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 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.