Raw, Undercooked Eggs Tied to Rise in Salmonella Poisoning Cases in Northeast

Raw and undercooked eggs have been linked to a dramatic rise in salmonella cases throughout the Northeastern United States over the last several years, according to a recent federal study.

In fact, the incidence of Salmonella enteritidis has increased by 500% since the mid-1970s in parts of the region. In 1985, for instance, there were 3,176 confirmed S. enteritidis infections, making this egg-borne strain the most common in New Jersey, New York and New Hampshire.

The bacterium, which can prove fatal in susceptible individuals, causes nausea, vomiting and fever.

Federal investigators at the Centers for Disease Control in Atlanta found that several foods acted as vehicles for the bacterium. Among the implicated items were undercooked scrambled eggs in Connecticut, a liquid protein supplement (containing egg) in Pennsylvania, homemade pasta in New Jersey, Italian-style rice balls in New York City and a regional brand of frozen pasta.

“Much of the increase . . . has been strongly, though not exclusively, associated with consumption of raw and undercooked commercial Grade A eggs from farms throughout the Northeast,” according to the California Morbidity newsletter, which carried an account of the federal study.

Precaution for California

Investigators have yet to pinpoint how the eggs themselves continue to be contaminated.

Although the percentage of S. e nteritidis is considered low in California, federal health officials issued precautions about eating raw eggs nonetheless.

The recommendations include:

--Advising consumers that eggs, like any other raw food of animal origin, may cause salmonella infections.

--Raw eggs should not be considered a “health food” and should not be included in the diets of immunocompromised individuals such as infants, the elderly and cancer or AIDS patients.

--Recipes leading to consumption of raw eggs (Caesar salad, eggnog, Hollandaise sauce, homemade ice cream or mayonnaise) should be considered risky. These recipes would be safe if pasteurized egg products were substituted for raw egg.

--Advising restaurants, schools and other food-service establishments of the risk posed by raw eggs. The practice of cracking dozens of uncooked eggs into a single container and letting them sit for future use should be discontinued in favor of individually cracking eggs for immediate cooking.

--Consideration should be given to using only pasteurized egg products instead of fresh eggs in nursing home populations, because they appear to be at high risk for severe disease and death from S. enteritidis infections.

The sharp increases of S. enteritidis on the East Coast has also prompted California health officials to urge that this state’s physicians be alert for the bacterium and any suspected egg-borne illness.

Calling Calcium--Even though health professionals remain at odds over the actual dietary benefits derived from vitamin and mineral supplements, many consumers continue to make the nutrient-laden pills and tablets a daily habit.

Others, however, remain confused by conflicting sources of information.

At one end of the controversy, traditional nutritionists endorse the benefits of a well-rounded diet--eschewing vitamin pills. Conversely, proponents of the health-food trade enthusiastically boost the encapsulated nutrients. And, on occasion, the medical profession weighs in with yet another disparate view.

Now, into the breach comes Procter & Gamble, which has launched a toll-free phone service that aims to answer the questions surrounding one of the more widely publicized supplements: calcium.

Callers to the Calcium Hot Line, launched last month, can discuss the dietary importance of this mineral, its purported role in maintaining bone strength and related health issues with medical professionals at the Dallas Osteoporosis Centre.

As many as 20 million people in this country suffer from some form of osteoporosis, a degenerative bone disease, according to federal statistics. Onset of the illness is thought to be linked, in part, to calcium-deficient diets. Compounding the situation, corresponding surveys found, is that most Americans are not consuming adequate amounts of calcium as defined by federal guidelines.

Procter & Gamble is sponsoring the phone service as a means of promoting Citrus Hill Plus Calcium, orange and grapefruit juice beverages. The Cincinnati-based consumer products firm claims that an eight-ounce serving of Citrus Hill, the first juice drink enhanced with calcium, provides 30% of the U.S. Recommended Dietary Allowance for the mineral.

The hot line provides a range of information on all dietary sources of calcium, the need for proper exercise and details on osteoporosis symptoms and treatment.

The service is available Monday through Friday from 6 a.m. to 4 p.m. PST at (800) 722-2663.

Fighting Food Allergies--Diagnosing whether an individual reacts adversely to a particular food remains difficult for physicians, according to a recent article in the Journal of the American Medical Assn.

Treatment options are equally elusive and the best instruction for those with allergies is to avoid the suspected foods, Dr. Hugh A. Sampson writes in the journal.

Even so, Sampson of the Johns Hopkins University School of Medicine in Baltimore and several colleagues claim that food allergies are not as widespread as generally believed. Though no hard figures exist, the journal article stated that somewhere between 0.3% and 7.5% of all Americans probably do experience some symptoms after eating a particular item.

The typical effects include nausea, vomiting, diarrhea, painful gastrointestinal cramps and skin reactions. There have been cases where the reaction proved fatal.

However, the Johns Hopkins team dismissed popular notions that some allergies, triggered by certain foods, can cause behavioral disturbances or depressions.

Skin testing to pinpoint food allergies, such as the radioallergosorbent method, is a tedious procedure, that can be hampered by false positives, the authors said. The elimination diet, another means of discovering food allergy, calls for suspect foods to be removed from meals. But this procedure is subject to bias by either patient or physician.

Finally, the journal article stated that several popular means of determining food allergies, cytotoxic testing and sublingual testing, are of no value.

“The basic treatment for food allergy is avoidance of offending foods,” according to the report.

The authors also caution that highly allergenic foods be avoided during pregnancy and breast-feeding if either parent has a history of food allergies. Whether the allergy can be transferred to children is uncertain, but there is reason to believe that such preventive steps may lessen the risk.