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Diseases & Topics

Food Poisoning & Food-Borne Illnesses

The food we eat and the beverages we drink — including water — can become contaminated by bacteria, viruses, parasites, toxins or chemicals that can cause food-borne disease or food poisoning. Most people have experienced at least intestinal upset at some time in their lives from eating food or drinking a beverage that was improperly stored or prepared, insufficiently cooked, or was otherwise contaminated.

Each year in the United States, food-borne disease causes an estimated 48 million illnesses, 128,000 hospitalizations, 3,000 deaths and over 1,000 outbreaks. Food-borne illness has a large economic impact across the nation, representing millions of dollars in lost income, lost revenue and healthcare-associated costs. The North Carolina Division of Public Health is committed to investigating cases and outbreaks of food-related illness in an effort to prevent this type of illness in our state. In North Carolina, all food-borne illnesses are reportable, and by law, operators of food and drink establishments must report to their local health department if they have reason to suspect an outbreak of food-borne illness in their customers or employees or when they have reason to suspect that a food handler at the establishment has a food-borne disease or condition (GS 130A-138). The sale and dispensing of milk and milk products is also regulated (GS 106-266.35) to minimize public health risks from unpasturized or raw dairy.

What is "food poisoning"?

In general, the term "food poisoning" is used to refer to any illness involving a combination of intestinal symptoms such as nausea, vomiting and diarrhea. However, the term "food poisoning" is misleading, since it groups all food-related illnesses by symptoms, rather than by the pathogen that causes the illness such as a toxin, bacteria or virus.

Food-related illness or food-borne disease is caused by a wide variety of pathogens and toxins. Because the microbe or toxin enters the body through the gastrointestinal tract, the most common symptoms of these illnesses are nausea, vomiting, diarrhea and abdominal cramps. However, food-borne illness can vary dramatically in terms of how soon symptoms begin after eating or drinking the contaminated food, the length of illness, and when and how well a person recovers. Also, many germs or pathogens that can contaminate food items may be transmitted by other means, such as contact with infected animals, contact with ill persons, or even as a result of laboratory accidents.

Intoxication vs. infection

Food-related illnesses fall generally into two categories: intoxication and infection. The term "food poisoning" applies most readily to the type of illnesses caused by toxins that may be in the food we eat. These toxins may be produced by bacteria growing on food that has not been handled properly; may result from chemicals, heavy metals and other substances in food; or because fish, shellfish or other animals have concentrated toxins in their flesh from their feeding habits and environment. In general, symptoms caused by toxins occur very soon after eating a contaminated food and may result in sudden and uncontrollable vomiting and/or diarrhea.

Infection from food-borne pathogens may be caused by bacteria, parasites or viruses. Common food-borne pathogens are Escherichia coli (E. coli), Salmonella, Norovirus and Listeria. Food-related illnesses from infectious pathogens typically take much longer to produce symptoms than toxins do. In the case of E. coli infections, symptoms may not appear until 10 days after a person has consumed the contaminated food item. Symptoms from these illnesses may also last longer than intoxication symptoms and are, in general, more easily passed from person to person.

Who is at risk for food-borne disease?

Every year in the United States, 17 percent of Americans get sick as a result of consuming contaminated foods or beverages. While usually very young, elderly or people with other illnesses suffer from food-related illness, anyone can become ill from eating contaminated food items.

What are the signs and symptoms of food-borne illness?

Usually, people suffering from a food-borne disease will have a combination of nausea, vomiting and diarrhea and/or fever. Some people may have all these symptoms, while others may only have one. Typically, food-borne illness only lasts a few days; however, sometimes more serious illness can occur. Ill persons may need to be hospitalized or may even die from a food-borne disease.

Where does food-borne disease come from?

Foods can become contaminated for a variety of reasons. Food-related pathogens are common in the environment and may contaminate a food item, "spoiling" it. While food laws and regulations exist in part to protect people from contaminated foods, some pathogens are so resilient that they persist despite these efforts. Furthermore, many pathogens harmful to humans exist naturally in much of the food we eat, such as meat and poultry. Usually, these pathogens are destroyed when the food is cooked. However, if the food is eaten undercooked or raw, or the food is handled improperly during preparation or storage, the risk for transmitting harmful pathogens to humans increases.

How can I avoid food-borne illness?

The most effective thing you can do to protect yourself and your loved ones from becoming ill from food-borne illness is to observe four simple food-handling steps:

  • Wash!
    • Wash your hands with soap and water before eating or cooking. If you have diarrhea, or are taking care of someone with these symptoms, wash your hands thoroughly or avoid preparing food altogether.
    • Be sure to wash fresh produce before eating it. Because harmful pathogens can inhabit the outside of vegetables and fruits, it is a good idea to remove the outer layers of cabbage and lettuce. Peel fruits and vegetables over the garbage or sink, or use one cutting board for peeling and another for cutting, to avoid contaminating peeled items.
    • Always thoroughly wash any surface that came into contact with raw meats, including utensils, cutting boards or cooking tools.
  • Separate!
    • Keep meats separate from fruits and vegetables. Always use separate surfaces for preparing foods that will be cooked (like meats) and foods that will be eaten raw (like vegetables) to avoid contaminating fresh foods with pathogens found on raw meats. Always place cooked foods on a fresh plate instead of back on the surface that held the raw food.
  • Cook!
    • Cook meats, poultry, eggs and seafood thoroughly. Use a food thermometer to check for proper cooking temperatures. Whole meat needs to reach 145° in order to be safe for eating. Ground meat should be 160° and poultry 165°. Eggs should be cooked until the yolks are firm.
  • Chill!
    • Chill all leftovers promptly in the refrigerator or freezer.

Common food-borne diseases

Infections caused by bacteria, parasites or viruses in food or drinking water include:

Illnesses caused by toxins in the foods we eat include:

Numerous other food toxins exist.

For Additional Information