This is the second feature in our series on food regulation, in the lead up to our first ever Time Out Talk. Dr Vincent Ho, who was interviewed for this piece, will be speaking on our panel. If you like what you're reading, you can find out more here.
We’ve all been there, and none of us have enjoyed it. It starts with a shudder. A little ‘something is not right’-ness. And then, three minutes later you’re shaking and sweating, your body is revolting, literally and physically, and the cool ceramic surface of the toilet is your only friend. Food poisoning and gastroenteritis aren’t quite as common in Australia as they are in say, Bali, but symptoms still affect 4.1 million Australians a year.
If you do find yourself stricken with something nasty, it might be tempting to put a big, black mark against the last restaurant you ate in. But, according to Dr Vincent Ho, clinical gastroenterologist and lecturer in medicine at the University of Western Sydney, eating out isn't always to blame. “It’s more common to get food poisoning with home meals, and that’s because people eat at home more often than they go out," he tells Time Out. "Generally speaking, in Australia, and other developed countries where we have good sanitation, the vast majority of the time when we go out, there isn't any food poisoning or gastroenteritis.”
If you do have an upset stomach, it could well be impossible to pinpoint why. “Especially since many people have food intolerances,” says Dr Ho. Mild cases of diarrhoea could just as easily be caused by exposure to irritants like gluten or lactose, as by a toxin, bacteria or virus.
If you get really, really sick (we’re talking temperatures of over 38°C, and uncontrollable shaking) food poisoning or gastro is likely the cause. Even then, it can be hard to figure out where it came from, unless other people are sick too. “We can often trace where contaminated batches of food come from. Often… it leads to an outbreak. For instance there was an outbreak caused by contaminated lettuce in NSW recently. They were able to trace that back by looking at the people affected, asking about what they were eating and looking for common elements.”
If there is an outbreak, not only can doctors figure out the venue responsible, “we can often trace it to the specific food within a restaurant.” So, if you go to a birthday party at a local pub, and everyone who ordered the parma ends up shaking and spewing, it’s pretty clear who’s to blame. But if only one person wakes up off-colour the next day, it could be anything from exposure to lactose to overindulgence.
If you have been affected by food poisoning, you’ll know about it quickly. Food poisoning is often caused by preformed toxins produced by bacteria within contaminated food. “Symptoms can occur as soon as 30 minutes after the exposure to the toxin,” says Dr Ho.
Meanwhile, gastroenteritis is not necessarily food-related and can be caused by a virus, parasite or bacterial infection. It usually takes longer “between 12 and 72 hours” to incubate inside you and start causing symptoms. Because it can take up to three days before you start having symptoms, even if you get sick right after eating, it might not be that meal which caused the problem. Sure, it might have been the leftover chicken you just ate or it could just have easily been germs you picked up from a communal plate of brownies at your staff afternoon tea two days before.
Poultry products and meat are the most common sources of food poisoning, but most cases of gastroenteritis can be traced back to inadequate hand washing. In Australia and other developed countries, “we’ve taken special preparations to reduce the incidences of food-borne infections.” We have health inspections, food safety laws and signs everywhere that say “all staff must wash hands” when we’re eating out. At home, we have to rely on ourselves, and it turns out, many people are not that reliable. It only takes 10 seconds of washing your hands with soap and water to seriously reduce your chance of passing around a stomach bug, and yet, most people aren’t doing it properly.
That’s the reason you’re more likely to pick up an illness at home, or in a closed-off environment like a cruise ship, day care or nursing home, where you’re exposed to lots of people’s germs, than you are from a restaurant. At a restaurant, "although there are always occasions where food isn't prepared optimally" there are structures in place to ensure caution. At home, you're on your own.
What to do if you are sick
“Oral rehydration is the cornerstone of treatment,” says Dr Ho. You can buy a rehydrating solution of sugar, salt and water from most pharmacists, and drinking a lot of it is the first step on the road to recovery.
As a short term solution, the BRAT diet – banana, rice, applesauce and toast – is good for a very unhappy stomach, but Dr Ho cautions against staying on a highly restrictive diet for very long. “In the longer term there shouldn’t be any restrictions of food.”