The Six Hidden Hazards of Tailgating

By Jane Farrell

Tailgating is one of the best parts of football season — but nothing quashes team spirit quite like food poisoning.

Understanding different types of bacteria and the ways they can be transmitted, plus a plan to keep your food safe, is key to enjoying your tailgate and keeping guests healthy, says Rachael Lee, M.D., assistant professor in the Division of Infectious Diseases at the University of Alabama at Birmingham.

“The top five causes of foodborne illness include norovirus, salmonella, clostridium perfringens, campylobacter and staphylococcus aureus,” Lee says. “Other pathogens such as clostridium botulinum, listeria and pathogenic E. coli cause fewer illnesses — but when they do, they can lead to hospitalization.”

Salmonella, shigella, campylobacter and pathogenic E. coli, which invade intestinal cells and can cause watery or bloody diarrhea, can come from fecal contamination of food. This includes raw meat, contaminated produce, and other contaminated water and food. In other cases, food can become contaminated by toxins from bacteria such as Staphylococcus and Clostridium, and when ingested, these toxins can cause abrupt nausea and vomiting with quick recovery —usually within one day.

Listeria is bacteria most commonly found in soil. It is carried in the intestinal tract of 5 percent to 10 percent of humans who are asymptomatic. Most foods will have certain bacteria; but not every food is contaminated with pathogenic bacteria, or bacteria that can make you sick. Pathogenic bacteria that multiply or create a toxin make one ill.

To lower your chances of food poisoning, follow these steps.

Understanding different types of bacteria, ways they can be transmitted and plans to keep your food safe is key to enjoying your tailgate and keeping guests healthy.

1. Wash your hands and food preparation items while cooking

Not washing your hands after using the restroom is a common cause of fecal-to-oral contamination, Lee cautions. Hand hygiene is the most effective way to prevent foodborne illnesses. People should wash their hands after using the restroom, before preparing food, after touching raw meat and before preparing anything uncooked.

2. Separate your food.

The Federal Food Safety Administration recommends using different plates, cutting boards and utensils for raw and cooked meats to prevent cross-contamination.

Poultry is a good example of meat that is contaminated when raw, Lee says. Sometimes, even if it is cooked thoroughly, people still get sick from eating it. This is because of cross-contamination.

“Did you properly wash the knife you used to cut into the raw turkey?” Lee asks. “If not, and you used it to cut the cooked turkey, the bacteria from the contaminated knife gets transferred to the cooked meat.”

Do not be fooled by the way meat and poultry look on the outside — they often brown faster than they cook on the inside, the FFSA warns. The only way to be sure food has reached a safe minimum internal temperature, which both prevents the growth of harmful bacteria and guards against overcooking, is to use a food thermometer.

The FFSA recommends cold perishable food items, such as raw hamburger patties, sausages and chicken, be kept in an insulated cooler packed with several inches of ice, frozen gel packs or ice containers. Pre-cooked perishable food items, including lunch meat, cooked meat, chicken, and pasta and potato salads, should be kept refrigerated too. Keep a thermometer in the cooler to ensure the temperature stays below 40 degrees.

Watch out for noncooked tailgate foods like mayonnaise and dessert icing, Lee says. Because they are not cooked, it can be hard to eradicate bacteria such as Staphylococcus if the items have already been contaminated. Even fruits and vegetables can contain pathogen bacteria; salmonella and pathogenic E. coli have been known to contaminate lettuce. The warmer the temperature, the more ideal it is for the bacteria to grow, so it is often best to keep everything chilled.

“Staph infections themselves don’t make us sick, but they produce toxins that do,” Lee says. “Be wary of popular tailgate foods like coleslaw and potato salad.”

5. Serve hot food safely.

If you bring hot take-out food to a tailgate, be sure to eat it within two hours of purchase, the FFSA recommends. That time frame shortens to one hour if the outdoor temperature is 90 degrees or more. Any perishable food that is not eaten within that period should be thrown away to prevent sickness from bacterial growth.

Don’t be fooled by the way meat and poultry look on the outside — they often brown faster than they cook on the inside.

Chilis, soups, stews and hot dips should be kept in an insulated container; if you cannot keep hot food warm during the drive to the tailgate, chill it before packing it in a cooler and reheat it on location to 165 degrees.

Starch-based foods such as pasta and potatoes can generate B. cereus, a spore-forming organism that creates an infectious toxin, after it sits and cools down. As the food cools to below 122 degrees, the spores germinate and start producing toxin, causing symptoms when ingested.

“The best weapon against getting sick from eating at a tailgate is doing due diligence,” Lee says. “If you’re doing the cooking, make sure your hands, cookware and utensils are clean and free from contamination. If you’re eating pre-prepared food, make sure it’s been kept at the right temperature.”

6. Keep an eye on your loved ones.

Most at risk are senior adults, babies and those who are immunosuppressed. Senior adults and babies are at a higher risk of dehydration, which can be harmful.

“Babies and senior adults who need assistance with daily living may not always know when they are thirsty and can’t necessarily tell their caretaker,” Lee explains. “They can’t always voice their symptoms, so it is important to make sure they stay hydrated.”

People with diabetes, cancer, lupus, rheumatoid arthritis, Crohn’s disease and other immunologic diseases are at risk of serious complications when it comes to foodborne illness. The bacteria could get into their bloodstream or settle in their bones, affecting their diseases further.

A particular strain of E. coli (O157:H7) and shigella can cause a rare complication called hemolytic uremic syndrome, which is when clots form in the very small vessels. They can block circulation to kidneys and brain and cause kidney failure and/or confusion. Lee recommends visiting your primary care provider immediately if you experience bloody diarrhea, or if you develop unexplained bruises or unusual bleeding or have decreased urination.

And if you do get sick, remember to hydrate.

“If you get sick from contaminated food, you might experience nausea, vomiting, watery or bloody diarrhea, and maybe fever. The good news is that your illness will last only a day or so if you stay hydrated,” Lee says. “For the most part, the toxins will work themselves out within 24 hours. You will just be sick and uncomfortable, but there are not any serious dangers unless you have a compromised immune system.”

Depending on the pathogen, foodborne illnesses are self-limiting, and one will recover within 24 to 72 hours. Once the body has dispensed the bacteria or toxin, the body will recover.

If you experience symptoms for more than three days, become dehydrated, dizzy, pass out or have a fever for more than 24 hours, you should see a physician.

“Hydration is more important than food, and the key to recovering from a foodborne illness,” Lee says.