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FOOD SANITATION

Community hygiene is an important part of public health that most physicians know little about, yet most physicians will have a case of food poisoning themselves at some time in their lives, besides treating cases in their patients. These cases usually involve food handled improperly in the home, such as tuna salad that was saved a little longer than it should have been. Generally the physician need only make the report of a case of food poisoning to the local health department and remind the patient, "When in doubt throw it out."

Most community outbreaks of food poisoning arise from the same sources as individual cases. Potluck dinners and socials at churches and schools give more people food poisoning than any other source in the United States. The local health department usually has jurisdiction to deal with such outbreaks through local ordinances supported by state law. It is important that such outbreaks be reported to the health department because locating the problem and educating the leaders of the organization may avert future outbreaks.

Local health departments usually have jurisdiction over the preparation or sale of food in the community, although their control over schools and public institutions may be limited. Federal laws govern such matters as the handling of food in interstate commerce, the licensing of drugs, and special hazards such as seafood and meat processing. Physicians should try to cooperate with health authorities to protect the food supply. Recognizing and reporting cases of food poisoning is the first step. Powerful institutional providers may bring great pressure to bear on health officials and physicians to overlook deficiencies. A college physician may be encouraged to substitute a diagnosis of gastroenteritis for one of food poisoning if the presumed source of the problem is the college food service. This would violate professional ethics, reporting laws, and the physician's duty to patients. A better response is for the physician to work with public health authorities to correct the problems that are causing the food poisoning. A physician who did not make proper diagnoses and reports might be held liable for illness in subsequent patrons of the establishment.

There also will be times when food poisoning will result from food that is damaged before it reaches the retail level. Most people are familiar with the recall of canned food that appears to have been contaminated during manufacture. This is usually discovered by an attentive private physician who recognizes botulism or other unusual diseases. Food may also become unfit for consumption because of improper handling. If a carload of fish has lost refrigeration and spoiled, it may cause a local disease outbreak of considerable magnitude. A physician who recognizes and reports an early case may save many people from illness. The health department would have the opportunity to locate the problem and supervise the destruction of the contaminated food.


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