When visiting China or any other country with a Chinese orientated culture it can be very challenging to try some of the exotic culinary preparations on offer. People of Chinese origin eat just about anything that is a source of protein. Local delicacies may include insects, reptiles, amphibians, all types of seafood and shellfish, many types of mamals and just about anything else you can think of.

Food poisoning among adventurous western tourists is quite common simply because of the fact that they have no or little awareness of the things which a local can stomach but would be very problematic for them. The prospect of being able to come home and show family and friends pictures of yourself munching on freshly fried cockroaches may be appealing but it may also turn out to be a mistake you might regret for a very long time.

Locals may have a much higher resistance to various food toxins and allergens that you. Their immune systems may well recognize and destroy bacteria which would make you very sick. Remember, they have been exposed to these things all their lives whereas for you it is completely new.

Many good hotels will keep lists of hotels which they feel that it is safe for tourists to eat and in addition they may also have a residential general practitioner on duty or be able to call a reputable GP within a very short space of time.

A good rule of thumb when eating in Chinese restaurants is only to eat in respectable busy places. Only accept your food it it is sizzling hot and do not order anything which your stomach is not used to. Also, never accept fruit which has been peeled for you, always opt to peel it yourself. Never eat salads. In fact, there are no salads in Chinese cuisine. Is it a coincidence that they all eat their food piping hot? Food for thought!

If you do fall sick in China or South East Asia always go to a doctor who has been recommended to you by a respectable establishment. Street doctors are often not qualified by internationally recognized medical schools and may make bad mistakes in diagnosis. Also some doctors may recommend unnecessary treatment and prescribe drugs that you do not need and which may do you more harm than good. It is also most unadvised to go to traditional practitioners because many of the herbal remedies which they prescribe may be infected with mold and cause more harm than good.

Common sense is an absolute must when eating of receiving medical treatment in China. The Chinese government itself are now organizing themselves to bring in a national standards authority which will act upon identical lines to those practiced in Eu regulations and the American FDA. The Chinese government has fully accepted that to continue to operate as they have until now is contrary to the Chinese national interest and prosperity of the Chinese nation. Please, be careful what you eat in China.

Cholera is a disease of the human digestive system and it is passed from person to person through the drinking if infected water or eating food infected with the cholera bacteria. Cholera is caused by the bacterium Vibrio Cholerae which is a comma shaped gram negative bacteria.

Cholera is usually contracted when the feces of an infected person or persons comes into contact with food or a water supply but cholera has been know to exist in non feces infected brackish water. However cholera has also been know to be contracted by eating raw shellfish which can be infected with cholera. Some coastal areas including the Gulf of Mexico, the west African Coast, The east African Coastline, parts of the Brazilian coastline and parts of the South China Sea coastlines are renowned for having cholera infected shellfish. It is suspected that the pumping of raw sewage into the sea is responsible for this phenomenon.

Cholera is very common in areas which have poor treatment of sewage and drinking water. Many cases of cholera infection are very mild but other instances may be very severe. The disease is caused when the bacteria produce cholera toxin which inserts itself into the cell walls of the cells which line the small intestine. It acts as a very efficient chemical water pump which draws vast amounts of water into the lumen of the small intestine.

The bacterial infection which causes cholera is not very dangerous in itself on condition that the symptoms of the disease are well managed. It is the symptoms which present the danger. Persons infected with cholera have been know to be seriously dehydrated within one hour from the onset of diarrhoea, can go into shock within three hours and can die from severe dehydration in the space of twelve hour if they do not receive proper medical attention.

If properly managed the body can wash the disease out in the space of a few days. the main problem with cholera is re infection. If there is no clean water or uncontaminated food to be had the cycle continues. The main impact of cholera is on the elderly, the very young and people who may already be weakened by malnutrition or another disease. The main treatment which is now used to combat this disease is oral re hydration therapy. Re hydration should be started as soon as possible. In very severe cases a drip may be needed in addition to oral re hydration therapy. Medical staff who are used to treating this disease and in using this technique have saved many millions of lives especially in the developing world.

Zoonotic diseases are ones which are passed from the animal kingdom to human beings. Many micro organisms tend to be species specific and it is for this reason that there are not a great many zoonotic diseases. Some diseases passed on to us via animals are very common whereas some others are very rare. Some have the potential to cause world catastrophes whereas others may just about give us an upset stomach.

Below you will find a list of zoonotic diseases in alphabetical order.

Anthrax is a serious disease that is found in all warm blooded animals. The specific host is thought to be antelope and carnivores seem to react more slowly to the bacteria. The bacteria responsible for the cause of anthrax is Bacillus Anthracis. Human infections usually occur through the skin but it may also be inhaled or ingested. This is a very resistant spore forming bacteria whose spores may survive for decades in soil or animal products. The distribution is worldwide. Gastro-Intestinal anthrax is a very uncommon, often-fatal manifestation of the disease, caused by devouring meat from an animal that died of the desease. Gastro-Intestinal anthrax causes infamation of the  stomach and the intestine accompanied by sores or ulcers, much the same as the lesions that appear on the skin in the skin form of anthrax. The primary signs of the disease include nausea, vomiting, loss of appetite and fever, followed by severe abdominal pain, vomiting of  blood, and severe and bloody diarrhea.

Brucellosis comes in four strains, B. abortus (in cattle), B. melitensis (sheep or goats), B. suis (pigs), and canis (dogs). The distribution of brucellosis is distributed worldwide. The disease id contracted via direct contact with animal excretions including milk. it is a disease caused by any of several forms of the gram-negative coccobacillus Brucella: Brucella melitensis, B. abortus, B. suis, and B. canis, the latter of which is very rare and causes only mild illness. Brucellosis is most common in rural areas among farmering populations, vets, meat packers, slaughterhouse staff, and livestock breeders. Laboratory workers are also among those who are at risk. It is primarily a disease of animals (including cattle, pigs, sheep, camels, goats, and dogs); humans usually contract it through ingestion of contaminated and unpasteurized milk or other non cooked milk products or by ingesting raw meat or bone marrow, through skin lesions and cuts, through direct contact with an infected animal, or through the inhalation of dust particles that may be present in contaminated soil. Symptoms of brucellosis are manifested as follows:  fever, chills, sweating, malaise, and weakness. The fever often occurs in recuring waves, rising in the evening and subsiding during the day,  separated by periods of remission at intervals. Other symptoms may include  weight loss, headache, muscle and joint pain, and an enlarged spleen, and  often orchiepididymitis in young men. In some victims the disease is acute; however, more often it is chronic, recurring over a period of months or years. Although brucellosis itself is rarely fatal, treatment is important because serious complications such as pneumonia, endocarditis, meningitis, and encephalitis may develop. Tetracycline plus streptomycin is the preferred treatment for this desease; bed rest is also of great importance. A vaccine is available outside the United States. The desease can also be called Cyprus fever, dust fever, Gibraltar fever, Malta fever, Mediterranean fever and  undulant fever. See also abortus fever.

Camphylobacteriosis is caused by the bacterium camphylorbacter spp. It is carried by many animal species with a seemingly increasing incidence rate. Most species of animals seem to be reasonably host specific but cross infection is possible usually via fecal contamination of food. Improper or incomplete cooking of food is the most common way that the disease is spread, and it is commonly thought by bacteriologists that poultry account for over half the diagnosed cases. Untreated water and raw milk are also potential sources of contamination.
The incubation period after exposure is from one to ten days.  symptoms begin with a day or two of mild fever, muscle aches, and headaches. This stage is followed by symptoms that involve the the intestinal tract. Diarrhea occurs with or without the presence of blood and severe abdominal cramps are the overriding intestinal symptom. The severity of symptoms may vary from case to case, ranging from only mild fever to  severe dehydration and very rarely death (this is seen mainly in the very young or old). The disease usually lasts for about a week, but persists longer in about twenty percent of cases. At least ten percent will have a relapse, and some patients will continue to pass the bacteria for several weeks after recovery.
Complications

Clostridial disease is caused by the bacterium clostridium spp. It is transferred by mammals, birds and fish with a worldwide distribution. Although the disease is normally transmitted through wound infection, food poisoning does occur. There is little danger of cross species transmission. The clostridial family of bacteria are noted by their ability to manufacture very potent toxins. The most potent toxin in nature is produced by the bacterium Chlostridium botolinium. This toxin renders the bodies ability to contract muscles inefective and death will occur by paralysis and asphxiation, or the inability to inhale. Clostridium botolinium is found in the manure of animals along with clostridium tetani, clostridium deficilium and clostridium perfringens, which causes gas gangrene. These bacteria are spore forming and the spores can survive for many years in soil. When conditions are favorable the bacterial spores will grow back into bacteria and begin to produce toxin.

Food that has been improperly preserved or stored can harbor botulinum toxin-producing clostridia. Botulism symptoms usually appear within 18-36 hours after eating contaminated food, in extreme cases it may take four hours to eight days for the bacteria to develop toxin. Initial signs of infection include blurred or double vision and difficulty in swallowing food and speaking.  Gastrointestinal problems may include constipation, nausea, and vomiting. As botulism progresses, the victim experiences weakness or paralysis, starting with the head muscles and progressing down the body. Breathing eventually becomes increasingly more and more difficult. and without medical intervention, respiratory failure and death are the likely outcome.

Listeriosis is caused by the bacterium listeria monocytogenes and it can be found in numerous species of animals and birds. It has a worldwide distribution. Lysteriosis was traditionally considered to be a disease of animals for the most part. However in recent decades there has been an alarming increase in the incidence of this disease. The symptoms can be severe and patients who are high risk may have a problem overcoming listeriosis. It is becoming resistant to many forms of anti-biotics. This is primarilya food borne bacteria. Lysteria can be contracted by the ingestion of contaminated meat, dairy products, shellfish, dust and by coming into contact with infected animals. Listeria can pass through the wall of the gut and enter the bloodstream. It likes to sit on the central nervous system and spinal column. Pregnant mothers can spread this desease to their unborn babies through the placenta. Listeria cam cause severe flu like symptoms, meningitis and encephalitis. Lysteria is also found in soil, sewage and in five percent of the intestines of humans without them feeling any ill effect.

Salmonellosis is transmitted by the salmonella spp. Bacteria which has over two thousand serotypes. It can be found in all animal species but it is not commonly thought to infect fish. The distribution of salmonellosis is worldwide and the occurance of this disease is mostly attributed to the ingestion of undercooked food which is contaminated with feces. It is a form of gastroenteritis that is usually caused by the ingestion of food that has been contaminated with a species of Salmonella bacillus. It is characterized by an incubation period of six hours  to forty eight  hours which is followed by sudden colicky abdominal pain, high fever, and bloody, watery diarrhea. Nausea and vomiting are common symptoms, and abdominal signs may be almost identical  those of acute appendicitis or cholecystitis.

Symptoms usually last from four to seven days, but diarrhea and fever may persist for up to 2 weeks. Dehydration may occur. There is no specific treatment for salmonellosis. Antibiotics are usually not prescribed unless the disease has spread beyond the intestine and into other organs. Adequate cooking, good refrigeration, and attention to personal hygiene, especially the washing of hands may reduce the frequency of  salmonella outbreaks. Salmonella can also cause typhoid fever.

Tuberculosis is caused by the bacterium mycobacterium bovis (cattle). It can be transferred to humans via cattle and non human primates. The distribution of tuberculosis is worldwide and has now been linked to the aids virus. The disease can be transmitted by any animal species including humans. It now normally takes treatment with three forms of anti-biotics simultaneously to combat this bacteria. No other desease throughout history has claimed so many lives.  The tuberculosis bacteria will infect the organ via which it entered the body. In most cases this is the lungs. As it has a protective enveloping it manages to outsmart the bodies specific immune system. The tuberculosis bacteria can survive within the non specific white blood cells and by colonising them it can move around the body from organ to organ. This is a slow process. It can transpire over a period of years. In the early part of the last century one in seven people were infected with tuberculosis. In the western world this number has dropped greatly due to the improvement in living conditions and lifestyle. In the third world, particularly Africa , conditions are still right for tuberculosis infection.

Tularemia is transmitted by the Francisella Bacteria. It is transmitted to humans by rabbits, dogs, cats, rodents, sheep and deer. Its distribution is circumpolar within the confines of the northern hemisphere. The disease is transmitted through ingestion when exposed to infected animals and also via bites of arthropods. It is an infectious disease of animals caused by the bacillus Francisella (Pasteurella) tularensis, which may be transmitted by insect vectors or direct contact. It is characterized in humans by fever, headache, and an ulcerated skin lesion with localized lymph node enlargement or by eye infection, GI ulcerations, or pneumonia, depending on the site of entry and the response of the host. This disease can be fatal if not treated with the appropriate antibiotics. Treatment includes streptomycin, chloramphenicol, and tetracycline. Recovery produces lifelong immunity. A vaccine was used in the past to protect laboratory workers but is not currently available; however, a new vaccine is in development. Also called deerfly fever, rabbit fever. Also spelled tularaemia.

Vibriosis is transmitted by the Vibrio parahemolyticus or the V. alginolyticus bacteria. It is transmitted salt water fish and shellfish and is found primarily in the pacific regions including Asia, Australia, North America and the gulf of Mexico . The cause is the ingestion of undercooked contaminated food. Vibriosis is caused by eating seafood contaminated with Vibrio parahemolyticus or Vibrio vulnificus. These bacteria damage the inner wall of the intestine, which causes diarrhea and related symptoms. Vibrio vulnificus can get through the intestinal wall and into the bloodstream.
Persons at risk for severe, often fatal vibriosis include those with liver disease (cirrhosis), excess iron (hemochromatosis), thalassemia (a blood disorder), AIDS, diabetes, or those who are immunosuppressed.
Symptoms of intestinal infection occur within two days of eating contaminated seafood. Symptoms last for two to 10 days and include watery diarrhea, abdominal cramps, nausea, vomiting, headache, and possibly fever. Symptoms of a blood infection develop one to two days after eating contaminated seafood, and include fever, chills, low blood pressure, and large fluid-filled blisters on the arms or legs. Similar blisters can also be produced by a Vibrio vulnificus skin infection. This can occur when the skin is pearced by the spines of infected fish. These infections can be severe and sometimes require amputations if not treated in time.

Yerisiniosis is caused by the yerisinia paratuberculosis or the V enterolitica bacteria and is passed onto human beings by Animals and birds. It is distributed in the northern hemisphere and is transmitted via contaminated food and water.

Yersinia p. causes septicemia (blood poisoning) often with signs of gastroenteritis which is caused by Yersinia pseudotuberculosis, this occurs in wild rodents, birds, and most domestic species, particularly cats, although this is not common. The symptoms are: high  fever, severe toxemia with a high fatality rate. At postmortem there are large numbers of embolic abscesses in most of the internal organs. It is also called  pseudotuberculosis because of the way it infects multiple organs.
Occurs also in many species of fish as a septicemia. This form of infection is caused by Yersinia ruckeri.

In my previous article on shellfish and crustaceans I referred to instances of when seafood became contaminated once it was out of the sea. There are many forms of seafood poisoning and I would like to talk of one of the more problematic and undetectable forms of seafood poisoning that we encounter quite often.

In the field of food hygiene we must also look at the condition of food which has been caught in the wild. This includes the world’s fisheries industry. Wild sea food, particularly that which has been caught on or around coral reefs, is thought to be superior to sources which are grown by aquaculture technologies. Locus, red snapper, lobster and shrimp caught and served fresh from the coral reef are prized as delicacies.

All creatures that live on the coral reef are part of a food chain. Everybody is eaten by somebody else eventually. The food chain begins with single cell creatures such as plankton.  Some forms of plankton emit a toxin called “ciguatoxin”. The reaction to this toxin in humans is called “ciguatera“. (sig-ua-terra).

The plankton enters the food chain at the bottom end where it is eaten my small coral reef creatures. The small creatures are eaten by bigger ones until, finally we arrive at the sea creatures that we love to sea on our plates at the seafood restaurant.

It is important to stress that although the toxin is released into the flesh of the fish it has little or no effect upon them and they can continue to live out there lives and function quite well despite being infected by the toxin. The toxin tends to accumulate mostly in the liver, pancreas, gills and head but is also present in potentially problematic concentrations throughout the muscle tissue as well.

Cases of ciguatera are seen mostly where raw seafood flesh is served but it is important to stress that the toxin is not destroyed or neutralized by the cooking process nor is it destroyed by the powerful acid (HCl) which is present in our stomachs during the digestive process.

The reaction experienced by victims of ciguatera include all or most of the classic allergic reaction symptoms. Sufferers may experience sweating, dizziness, nausea, fainting, tightness of breath, burning of the mouth, itchiness, rashes, blurring of the vision and other symptoms.

This may sound frightening but although highly unpleasant, Ciguatera is very rarely fatal, especially if the victim arrives promptly to a place where he or she can receive modern medical treatment. Patients usually make a full recover within three to five days.

Some cases can be fatal but these cases are usually where people have severe medical conditions or other sensitivities that can be sparked off in conjunction with the symptoms of Ciguatera.

The only way to protect yourself is never to eat seafood in restaurants in locations that you have no prior knowledge of. Prefer to eat fish species from the open sea or freshwater sources. Eat or buy seafood from reputable businesses that have no previously reported incidences of Ciguatera.

If you are like me you like shellfish in all forms, shapes and sizes. I just cant get enough shellfish, particularly shrimps, squid and lobster. Personally, I think that shellfish are one of the best food sources available. They are almost all protein, no fat and almost zero cholesterol. What could be better?

But wait. Before you let yourself dash off to the nearest seafood restaurant here are a few things that you should know about your favourite tasty morsel. Shellfish are one of the most dangerous of all forms of food. That’s right, you heard me well, one of the most dangerous and for several reasons.

Firstly, even if you are one hundred percent sure that the shellfish in question is completely fresh, there is still the question of seafood allergies to consider. Shellfish have one of the highest counts of allergic reaction rates per capita. The reason for this is precisely because shellfish are constituted primarily of protein. Most of our immune responce reacts to proteins and the reason for that is because our antibodies are themselves proteins and they are designed to seek out foreign invaders who’s skeletal walls are made of protein.

One of our antibodies, which is known as “I.G.E” causes very acute responses of the immune system. One such immune response is anafilactic shock. If a protein from a shellfish is recognized as an alien threat and becomes attached to I.G.E. antibodies, a potentially fatal chain of reactions may be set into effect.

So, say a person would like to try shellfish for the first time, how could he test if he has an allergic response? One simple option is to take a piece of the shellfish after it has been cooked and to rub it onto the inside of the lower lip. If you are allergic the lip will either swell up, tingle or produce a burning sensation. One may also feel internal side effects such as tightness of breath, facial swelling, excessive salivation,sweating and drop in blood pressure which may cause vomiting , dizziness or red rashes over extensive areas of the body. If that is the case, seek medical treatment immediately in a hospital and don’t go anywhere near shellfish, they are not for you.

Up to now I have talked about allergic reaction to the protein in fresh and untainted shellfish. There is, however a different kind of allergic reaction that one can get from shellfish. It may be of little consequence to the sufferer how he got his allergic reaction but the difference is important from medicinal and scientific perspectives. One may  suffer an allergic reaction to bacterial toxins and/or to waste products of bacteria within the shellfish itself. This is important because the person affected from such bacterial substances may not be allergic to shellfish at all per say and had it not been for the bacterial activity, no reaction would have been encountered at all.

The other danger concerning shellfish is that of bacterial infection. Shellfish are a very easy target for bacteria because a) they contain a high percentage of water and b) they are made up of protein which are an excellent source of food for many dangerous forms of bacteria such as the clostridium genus. Shellfish become contaminated up to ten times more quickly than most other forms of food.

This means that we need to take great care when dealing with shellfish. Shellfish are safest when bought frozen. The reason for this is  they are caught by trawler ships which are really floating factories and they are frozen and packed within minutes of being caught on production lines which are maintained at a constant ambient temperature of four degrees celcius. In conditions such as these the likelihood of contamination is as near to zero as it is possible to get.

So how do you prepare frozen shellfish? My advise is not to thaw frozen shellfish. Boil water and throw them into the boiling water. Cook them until  your crustaceans have changed color and all of them have turned pinky orange in color. Take them out of the water without cooling them at all and after allowing them to drain mix instantly with your pre cooked sauce, while the sauce is still boiling. Serve sizzling hot.

Never allow shellfish dishes to cool and I strongly advise against re heating shellfish dishes, including Paella. Keep it simple and safe, thats the key. In the case of frozen clams, mussels, winkels and such like, discard any that have not opened during the cooking process.

When buying fresh shellfish you should always ensure that the creatures are still alive. If they don’t move, don’t buy. Shells like clams should be closed and you should see them tighten the pressure of the closure when you tap the shell. Do not buy any that don’t react. Personally I like to buy directly from the fishing boats right after they have docked. That way I am one hundred percent sure that they are absolutely fresh. Definitely do not by anything that is not stocked in crushed ice.

One trick that a lot of merchants use and you should look out for is to splash fresh sea water over shellfish and other forms of fish. The reason they do this is so that the merchandise had a fresh sea smell that will make it more difficult for you to recognize other bad smells that might be present on fish and shellfish that has not been stored properly and has been outside for an extended period of time. Watch out for this. If you sea a bucket of water near a stand, you will now know it’s purpose.

Shellfish should be cooked in a sauce which is tart, peppered and salted to taste. All of these qualities will lower the Ph of the shellfish and lessen the risk of bacterial growth.  Avoid adding leaf herbs to shellfish because leaf herbs have bacteria on them which may contaminate your food.

All spices and herbs, if used, should be fried in oil at the beginning of the preparation of the sauce. This way, any bacteria in the spice or on the herb will be killed by the heat of the oil.

Follow these basic principles and you should stay out of shellfish hell.