Food Poisoning While Pregnant

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Food poisoning during pregnancy can be terribly uncomfortable, but it can also be a cause for concern. There is a possibility of passing the illness on to your unborn child, and in severe cases, foodborne illness can cause stillbirth or miscarriage, especially in those women who are already at risk.

As a result, it is especially important to practice food safety guidelines and even avoid certain foods during pregnancy. If you start to notice symptoms, quick communication with your healthcare provider can play a key role in keeping your pregnancy safe and healthy.

Types of Food Poisoning

Certain bacterial infections are well established as possible miscarriage causes. Several specific foodborne illnesses (aka food poisoning) are linked to miscarriage.

Listeriosis

Listeriosis is a severe illness caused by the bacteria Listeria monocytogenes. According to the CDC, there are certain foods that are more likely to contain listeria, including:

  • Melons
  • Processed meat products like hot dogs and cold cuts
  • Raw milk
  • Raw sprouts
  • Smoked fish
  • Soft cheeses

In addition to affecting pregnant women, this illness also commonly infects older adults with weakened immune systems and newborns. Adults who aren't pregnant and have intact immune systems are at less risk of catching this illness.

Those who are not pregnant may experience symptoms including headache, stiff neck, confusion, loss of balance, or convulsions when they have this infection. But symptoms in pregnant women are slightly different.

Signs of listeriosis in pregnant women may include fever, muscle aches, fatigue, other flu-like symptoms.

Listeriosis is treated using antibiotics. In pregnant women, amoxicillin may be prescribed.

Listeriosis outbreaks most frequently occur in the summer. Experts advise that prevention in pregnant women relies on adherence to strict diet recommendations such as reheating of leftovers until steaming and avoidance of foods likely to contain the bacteria.

Salmonellosis

Salmonellosis is a foodborne illness caused by the bacteria Salmonella. Symptoms of salmonella include diarrhea, fever, and abdominal cramps. In severe cases, salmonellosis can cause infections in the urine, blood, bones, joints, or the nervous system.

Foods that may contain these bacteria include:

  • Eggs
  • Fruit
  • Pork
  • Sprouts and other vegetables
  • Some processed foods (such as nut butters, frozen pot pies, chicken nuggets, and stuffed chicken entrees).
  • Undercooked poultry

Undercooked poultry products, such as chicken or turkey, are the most common sources of contamination with salmonella. The CDC notes that contaminated foods usually look and smell normal.

There has been at least one case of a pregnant woman passing the infection onto the newborn, who was then treated unsuccessfully for at least five months with medications including ampicillin, gentamicin, and amoxicillin. But these reports are rare.

The treatment of salmonellosis infection may depend on the severity of the infection. In many cases, affected individuals are told to consume extra liquids. In more severe cases, antibiotics are used.

E. Coli Enteritis

Escherichia coli (commonly abbreviated to E. coli) is a type of bacteria that is the most common cause of travelers' diarrhea. There are different strains of E. coli and not all of them are likely to make you sick. In addition to diarrhea, other strains may cause urinary tract infections, respiratory illness, and pneumonia, and other illnesses.

E. coli enteritis involves swelling of the small intestine caused by infection with E. coli bacteria. Although E. coli is naturally found in our intestines, strains of E. coli present in certain contaminated foods can cause E. coli enteritis. 

E. coli enteritis is often the result of unsafe food handling practices, including:

  • Meat or poultry that came into contact with intestinal bacteria during processing
  • Unsafe handling of food during transport or processing
  • Unsafe food handling in grocery stores, restaurants, or homes
  • Water that contains animal or human waste

Authors of one study on E. coli in pregnancy note that fruits and vegetables on farms can carry the bacteria if they come into contact with animal feces. They advise that women should seriously consider avoiding all fresh farm berries and open-produce garden vegetables while pregnant.

Typical symptoms of E. coli enteritis include diarrhea, fever, stomach cramping, and loss of appetite. Experts advise that the general public should contact their healthcare provider if you have diarrhea that lasts for more than three days or diarrhea that is accompanied by a fever higher than 102˚F, blood in the stool, or so much vomiting that you cannot keep liquids down and you pass very little urine.

Treatment for E. coli enteritis entails hydration and the possible use of antibiotics.

Campylobacteriosis

Campylobacter is a strain of bacteria that causes campylobacteriosis, a common cause of diarrheal illness in the United States. The bacteria may be carried by chickens, turkeys, cows, and other animals that show no signs of illness. The meat or milk from those animals may contain the bacteria.

Water (drinking water and open water), fruits, and vegetables can also become contaminated with the bacteria if they come into contact with animal or bird feces or with soil that has been contaminated with bird or animal feces.

Symptoms of this infection may include bloody diarrhea, fever, stomach cramps, nausea, or vomiting. Symptoms usually last about a week. Most people recover without the use of antibiotics, but medications may be prescribed for women who are pregnant.

Current research studies investigating campylobacteriosis in pregnant women are limited, but one widely-cited study from 2002 notes that severe consequences such as infection of the fetus, miscarriage, and stillbirth are possible. Study authors advise that pregnant women take special care in food handling and preparation to prevent such infections.

The Centers for Disease Control and Prevention advises that all consumers wash produce and choose pasteurized milk as pasteurization kills the bacteria in milk, making it safe to drink.

Food Safety Tips During Pregnancy

During pregnancy, it is smart to be extra careful about eating in restaurants, choosing foods at the grocery store, and preparing food at home.

Foods to Avoid

The best way to protect yourself from foodborne infections is to avoid foods at risk of contamination. Be especially careful at locations such as farmers markets to check labels for ingredients and processing information.

Different organizations including the American College of Obstetricians and Gynecologists (ACOG) and the U.S. Department of Health & Human Services (HHS) provide guidelines for foods to avoid during pregnancy to minimize your risk of food poisoning.

Foods to Avoid During Pregnancy

  • Fermented or dry sausage (unless it has been reheated to steaming hot before eating)
  • Freshly made or homemade hollandaise sauce
  • Homemade Caesar salad dressing
  • Homemade eggnog
  • Homemade ice cream
  • Hot dogs, luncheon meats, deli meats, and cold cuts (unless heated until steaming hot just before serving)
  • Premade deli meat or seafood salads
  • Raw batter (such as cookie or cake batter)
  • Raw milk (or products made from raw, unpasteurized milk)
  • Raw sprouts (alfalfa, clover, mung bean, and radish sprouts)
  • Raw or undercooked eggs
  • Raw or undercooked seafood (including raw sushi, sashimi, ceviche, raw oysters)
  • Raw or undercooked meat
  • Refrigerated pate and meat spreads
  • Refrigerated smoked seafood (including lox, or fish such as salmon, trout, whitefish, cod, tuna, or mackerel that are labeled as kippered, nova-style, or jerky)
  • Soft cheeses (such as brie, feta, Camembert, Roquefort, queso Blanco, queso fresco) unless the label specifically states that they have been made with pasteurized milk
  • Tiramisu
  • Unpasteurized juice or cider

Safe Food Handling

The ACOG and the HHS also provide guidelines for safe food handling to avoid food poisoning during pregnancy. In general, they advise that you keep your kitchen clean, including knives, countertops, and cutting boards after handling and preparing uncooked foods. And wash your hands regularly before and after handling food.

Food preparation guidelines fall into different categories based on the type of food you might be preparing.

Fruits and Vegetables

Rinse all raw produce thoroughly under running tap water before eating, cutting, or cooking. Cook sprouts thoroughly if you choose to consume them.

Eggs

Egg dishes should be cooked until they reach an internal temperature of 160°F. If you prepare eggs alone, cook them until both the yolk and the whites are firm.

Meat

When cooking meat, use a food thermometer to make sure your food reaches the USDA-recommended safe minimum internal temperature. You can download and print a complete list of safe temperatures at the FoodSafety.gov website. Post it in your kitchen for a quick reference.

Some examples of safe internal temperatures include:

  • All poultry: 165°F
  • Beef veal or lamb steaks: 145°F
  • Ground beef: 160°F
  • Leftovers and casseroles: 165°F

Government sources also recommend that you freeze meat for several days at sub-zero (0°F) temperatures before cooking to reduce the chance of infection.

Seafood

Seafood should be chosen carefully. The ACOG recommends that you avoid seafood that is likely to be high in mercury (including shark, bigeye tuna, marlin, and orange roughy) for reasons other than bacterial poisoning.

  • Fish with fins should be cooked to an internal temperature of 145°F or until flesh is opaque and separates easily with a fork.
  • Clams, oysters, and mussels should be cooked until the shells open.
  • Shrimp, lobster, crab, and scallops should be cooked until the flesh is white and opaque.
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