienced food poisoning firsthand several years ago when he had dinner at a fancy Washington restaurant and ordered lobster with raspberry sauce as an appetizer. He was feeling bad by the end of the meal, and on his drive back to Baltimore had to stop the car to be sick.
The next morning he was scheduled to perform an endoscopy at 8 a.m., so he got to the hospital early and said to the nurse, "I feel horrible. I want you to pump my stomach out."
"After that I felt fantastic," he says. He went on to do the procedure. "The bottom line is that within 12 hours I felt better."
Well, OK. But it seems easier just to take the precautions Goldberg and other food safety professionals recommend, especially when you're in control of the kitchen. Even though those precautions are frequently suggested, says Spence, "we're still waiting for people to catch up."
Americans are sometimes reluctant to change their traditional ways of preparing holiday foods. No one they know has been food poisoned, they say. They resist using meat thermometers even though, as Giant Food's vice president of consumer affairs Odonna Mathews, who has a degree in nutrition, points out, the new quick-response thermometers make it easy to check the temperature of hot and cold foods in a few seconds.
"It's hard to make food safety front-page news," Mathews says, "unless there's an outbreak."
But food-borne illnesses are certainly in the public consciousness these days, with the frequent news stories about mad cow disease, outbreaks of E. coli and contaminated produce from Third World countries.
Salmonella poisoning from eating raw eggs isn't as much in the news as it used to be, but it's still a concern.
"I eat over-easy eggs," says Goldberg, "but I keep antibiotics nearby."
This time of year avoiding raw eggs also means not sampling the holiday cookie dough, and not letting children lick the bowl.
"The big thing about food-borne disease is the way marketing is done in 2004 compared to 1970," says Dr. John Bartlett, chief of the Division of Infectious Diseases at the Johns Hopkins University School of Medicine. "These days a single hamburger has meat from a hundred cows. We never used to have these huge outbreaks."
And it's not just meat and poultry. With the globalization of the food supply, you never know how many unwashed hands have handled the produce in your supermarket and what unfamiliar bacteria linger there. Even in the United States, which has one of the safest food supplies in the world, raw fruits and vegetables can be deadly.
Last November, tainted green onions were the source of hepatitis A contamination in Pennsylvania, Georgia and Tennessee. More than 500 people were infected and three ultimately died. In the 1990s, Guatemalan raspberries were to blame for an outbreak of cyclosporiasis, a diarrheal illness. The good news, says Bartlett, is that plain chlorinated tap water will kill bugs.
"Most of us eat this stuff all the time and don't get sick," adds Bartlett, but he also points out that certain groups of people are more at risk: bottle-fed babies, pregnant women, the elderly, and those whose immune systems are suppressed.
Even though food-borne infections can be relatively minor in the short run, the Food and Drug Administration believes a small percentage of them leads to secondary long-term illnesses. For example, certain strains of E. coli can cause kidney failure in babies and young children.
Listeria, a bacteria found in soft cheeses, unpasteurized milk and imported seafood, is sometimes to blame for meningitis and stillbirths. Campylobacter, the second most common cause of diarrhea in the United States, is implicated in Guillain-Barre syndrome, a serious nervous system disorder.
The good news is that most people who get mild food poisoning suffer for a day or two and get better. The most important thing they can do is to replace the fluids they lose so they don't get dehydrated.
You don't really need to worry, say the experts, unless symptoms last for more than three days, you are light-headed, or you have bloody diarrhea, substantial abdominal pain, shaking chills, abdominal distention or fever over 101 degrees.
Otherwise, there's no need to call the doctor or dose yourself with over-the-counter medications.
"With self-limiting illnesses," says Goldberg, "it's better just to let them run their course."
Safety tips for the chef
Eight simple rules to avoid food-borne illnesses:
1. Wash your hands in hot, soapy water before, during and after preparing food.
2. Avoid cross-contamination by washing cutting boards and knives in hot, soapy water when you switch tasks. Better still, have two separate cutting boards, one for produce and one for meat, poultry and seafood.
3. Cook turkey and other whole poultry to 180 degrees, meat to 145-160 degrees and stuffing to 165 degrees.
4. Wash all produce in running water. Scrub firm fruits and vegetables with a clean brush.
5. Realize that you're taking a chance when you eat raw egg. That includes eggs sunny side up, raw cookie dough and old-fashioned Caesar salad dressing.
6. Set your refrigerator below 40 degrees.
7. Don't let food sit out at room temperature for more than two hours.
8. Use leftovers within three or four days, and reheat them to at least 165 degrees.