Food Poisoning.

[Richb2004v2]

I have suffered food poisoning on four occasions in less than two years here in Thailand. Prior to this I hadn’t really suffered at all. I eat from all kinds of food sources including street vendors. Although I say food poisoning this is only my guess. The condition lasts between 24 and 48 hours and consist of sickness, diarrhea, headache and stomach ache and dizziness. My wife is now worried about what to give me to eat for fear of me getting it again. Tonight she made me eat McDonalds!

How often do the Thaivisa members suffer like this, and do you have any advice other than ‘don’t eat from places that look real dirty’?

[Donz]

first few times i went to thailand i used to get it, my stomach is used to it and i can eat anything, apart from there dairy stuff.

My stomach just cant hack it. did you eat dairy at these times?

[Richb2004v2]

first few times i went to thailand i used to get it, my stomach is used to it and i can eat anything, apart from there dairy stuff.

My stomach just cant hack it. did you eat dairy at these times?

I don't think so.

It used to be that I could eat anything.

My wife informs me I am having cheese and pickle toasties for tea. Mai ped I guess.

[rishi]

.... Although I say food poisoning this is only my guess. The condition lasts between 24 and 48 hours and consist of sickness, diarrhea, headache and stomach ache and dizziness ...

... and what did you drink? An extensive amount of cheep whisky and beer drinking could also give those symptons.

[Donz]

Maybe your just having a string of bad luck, if i have what your having for dinner in thailand I would be on the crapper all night

[taxexile]

What is food poisoning?

Food poisoning is defined as any disease of an infectious or toxic nature caused by the consumption of food or drink. The term is most often used to describe the illness, usually diarrhoea and/or vomiting caused by bacteria, viruses or parasites. Very occasionally poisonings from chemicals may be the cause.

How common is food poisoning?

In the United Kingdom about 2 million people a year suffer from an attack of diarrhoea and/or vomiting due to food poisoning. Most do not consult their doctor and the cause is not often found. Food borne microbes are isolated in only about 100,000 cases a year and although large outbreaks can occur, usually only one or two people are affected.

Which bacteria cause food poisoning?

The bacteria most commonly found (about 40,000 cases annually) are called Campylobacter. These may be present in unpasteurised milk or raw poultry. Birds pecking the tops of milk bottles may infect the milk on the doorstep but in most cases the contaminated food is not identified.

Salmonella is the next most commonly found group of bacteria (about 30,000 per annum). They may be present in raw meat, poultry and occasionally eggs. For the remainder, Staphylococcus Aureus, Clostridium Perfringens and Bacillus Cereus produce toxins or poisons in food which may result in severe vomiting. C. Perfringens is usually associated with meat and B. Cereus with rice.

Some variants of normal intestinal bacteria are a cause of food poisoning. A particularly severe type is caused by E. Coli 0157. It is present in some cattle and may contaminate raw meat. It can cause bloody diarrhoea and kidney failure, particularly in the elderly, but is only rarely a cause of food poisoning.

What are the symptoms of food poisoning?

Vomiting and/or diarrhoea are the most common symptoms. Fever, abdominal pain or blood in the stools may occur. The illness is usually short lived but can be very serious or even life threatening, particularly at the extremes of life. Full recovery may take between a few hours to several weeks depending upon the fitness of the patient and the type of infection.

How quickly does it happen?

Some types of food poisoning can produce symptoms within a few hours of the contaminated food being eaten, whilst others may not occur for some days. S. Aureus or B. Cereus will typically cause illness between 2-12 hours after the meal, whilst symptoms of Salmonella or Clostridium Perfringens usually develop between 12-24 hours afterwards. Infections with Campylobacters are slow to produce symptoms and illness may occur up to a week or more after the infected food has been eaten.

What can be done to avoid food poisoning?

It is not necessary to avoid those foods commonly implicated in food poisoning, since Salmonella, Campylobacter and E. Coli 0157 are killed in foods, provided they are adequately cooked. Important points to remember are detailed below.

Prevent the growth of bacteria by ensuring that all food stored in the refrigerator is covered and adequately chilled (ideally around 5° centigrade) and take care that chilled or frozen foods are not allowed to warm up in the hot boot of a car on the way home from the shops.

Always wash your hands after visiting the lavatory.

Take care to ensure thorough cooking and re-heating of all meat, especially poultry. Make sure that deep frozen food is thawed before cooking. This is especially important when using a microwave oven. Burgers should be cooked until there are no pink bits left and the juices run clear. Everyone should be aware of the small risk associated with foods containing uncooked eggs such as mayonnaise and certain puddings. Ensure that red kidney beans are always cooked for the recommended time to remove the toxin that is present in the raw beans.

Wash your hands after handling raw meat or eggs, particularly before handling other foods.

Do not re-use utensils with which you have prepared raw eggs or meat without first washing them with hot water and detergent. Do not allow juices from raw meat to come into contact with other foods.

Avoid eating raw eggs or uncooked foods made from them.

Vulnerable people e.g. the elderly, the sick, babies and pregnant women should eat eggs only which have been cooked until they are hard (both yoke and white).

Wash salads thoroughly before eating.

Do not drink any type of unpasteurised milk.

Treatment

Most food borne infections resolve without medical attention. Depending on the type of bacterial infection antibiotics may be prescribed in some cases. Before doing this, the doctor will usually require a stool specimen for analysis, in order to discover which particular bacterium is responsible.

Dehydration caused by diarrhoea and vomiting should be treated immediately with oral rehydration solutions available over the counter at chemists. If these preparations are not available, you can make your own using a generous pinch of salt (1.5gram) and a teaspoon of sugar stirred into a glass of fruit juice or water (250ml).

This is particularly important for infants and young children. If the illness lasts more than a few days or there is blood in the stools, medical advice should be sought urgently.

[Noel]

Steer clear of McDonalds, KFC and Pizza Hut and you should be fine...

[geoffphuket]

Getting a new wife cured my food poisening bouts

[Alreadyinuse]

Steer clear of McDonalds, KFC and Pizza Hut and you should be fine...

Even though these options are extremely boring especially when you are in Thailand with its diversity in cooking. I would say that unfortunately these are your safest options. Skip the ice in the drinks, it could be made of water from the tab. Who knows??

[Alreadyinuse]

I know that some people get sick of that food also but it will most likely not be food poisoning

[Donz]

Everytime i ate from maccas in Samui i was on the crapper how hours

[Noel]

Steer clear of McDonalds, KFC and Pizza Hut and you should be fine...

Even though these options are extremely boring especially when you are in Thailand with its diversity in cooking. I would say that unfortunately these are your safest options. Skip the ice in the drinks, it could be made of water from the tab. Who knows??

Tap water could equally be used for washing various ingredients (vegetables, fruit etc), but I doubt that is the culprit.

The (thankfully few) times I have suffered violent stomach upsets over the years here, on almost all occasions the prime suspect has been seafood.

I am now particulary wary of any seafood products on sale in supermarkets that have obviously been prepared on site.

I strongly suspect that unsold produce may well reappear on the shelves the following day and beyond in some outlets, despite what their date stamp (if there is one) says...

[Alreadyinuse]

Getting a new wife cured my food poisening bouts

This could also be a good alternative atleast you know it would be fresh and cooked properly... But then again living in Thailand your would be risking your life on a daily basis by just passing the streets of Bangkok

[Goldenbead]

Could it be that you are allergic to some ingredient in the food? After eating prawns for most of my life, I developed an allergy to them about 14 years ago. My symptoms are usually like food poisoning. Occasionally, I would get an itchy mouth but for a while I was sure I was unlucky with bad prawns. You never know. I am super careful now though.

[Beavis and Butthead]

Thursday night I had 2 Heinekens and then ate McDs. I puked all of it up but felt OK in the morning.

[Alreadyinuse]

Thursday night I had 2 Heinekens and then ate McDs. I puked all of it up but felt OK in the morning.

Nothing wrong with Heineken, nothing really wrong with Mc Donalds.

Did you see something ugly?

[egeefay]

I try to stay away from the street vendors.

They are out there all day without access to running water so they don't always keep their hands clean (no washing after handling money and using the toilet). Nor do they carefully wash dishes after they get used by customers.

Because they have no access to refrigeration they Sometimes keep meats dangling in the hot sun without refrigeration for hours.

Overall, Thailand doesn't have the same standards for food handling as in the west. They are pretty laxed and it's very common for visitors to get food related ailments.

While it's true that many psoters have boasted that they've neverhad any problems with the food, My guess is due more to luck than anything else. There are a lot of horror stories out there. And It only takes one trip to the hospital to make a convert out of the most seasoned diner.

The safest thing is to buy and peel your own fruit. Drink liquids from bottles. And try to make sure everything you eat...especiall vegetables... is well cooked.

That being said, there are a lot of restaurants in the west (especially Asian restaurants) that could stand a closer inspection by the health department.

Just bear in mind that Whenever you eat out you are at the mercy of someone whose main goal is to make a profit.

[libya 115]

Everybody enjoys large melons...BUT:

Melons are the most common source of food poisoning, in South East Asia according to W.H.O. statistics, and have killed at least four adults and one child so far in 2006. The rough skin is extremely difficult to clean and harbours a variety of harmful bacteria. This bacteria then infects the soft fleshy inside when cut open with a knife.

Often pre-sliced melon, is sold or served, in body heat temperatures; bacteria multiply then BINGO: projectile vomitting and uncontrollable bowel evacuations is the unpleasant result.

[kerryk]

Living in Thailand it is impossible to avoid the ice. A drink heats up in minutes without ice and a lot of food is chilled with ice even if you don’t see it.

It is impossible to avoid the tap water as all of your food is washed in tap water as are the dishes and cooking utensils rinsed in tap water without a bleach rinse.

Don’t ever look in a Thai restaurant kitchen and really never look in a dishwashing area and never ever look into a Chinese kitchen in Thailand.

Cutting boards are rarely sanitized and slicing machines perhaps once a day.

Macdonald’s has one of the best sanitizing systems in the world. The quarry tile the walls in the kitchen as well as the floors so they can flood daily. Macdonald’s main sanitation problem is the low wage staff hired. I can’t stand the food at Macdonald’s but the sanitation if carried out correctly is better than most hospitals.

The problem with cooking Thai food is the shortness of cooking times. Everything is prepped and held at room temperature and then stir fried at high temperatures for a short period of time. I have not been to every country in the West but are eggs held at room temperature in grocery stores in the West?

Rat droppings are problem as they dry and blow in the air spreading contamination. Cats in restaurants of course help reduce the problem. Even if the cat is not hungry they chase the rats just for sport. It is a pity cats are not allowed to live in restaurants in the West.

Clostridium Perfringens is what you get from the cook or dishwasher not washing his hands with soap and water after touching fecal matter. So it not a good idea to look into the employee restrooms at Thai restaurants.

Any kind of processed food should be held cold or hot 40 degrees or 145 degrees Fahrenheit (4 and 143 Celsius) this is of course rarely accomplished in Thailand.

I think by and large the easiest food to contaminate is ice cream. The making of ice cream is very difficult even if good sanitation procedures are followed. I have cleaned ice cream making machines thoroughly and still after swabbing for bacteria found significant amounts.

Mayonnaise is another difficult product to keep free from bacteria. In the home cleaning sponges are often the culprit of food poisoning. Soap and hot water does not kill all of the bacteria.

I have gotten food poisoning about four times in the last 12 months. Of course I realize the symptoms which is more than most people do in mild cases. 9 out of ten times when you have very loose stools that is food poisoning.

The very young and the old are more easily effected than the average person.

The answer is to cook at home and wash your produce in bottled water and cook the meats and vegetables an appropriate amount of time. Pork needs to be cook twice as long as chicken. I use a slow cooker to hold my meat after I have stir fried it. I then stir fry the vegetables add liquid and eggs if called for and then add the meat at the end.

If your are having problems because of food cooked at home bleaching the cooking utensils cutting boards and sponges may help or using bottled water to clean the produce.

When I buy food at the street market I normally buy things that I can re heat if I don’t see them cooked.

Most of the Thai people I know get food poisoning about once a month but they don’t notice it as much as a Western person as diarrhea is a very common occurrence here. Perhaps I am wrong about this but it is difficult for me to ask a person I don’t know really well about his or her bowels. My Thai friends never mention it but since our only bathroom is off of the living room when we have friends over it is rather obvious.

My own cooking procedure is to marinate beef, chicken, pork, fish and shellfish before sautéing. Beef a day, chicken and pork half a day and fish and shellfish a couple of hours. Then I brown the beef, and pork and slow cook for at least two hours. The chicken, fish and shellfish I stir fry or BBQ.

When you buy the food at the grocery store it may be contaminated but proper washing and cooking will destroy anything short of botulism and that mainly exists in improperly canned foods.

If you look at Som Tom. They use crabs, who knows how they were cooked or where they came from and hold them at room temperature (ideal for growing bacteria) for who knows how long and then beat them with a mortar that hasn’t been sanitized since the dawn of man and mix them in with vegetables that have been cut with a knife that gets washed once every 24 hours. The acid content of the sauce may kill the bacteria and I believe that is

[Alreadyinuse]

Often pre-sliced melon, is sold or served, in body heat temperatures; bacteria multiply then BINGO: projectile vomitting and uncontrollable bowel evacuations is the unpleasant result.

I love your vocabulary.....

[kat]

That was very informative. I'll have to implement some of those steps, especially about pre-cooking meat. I have been very ill here, and I'm afraid my stomach will never be the same. At some point, I picked up Giardia, which I later learned is very hard to lose, even after treatment (no thanks to my doctor; I had to find that out myself).

I believe I picked up Giardia in Phuket, after eating oysters. I know it was a stupid thing to do, but I am the type that loves food. When I first arrived in Thailand, I also ate everywhere, and with a lot of chilies. I don't know how Thais do it, but I believe their luck runs out at some point. I think elderly Thais don't eat with as much chile any more, but I could be wrong about it. I think after living here for 4 years, my stomach is now elderly.

I don't know what to tell you, except that the only sure way is to eat in from now on. For me, that isn't realistic.

[ayakiawe]

formalin in the sea food cause this type of reaction with me....

I thought I was going to die when I had it....

Asians must love putting this chemical in many things too! Its even in the beer here too!

Watch out is all I can say and prepare your own food sources better yet!

[libya 115]

That was very informative. I'll have to implement some of those steps, especially about pre-cooking meat. I have been very ill here, and I'm afraid my stomach will never be the same. At some point, I picked up Giardia, which I later learned is very hard to lose, even after treatment (no thanks to my doctor; I had to find that out myself).

I believe I picked up Giardia in Phuket, after eating oysters. I know it was a stupid thing to do, but I am the type that loves food. When I first arrived in Thailand, I also ate everywhere, and with a lot of chilies. I don't know how Thais do it, but I believe their luck runs out at some point. I think elderly Thais don't eat with as much chile any more, but I could be wrong about it. I think after living here for 4 years, my stomach is now elderly.

I don't know what to tell you, except that the only sure way is to eat in from now on. For me, that isn't realistic.

Yes, I agree Giardia Lamblia is hel_l: worse than dysentry or cryptosporidium poisoning.

It: ( Giardia), keeps going then coming back. I marked off the days on the calendar 34 days, dysentry was 4 to 5 days, cryptosporiduim was 20 days. (To rid my body of).

I feel sorry for people who get bacterial G.I. infections or parasitic infections. I say water is the number one culprit and ice.

I did read, (and half believe) that imbibing a glass of wine or spirits during eating can help ward off some infections, but there is no concrete proof.

[kat]

Wow - so you had all three. How do you know Giardia is finally gone? I think there is also trouble with reliable tests sometimes.

[libya 115]

Wow - so you had all three. How do you know Giardia is finally gone? I think there is also trouble with reliable tests sometimes.

The best way is antibiotic treatment with METRONIDAZOLE. Dosage: 400mg 3 times a day for 5 days.

Then regular stool samples to pathology: the cysts need to be eradicated.

If infection lingers......then attempt MEPACRINE HYDROCHLORIDE. Dosage 100mg 3 times daily for 7 days.

However all drug treatment should be approved by a fully qualified doctor, self medication has risks.

[redwood13]

Thank you kerryk, excellent summary of the ways and means of heathy cooking & eating in Thailand. I used to do medical microbiology but I long ago gave up trying to advise folks. People believe what they want to believe.

Hopefully you'll also post this on some of the other boards we both read.

-redwood

[Thaimonkeymeat]

Hehe, this reminds me of my days studying hospitality, and cheffing as something for me to do in uni. With the eggs, should they be in the fridge or in an open space at room tempreture? Well the answer is easy, depends on how long it takes you to use them. Usually it is up to the buyer if they want in the fridge or left at room tempreture, however when in room tempreture the life of a raw egg is lowered a little, and than you get the wonderful smell of rotten eggs when broken. Myself I prefer the eggs at room tempreture, because I will use a full dozen in under a week, and they are fine.

Also just to let you guys know, the breeding tempreture for any type of bacteria is from around 30 something degrees, to 120 degrees. Anything over 120 degrees, and than you will be killing spores which are the culprits for alot of dangerous types of food poisonings.

Another interesting thing, I read here it was possible to get food poisoning in 2 hours, I was just curious where you got that information from, because if it was 2 hours, than there would not be enough time for it go be digested in the stomach, than go into the intentines, and seep into the blood stream, where than it would corrupt healthy blood cells, with the bacterias DNA, to create more, and more of the critters. From what I have had to study, and also read in books, it takes roughly 8 hours, for this process to happen, go through your digestive system, and so on.

I may be wrong, and if I am, than I will be happy to change my point of view, so I am asking where you got that from, so please pm me and let me know or something.

Another thing that was brought up here, the water. I can only go by experience from Taiwan water, the rule of thumb that all Taiwanese say, don't drink the water, because it is recycled water. I don't have a clue what they mean by recycled water, and I will never ask, hoping that when I take a shower, I am taking a shower in water that was at least not from a flushable place.

In fact China itself, over 70% of its water supply is recycled, and this is just my guess, that maybe Thailands water is to recycled as well, I may be wrong, and probably am.

Also heres an interesting fact, most of us are carriers of a dangerous bacteria, that lives in our mouths, in short it is called golden staff. In short a food poison, which many of us are strangely carriers of, also we pass it on to others, sometimes making them sick, if they weren't a carrier of it.

Well, the only way to really be free from these poisons, is don't eat, or to be really carefull do what the bubble boy, did, live in a bubble

[ronw]

Thursday night I had 2 Heinekens and then ate McDs. I puked all of it up but felt OK in the morning.

Eating anything from Mc Crap is enough to make anyone puke.....

[cathyy]

Getting a new wife cured my food poisening bouts

I hate to say so, but geoffphuket has a valid point. All the episodes of fod poisoning I have had -all mild, thankfully- can be traced to eating at a friend's house.

His Thai wife leaves cooked hot dogs and chicken from KFC out at room temperature at least 10 hours, if not 20, and doesn't think they may be spoiled. Apparently she thinks that cooked meat doesn't spoil. She cooks coconut curries early in the morning for the monks, leaves them at room temperature, and then serves them to guests for lunch 6 or 8 hours later. When I asked her about it, she said the chilies keep the food from spoiling. No, they just keep you from being able to tell the food is spoiled.

This is a Thai lady who lived in the US for over 20 years! She washes all her produce to get rid of pesticide residue, keeps an immaculate kitchen, and still has no concept of how rapidly cooked food will spoil. I guess she just has returned to her Thai origins in terms of handling prepared food, while she has Western standards for uncooked food.

[redwood13]

Another interesting thing, I read here it was possible to get food poisoning in 2 hours, I was just curious where you got that information from, because if it was 2 hours, than there would not be enough time for it go be digested in the stomach, than go into the intentines, and seep into the blood stream, where than it would corrupt healthy blood cells, with the bacterias DNA, to create more, and more of the critters. From what I have had to study, and also read in books, it takes roughly 8 hours, for this process to happen, go through your digestive system, and so on.

I may be wrong, and if I am, than I will be happy to change my point of view, so I am asking where you got that from, so please pm me and let me know or something.

"The delay between consumption of a contaminated food and appearance of the first symptoms of illness is called the incubation period. This ranges from hours to days (and rarely months or even years, such as in the case of Salmonella Typhi (typhoid fever)), depending on the agent, and on how much was consumed. If symptoms occur within 1-6 hours after eating the food, it suggests that it is caused by a bacterial toxin rather than live bacteria."

And:

"In addition to disease caused by direct bacterial infection, some foodborne illnesses are caused by exotoxins which are excreted by the cell as the bacterium grows. Exotoxins can produce illness even when the microbes that produced them have been killed. Symptoms typically appear after 1-6 hours depending on the amount of toxin ingested.

Clostridium botulinum

Clostridium perfringens

Staphylococcus aureus

For example Staphylococcus aureus produces a toxin that causes intense vomiting. The rare but potentially deadly disease botulism occurs when the anaerobic bacterium Clostridium botulinum grows in improperly canned low-acid foods and produces a powerful paralytic toxin."

http://en.wikipedia.org/wiki/Foodborne_illness

-redwood