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CONTAMINANTS FOOD-BORNE ILLNESSES smart FOUND IN SEAFOOD: • Bacteria – The Vibrio bacterium is Some caution should be taken when eating seafood most commonly reported as the cause of food-borne disease. It usually follows consumption of improperly ish and seafood are low in fat and are HOW TO PROTECT handled seafood or raw shellfish. It excellent sources of protein, vitamins, YOURSELF: usually causes diarrhea and abdominal and minerals. However, the danger pain lasting 1 to 7 days and can F When purchasing seafood at the grocery store or of eating seafood contaminated with sometimes cause death. fish market: toxins, bacteria, or viruses is a real public • Viruses – The Norwalk virus results • Buy seafood last before going home. health concern. in outbreaks of gastrointestinal • Look for the freshest quality when buying fresh As many as 9,000 deaths and 6.5 disease, which can cause dehydrating fish. Whole fish should have clear, bright eyes million to 33 million illnesses in the United diarrhea. Recent outbreaks have been that protrude, bright red or pink gills, no slime, States each year are believed to be related associated with the consumption of firm yet elastic flesh, and shiny skin. Fillets to all food-borne contaminants. raw oysters, but the virus can also be spread should also be firm and have a moist appearance, Pregnant women and their fetuses are through contaminated water and ice, salads, with no browning at the edges. among the groups at higher risk frosting, other shellfish, and person-to-person • The fish should be cold to the touch and not smell for food-borne infections. contact. Hepatitis A virus (HAV) infects the “fishy.” However, there is some liver and causes symptoms that include fever, • At the checkout counter, ask to have your seafood preliminary good news, fatigue, nausea, abdominal discomfort, dark bagged separately, at the top of your grocery bag according to an article urine, and jaundice after a prolonged or with other cold items. If your trip home will in this issue of incubation period that can last more then 2 take more than an hour, pack your seafood in a JAMA (page months. HAV is primarily spread person-to- cooler with ice. 701). The person in a fecal-oral route. But outbreaks At home: study have occurred when certain types of foods • Store seafood in the coldest part of your indicates (shellfish, lettuce, frozen raspberries, and refrigerator at a temperature as close to 32º F as that frozen strawberries) were contaminated before possible. preparation. • Do not use wooden cutting boards for cutting raw • Natural Toxins – These toxins cannot be fish, poultry, or meat. Plastic boards are easier to identified by sight, smell, or taste and cannot clean and sanitize. Thoroughly clean any surface be destroyed by cooking or processing. or utensil after each use. Symptoms range from upset stomach and • Do not reuse any platter or plate used to diarrhea to paralysis and death. transport raw seafood until it has been • Chemical Residues – Toxic chemicals, such thoroughly cleaned. children as methylmercury (MeHg), • The shelf life of fish varies by variety and quality. of women polychlorinated byphenyls (PCBs), and As a general rule of thumb, try to use fish or who were dioxin, can accumulate in aquatic animals shellfish within 1 or 2 days of purchase. exposed to and endanger the lives of people who eat • Never thaw frozen seafood at room temperature, mercury from eating them. Studies like the current one in JAMA or with hot or warm water. Defrost it in the fish while they were continue to investigate the effects of these refrigerator. If that’s not possible, thaw it under pregnant did not chemicals. cold running water. experience any more • Marinate all seafood in the refrigerator and not at FOR MORE INFORMATION: developmental problems than room temperature. children born to women not • Food and Drug Administration and the Center • Refrigerate leftover seafood within 1 hour and exposed to mercury. for Food Safety and Applied Nutrition eat within 2 days. The overall health benefits of eating Food Information & Seafood Hotline 800/FDA-4010 or www.fda.gov seafood outweigh the small possibility of WHO IS AT INCREASED RISK? food poisoning. Just follow the • Centers for Disease Control and Prevention recommended precautions on this page to People more susceptible to food-borne infections Office of Health Communication protect yourself. include: National Center for Infectious Diseases • Those with lowered immunity due to HIV or AIDS 1600 Clifton Road, MS C-14, Atlanta, GA 30333 Additional Sources: Food and Drug • Those on medications for cancer treatment or or www.cdc.gov/ncidod/diseases/foodborn Administration, U.S. Department of Agriculture, organ transplantation /foodborn.htm U.S. Environmental Protection Agency, Centers for • Pregnant women and their fetuses Disease Control and Prevention, Council for • People with diabetes INFORM YOURSELF: Agricultural and Technology, U.S. • Young children To find this and previous JAMA Patient Pages, Department of Health and Human Services Public • The elderly check out the AMA’s Web site at Health Service, National Academy of Sciences www.ama-assn.org/consumer.htm.

Mi Young Hwang, Writer Richard M. Glass, MD, Editor Jeff Molter, Director of Science News The JAMA Patient Page is a public service of JAMA and the AMA. The information and recommendations appearing on this page are appropriate COPY FOR YOUR PATIENTS! in most instances; but they are not a substitute for medical diagnosis. For specific information concerning your personal medical condition, JAMA and AMA suggest that you consult your physician. This page may be reproduced noncommercially by physicians and other health care professionals to share with patients. Any other reproduction is subject to AMA approval. Bulk reprints available by calling 212/354-0050.

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