Who is most susceptible to food poisoning complications? In many recall notices and all notice of outbreaks, we mention that people who belong to certain groups should be very careful about foods contaminated with pathogens. The FDA calls these groups “at risk.”
These groups are more susceptible for several reasons. In some, their immune systems may be compromised by age or disease. In others, an illness means their body is less able to fight infections.
Of the estimated 48,000,000 food poisoning infections that occur every year in the United States, about 128,000 people are hospitalized and there are 3,000 deaths. People who are in these at risk groups are at greater risk for developing serious complications.
Pregnant Women
During pregnancy, the mother’s immune system is concentrated to focus on the fetus. Bacteria can also cross the placenta and infect the fetus, whose immune system isn’t able to fight infection because it is undeveloped. Contracting a food poisoning infection during this time can cause miscarriage, premature labor and delivery, stillbirth, and the death of a newborn.
Listeria monocytogenes is especially dangerous for this group, which is why pregnant women are advised to avoid deli meats and cheeses, luncheon meats, enoki mushrooms, unpasteurized milk and milk products, refrigerated pates, smoked seafood, deli-prepared foods such as salads and sandwiches, raw sprouts, and commercially made caramel apples. About 1/3 of listeriosis cases occur during pregnancy.
The Very Young
Children under the age of five are much more likely to suffer serious complications from a food poisoning infection. Their immune systems are still developing. In addition, young children make less stomach acid that can destroy bacteria, making them more vulnerable to infection.
Their bodies are also smaller, so vomiting and diarrhea can easily lead to dehydration that can be serious.
Children under the age of five are much more susceptible to a Shiga toxin-producing E. coli infection complication called hemolytic uremic syndrome (HUS). HUS is a type of kidney failure.
Foods that have caused outbreaks in the past include undercooked ground meat, unpasteurized or raw milk, unpasteurized fruit juices, lettuce, spinach, and uncooked cookie dough and cake batters. Contact with farm animals, in fairs and petting zoos, have also led to illness. Since children find little animals irresistible, it’s difficult to stop them from petting and kissing these animals.
The Elderly
People over the age of 65 are more susceptible to food poisoning infections. As people age, their immune systems don’t respond to pathogens such as the bacteria that can be found in food. These people are also more likely to have chronic illnesses, which can stress the body and reduce the immune system response.
In addition, the digestive system holds onto food longer as we age, which gives more time for bacteria to reproduce. And stomach acid levels decline as we get older, which means more bacteria will survive to get to the intestines. After age 75, immune systems in many adults are very weak.
These people are in the same boat as pregnant women in Listeria monocytogenes infections. In any Listeria monocytogenes outbreak, those who are hospitalized are much more likely to be elderly. Ice cream has caused several serious listeriosis outbreaks among the elderly.
People With Chronic Illnesses and Compromised Immune Systems
Chronic illnesses include diabetes, heart disease, liver disease, and kidney disease. People with these illnesses have weakened immune systems. Anyone in dialysis is 50% more likely to contract a Listeria infections. In those with diabetes, high blood sugar levels suppress the activity of white blood cells that fight infection.
Anyone with a compromised immune system has the same risks. This group includes people who have had organ transplants, those with autoimmune diseases, anyone undergoing chemotherapy, and those with HIV and AIDS.
How to Protect Yourself
First of all, there are safer food choices for people in these groups. For instance, leafy greens have been linked to many serious outbreaks, including E. coli O157:H7 outbreaks, recently. Those greens do not typically undergo a kill step. So instead of eating raw spinach or kale, cook them. Mustard greens are also delicious cooked.
Avoid raw milk, raw milk products, unpasteurized fruit juices, and raw nuts. Avoid uncooked sushi and sashimi. In fact, anytime you can cook a food, cook it. Don’t eat raw eggs or anything with uncooked flour.
If you like pates and spreads, buy canned versions and not the refrigerated type. Buy commercially prepared salad dressings instead of making them yourself, especially if the recipe uses uncooked eggs. Avoid precut produce; buy the whole version yourself, clean it, cut it and refrigerate it.
And always follow safe food preparation rules. Keep a reliable food thermometer on hand and know the safe final internal temperatures for meats, poultry, seafood, eggs, and leftovers. Keep an eye out for food recalls and outbreak announcements. And if you know the symptoms of food poisoning, you can get help early before you become seriously ill.
