Whether sampling local delicacies abroad or cooking burgers tent-side, eating is half the fun of vacations.
Considering the odds of food poisoning, however, it's not a risk-free pastime. At home and away, there are up to 80 million cases of U.S. residents contracting food poisoning every year, according to estimates by the Centers for Disease Control and Prevention, and as many as 9,000 die.
As of the end of June, there have been an estimated 21 outbreaks of food-borne diseases in California this year, said Stanley R. Bissell of the state Department of Health Services. In all, 308 persons were reported ill. (No statistics on the number of deaths are yet available.)
Food poisoning, an umbrella term, describes ailments caused by a variety of organisms. Often the condition is short-lived and resolves when the traveler drinks substantial amounts of fluid and rests. But food poisoning can also be deadly.
Knowing what foods to avoid when camping in the U.S. or traveling abroad--and how to cook others--can minimize the dangers.
A good rule to follow is eat "no raw seafood," according to Dr. David Swerdlow, a CDC medical epidemiologist.
That also applies to marinated seafood, added Dr. Michele Barry, professor of medicine and director of the International Health Office at Yale University School of Medicine. Although many people believe marinating seafood is as good as cooking it, that's not true, she said. "Marinating doesn't necessarily kill organisms," she said.
Even when well-cooked, some fish and shellfish contain poisonous toxins, according to the CDC. In travelers, the most common kind of fish poisoning is ciguatera, which can be caused by eating barracuda, red snapper, grouper, amberjack and sea bass.
Ciguatera poisoning occurs in the tropics, according to the CDC, especially the West Indies, Pacific and Indian Ocean. Outbreaks can recur in regions that have not experienced problems for years. And the larger the fish, Barry said, the higher the risk.
Travelers should not bring perishable seafoods home from other countries, warned the CDC, because cholera cases have occurred among those who ate crab they carted home from Latin America.
Fruit can also be contaminated. The poorer the sanitation in the area, the more careful a traveler should be.
Travelers should eat fruit only if they can peel it themselves, Swerdlow advised, cautioning against cut-up watermelon. It's also wise to avoid raw lettuce, and rice and beans that have cooled.
Don't buy from street vendors, Barry warned. In particular, avoid pork that's been cooked outside over an open flame.
In places with poor sanitation--such as rural areas and developing countries--don't drink water unless it's bottled and don't use ice cubes.
Cook ground beef until the juices run clear, Swerdlow said, and make sure burgers are well cooked without any pink in the center. When dining out, cut a burger in half before eating it to be sure it is well done. Thorough cooking is vital to kill E. coli (Escherichia coli), the bacterium that contaminated fast-food burgers in 1993 in a widely publicized case, killing three.
Other food poisoning prevention strategies commonly advised by public health officials:
* Don't serve meat in the same dish that was used to carry raw meat to the grill or campfire.
* Change dish towels often to minimize bacterial buildup.
* Don't keep meat at room temperature for more than an hour after cooking before returning it to a cooler.
* After handling raw meat, wash hands.
* Wash utensils and cutting surfaces used to prepare raw meat before letting other foods come into contact with them.
Tainted food can cause illness from 30 minutes to two weeks later, according to the U.S. Department of Agriculture.
Depending upon the organism, symptoms can include nausea, vomiting, abdominal cramps and bloody diarrhea.
Deciding when medical attention is needed can be difficult, Swerdlow said. But in general, travelers should get help if they are passing a great number of stools, if there is blood in the stools or if there is fever. It's wise to get help if you cannot hold down food and if symptoms don't seem to be improving. Children and the elderly are considered more susceptible than other age groups.
The Healthy Traveler appears the second and fourth week of every month.