foodborne illness

Protect your health from E. coli

You can’t help but hear about recent problems with foodborne illnesses and wonder when — not if — one bad meal will make you or your family sick… or worse.

Even more distressing are daily news reports that more big box retailers, restaurants and food companies are reporting problems with making, handling and distributing our foods safely.

Escherichia coli, better known as E. coli, has been one of the more recent and popular bacterial invaders hiding in tainted rotisserie chicken salad at Costco Warehouse Club or unknown, sickening ingredients in foods prepared at Chipotle Mexican Grill restaurants.

Yet, E. coli is one of the most common types of bacteria around, living harmlessly in guts of humans and animals. Moreover, a recent University of Michigan study discovered how a protein in E. coli may be responsible for inhibiting the spread of Parkinson’s disease.

So, you may be wondering how E. coli bacteria can be benign, yet so dangerous.

The Dangers of E. coli

When some forms of E. coli spread into our environment from improper food handling, processing or cooking, contact with contaminated water or working with animals, given our national and international food supply chain and less funding at the federal level for food safety, people get sick.

Some 48 million Americans are sickened by a foodborne illness, and more than 125,000 are hospitalized every year, according to the Center for Science in the Public Interest’s latest Outbreak Alert that analyzed data collected for a decade.

For most who come in contact with E. coli, the uncomfortable symptoms — severe abdominal cramping, watery diarrhea and gas — will pass within 10 days, if not sooner. If these symptoms sound very familiar to you, they’re also associated with traveler’s diarrhea.

However, one serious and infectious complication with E. colihemolytic uremic syndrome — destroys red blood cells and may lead to kidney failure and dialysis treatments.

Follow These Steps to Avoid E. coli

Fortunately, the steps you can take to avoid being sickened by E. coli are very easy to follow.

  • Wash your hands before preparing foods and after contact with barnyard animals (sheep, goats and cows) with plain soap (no antibacterial substances) and clean water.
  • Also, wash all fruits and vegetables thoroughly before cooking or eating them.
  • Cook meats at the proper minimum internal temperature.
  • The same “keep it clean” mantra also applies to cutting boards, plates, countertops, cooking surfaces and utensils.

Taking a daily probiotic, ideally containing with multiple species of beneficial bacteria — like EndoMune Advanced Probiotic and EndoMune Junior — strengthens the immune system that protects your health from nasty foodborne problems like E. coli.

A probiotic every day keeps listeria away!

The norovirus isn’t the only infectious disease sneaking up to harm the health of unsuspecting Americans.

Over the past six months, America’s once safe food supply—from whole foods including plums, peaches and nectarines to processed foods like bagged salads, cheeses, salsa, peanut butter, fruit pies, hummus and pre-packaged meals—has been plagued by the harmful foodborne L. monocytogenes bacterium, better known as listeria.

Unfortunately, this latest outbreak of listeria doesn’t have any boundaries, as major grocers, including Target, Trader Joe’s, BJ’s, Costco, Hy-Vee, Sam’s Club, Whole Foods, Wegmans and Giant Eagle, have sold foods that have been recalled due to potential contamination.

Listeria popped up on the radar of food safety experts and consumers most notably in 2011 when an outbreak infected cantaloupes grown at Colorado-based Jensen Farms that sickened 147 Americans in 28 states, including 40 in the Centennial state.

Of those who were sickened, 33 people died and a pregnant woman suffered a miscarriage, culminating in the worst foodborne outbreak in the U.S. in at least a century.

The human targets of listeria

Listeria is a very hardy bacteria—it can survive even in refrigerated and freezing environments—and is very common in our environment, yet very few Americans (1,600) are sickened by it annually.

Symptoms range from the light—fever, muscle aches, nausea and diarrhea—to the more serious—headaches, stiff neck, loss of balance, confusion and convulsions—and the incubation period could stretch out to 70 days. Yet, pregnant women may only feel a mild flu.

However, in the right environments, listeria can be very deadly, as it is the third leading cause of death from food poisoning. Patients at the greatest risk of harm:

  • Pregnant women and their newborns
  • People with weakened immune systems
  • Seniors age 65 and older

The six ways to avoid listeria infections

The good news: People who are prone to develop more serious problems due to listeria or other food poisoning issues can take some very simple steps to avoid them:

  1. Avoid unpasteurized (raw) milk or soft cheeses.
  2. Refrigerate any leftovers within two hours and reuse them in no longer than four days.
  3. Maintain the same low temperatures in your refrigerator (40 degrees Fahrenheit or lower) and freezer (0 degrees or lower) with a thermometer.
  4. Don’t eat hot dogs and deli meats until they’re steaming hot.
  5. Avoid eating risky foods by monitoring websites like
  6. Take a multi-species probiotic like EndoMune Advanced Probiotic or EndoMune Advanced Junior for kids can help prevent infections caused by contaminated foods by boosting your intestinal immunity.

New Study Reveals Danger of Bacteria in Sack Lunches

It is back to school time. While you are out shopping for school clothes and supplies, I want to encourage you to consider adding EndoMune to your shopping list.

Over the years I have written a number of newsletters that discuss the benefit of probiotics for children. Topics have included: lessening the risk of infectious diarrhea, preventing cold and flu symptoms and avoiding antibiotic related diarrhea.

This month I want to discuss a new reason for giving your child a daily probiotic: foodborne illnesses.

An interesting study(1) was published this month in the respected medical journal, Pediatrics. The study discussed the risk of foodborne illnesses in sack lunches prepared at home for preschool children going to day care centers. The researchers wanted to determine the temperature of the perishable foods during the morning hours prior to lunchtime.

What Causes Foodborne Illnesses?

Before diving into the findings of the article, I would like to make some general comments about how contaminated foods cause intestinal infections that lead to symptoms of nausea, vomiting, diarrhea, fever and abdominal pain.

Most foodborne infections are undiagnosed and unreported, although the Centers for Disease Control and Prevention estimates that every year about 76 million people in the United States become ill from contaminated foods. Of these people, about 5,000 die(2).

Almost half of the reported foodborne illnesses occur in children, with the majority occurring in children under age 15 years. Frightening, right?

Children are at high risk for foodborne illness for several reasons: immature immune system, reduced stomach acid to kill harmful bacteria, and low body weight – which means a lower dose of pathogen is required to cause injury(3).

There are three important factors when considering food safety: (1) type of food, (2) stored temperature, and (3) time exposed to unsafe temperature.

Bacteria that cause foodborne illnesses like Salmonella and E. coli grow rapidly in certain types of foods. Meat, poultry, fish, dairy products and cut fruits and vegetables are most likely to carry these bacteria.

If the bacteria are present when the food is prepared, then refrigerating the food to below 40°F prevents the bacteria from multiplying and causing an infection. Additionally, cooking foods to a temperature greater 165°F will kill any bacteria in food.  Once cooked, the hot foods need to stay at a safe temperature of greater than 140° F prior to serving or refrigerated to less than 40°F for storing.

When perishable foods like chicken salad or bologna sandwiches are left in the “danger” temperature zone of 40°F to 140°F for greater than two hours, the harmful bacteria rapidly multiply. When this happens, the foods must be discarded due to risk of contamination by bacteria and toxins, which can cause mild to life threatening intestinal infections.

Pediatrics Study: Sack Lunches at Risk of Bacteria Proliferation

This brings us back to the study. The objective was to measure the temperature of the foods in preschool-aged children’s sack lunches. Using non-contact temperature guns, the researchers tested 705 lunches that contained a total of 1,361 perishable foods. The temperature was measured 90 minutes before lunchtime.

The results were astounding: Only 22 or 1.6% of the 1361 perishable food items were in a safe temperature zone.  Overall, 97.4% of meats, 99% of dairy, and 98.5% of vegetables were in the danger zone.

The researchers found that the use of thermally insulated bags with ice packs only marginally improved the number of perishable foods in the safe temperature zone.

So what is a parent to do?

Here are some recommendations:

  • Wash hands and use clean cutting boards and knives.
  • Use safe foods like peanut butter (if allowed), raw, cooked or dry fruit and raw vegetables.
  • Consider making a meat sandwich of turkey or roast beef the night before and putting in the freezer using bags designed for freezing. It will take 3 to 3.5 hours for the sandwich to thaw.
  • Soups, stews and chili make a hearty lunch. To use them in a packed lunch, heat to boiling and put in a sterilized thermos bottle.

Finally, I recommend giving your child a high quality probiotic like EndoMune Junior.

Studies have shown that probiotics are able to defend the human intestinal tract against harmful bacteria. The probiotic bacteria stimulate the immune response, prevent pathogens from adhering to the intestinal lining cells and produce antibacterial proteins(4).

There has been increasing evidence in the last 10 years for the benefit of probiotics in preventing and treating acute diarrhea in children. A number of studies have found that giving probiotics versus a placebo to children in day care facility can statistically lessen the risk of having an episode of diarrhea(6,7).

Take Home Message

Given the results of the study on food temperature in school lunch bags, I would think it would be a good idea to give EndoMune Jr to lessen the risk of experiencing a bout of foodborne gastroenteritis.

Eat healthy, exercise and live well!
Dr. Hoberman


(1) Temperature of Foods Sent by Parents of Preschool-aged Children. Almansour FD, Sweitzer SJ, Magness AA.
(2) Food-related illness and death in the United States.Mead, P., L. Slutsker, V Ddietz et al.Emerg Infect Dis, Sept-Oct 1999, 56(No. 53).
(3) Children and microbial foodborne illness.Buzbym H>C. Food Revuewm 2001l 24(2):32-7.
(4) Use of probiotics in children with acute diarrhea. Szajewska H, Mrukowicz JZ. Paediatr Drugs. 2005;7(2):111-22
(5) Probiotics for treatment of acute diarrhoea in children: randomised clinical trial of five different preparations. Canani RB, Cirillo P, Terrin G, Cesarano L, Spagnuolo MI, De Vincenzo A, Albano F, Passariello A, De Marco G, Manguso F, Guarino A. BMJ. 2007 Aug 18;335(7615):340
(6) Efficacy of probiotics in prevention of acute diarrhoea: a meta-analysis of masked, randomised, placebo-controlled trials. Sazawal S, Hiremath G, Dhingra U, Malik P, Deb S, Black RE. Lancet Infect Dis. 2006 Jun;6(6):374-82
(7) Probiotics for children with diarrhea: an update. Guandalini S.J Clin Gastroenterol. 2008 Jul;42 Suppl 2:S53-7

Probiotics Provide Insurance Against Salmonella

What do peanut butter, pistachios, cantaloupes, and eggs have in common? They have all been recent sources of Salmonella food borne illnesses in humans.

Since we are in the middle of a nationwide outbreak of a Salmonella infection due to contaminated eggs, I thought it would be of interest to discuss the benefits of probiotics against Salmonella infections.

If you are feeling paranoid about what to eat, you may feel safer taking EndoMune after reading this newsletter.

There are a number of reasons why probiotics may prevent or shorten the duration of a bout of infectious diarrhea like Salmonella.


  1. Secrete bacteriocins (proteins that can kill harmful invading bacteria)
  2. Produce products like lactic acid and hydrogen peroxide that inhibit infectious bacteria
  3. Stimulate the intestinal immune system to release antibodies and inflammatory cells to destroy the hostile bacteria
  4. Carpet the intestinal lining to prevent the harmful bacteria from attaching and invading the intestinal lining cells

With the knowledge that probiotics can have a beneficial effect against infectious bacteria, researchers have done several types of investigations.The following are studies where probiotics have been shown to be helpful:

Acute Infectious Diarrhea

A number of controlled trials(1) have compared probiotics versus placebo when treating children and adults with acute infectious diarrhea, including Salmonella. The general finding was that probiotic could reduce the duration and severity of the illness. The diarrheal illnesses were shortened, on average, 1-2 days in the individuals who were taking a probiotic.

Traveler’s Diarrhea

The cause of traveler’s diarrhea is exposure to food and water that has been contaminated with fecal matter due to poor sanitary and public health conditions. The organisms that cause the diarrhea are bacteria, viruses and parasites. Studies have found that bacteria like E. coli, Shigella, Salmonella and Campylobacter account for 80% of the episodes. There have been a number of published controlled trials giving travelers either probiotics or placebos. A review(5) of 12 well done clinical trials found that probiotics were safe and generally effective in preventing traveler’s diarrhea. Compared to the travelers receiving a placebo, the probiotic travelers had about 25-50% fewer bouts of diarrhea.

Experiemental Studies

Several recent research studies have investigated how probiotics inhibit Salmonella. One study(6)incubated either Salmonella alone or the combination of probiotics and Salmonella on cultures of human colon cells. The immune reactions in the intestinal cells that were exposed to the probiotic with the Salmonella were much greater than that seen in the cells in contact with only the Salmonella. The study showed that the probiotics could stimulate the release of protective immune reactions against the Salmonella bacteria.

In another study(7), one group of mice were fed probiotics for seven days before being challenged with Salmonella. The other group did not receive the probiotic. The survival rate was greater and the infection milder in the group receiving the probiotics. Studies of the intestinal fluid found much higher levels of antibodies against the Salmonella bacteria.  Again, this would indicate that the probiotics stimulate the intestinal immune system to fight harmful intestinal bacteria.

Take Home Message

Be careful about the eggs you consume and make sure you cook them thoroughly. Avoid the runny eggs like poached eggs or eggs that are served sunny-side up. Eggs Benedict with hollandaise sauce is probably not a good idea, at least for now. You may want to consider a bowl of oatmeal until all the bad eggs are recalled.

If you are still concerned about exposure to Salmonella, consider taking a high quality probiotic like EndoMune.

Eat healthy, exercise and live well!
Dr. Hoberman

(1) Guidance for substantiating the evidence for beneficial effects of probiotics: prevention and management of infections by probiotics.Wolvers D, Antoine JM, Myllyluoma E, Schrezenmeir J, Szajewska H, Rijkers GT.J Nutr. 2010 Mar;140(3):

(2) Probiotics have clinical, microbiologic, and immunologic efficacy in acute infectious diarrhea.Chen CC, Kong MS, Lai MW, Chao HC, Chang KW, Chen SY, Huang YC, Chiu CH, Li WC, Lin PY, Chen CJ, Li TY.Pediatr Infect Dis J. 2010 Feb;29(2):135-8.

(3) Clinical evidence for immunomodulatory effects of probiotic bacteria.
Ruemmele FM, Bier D, Marteau P, Rechkemmer G, Bourdet-Sicard R, Walker WA, Goulet O.J Pediatr Gastroenterol Nutr. 2009 Feb;48(2):126-41. Review

(4) Probiotics for treating infectious diarrhoea(Cochrane Review). Reviewers: Allen, Stephen J; Okoko, B; Martinez, Elizabeth G; Gregorio, Germana V; Dans, Leonila F. Review Group: Cochrane Infectious Diseases Group; Cochrane Database of Systematic Reviews; Edited/Substantively amended: 11 November 2008; Edited (no change to conclusions) this issue

(5)McFarland LV: Meta-analysis of probiotics for the prevention of traveler’s diarrhea. Travel Med Infect Dis. 2007;2:97-105

(6) Microbial products from probiotic bacteria inhibit Salmonella enteritidis 857-induced IL-8 synthesis in Caco-2 cells.Malago JJ, Nemeth E, Koninkx JF, Tooten PC, Fajdiga S, van Dijk JE.Folia Microbiol (Praha). 2010 Jul;55(4):401-8. Epub 2010 Aug 3

(7) Anti-infective mechanisms induced by a probiotic Lactobacillus strain against Salmonella enterica serovar Typhimurium LeBlanc Ade M, Castillo NA, Perdigon G.Int J Food Microbiol. 2010 Apr 15;138(3):223-31. Epub 2010 Feb 1.

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