Red Flag...........................................................................................................................................................................

Food poisoning and antacids don't mix

In May 1996 the General Accounting Office reported to Congress: "Between 6.5 and 81 million cases of foodborne illness and as many as 9100 [related] deaths occur each year." Between 2% and 3% of all cases of food poisoning have serious consequences, and those most at risk are the pregnant, children, the elderly and the immune-compromised or immune-suppressed.

Although many people are aware of the occasional outbreak of foodborne illness covered by the press, many experience such illnesses without being aware of it: mild cases feel like flu and clear up uneventfully. But a new phenomenon of American life may make millions more susceptible to foodborne illness -- and its consequences.

A recent survey indicated that one third of all adults in the US take some sort of over the counter heartburn drug at least twice a week. The American College of Gastroenterology warns about overuse of such drugs, since heartburn and indigestion may be symptoms of a problem that requires more than symptomatic treatment.

But until now, no one has pointed out a fact mentioned in The Merck Manual, a basic medical reference book: Antacid drugs can facilitate a common foodborne illness -- Salmonella infection.

• Salmonella sickens between 800,00 and 4 MILLION Americans each year. About 2% of the stricken must be hospitalized, and 0.1% die of their illness.

• Salmonella is nearly ubiquitous in the environment: there are over 2000 types identified so far, which can contaminate seafood, fruits and vegetables, meats and meat products, poultry, eggs and egg products, and milk. Improper food handling practices can spread salmonella from one source to another, and dishes containing contaminated ingredients can become potent sources of Salmonella exposure.

• Acute symptoms of Salmonella poisoning -- diarrhea, fever, sometimes vomiting-- are often mistakenly attributed by sufferers to intestinal flu, according to the Centers for Disease Control. But Salmonella also has long-term consequences, and if the initial infection was misdiagnosed or undiagnosed, the onset of such symptoms may seem inexplicable. They include: arthritis; inflammation of joints, eye membranes and urinary tract (Reiter's Syndrome); and inflammation of the pancreas, spleen, gallbladder, thyroid, and/or heart. Salmonella infection costs the nation $0.6 to $3.0 BILLION per year.

How do antacids facilitate Salmonella infection? Digestive acids -- acids neutralized by antacid medications -- offer some protection from Salmonella infection. When they are neutralized, this line of defense is lost. Ironically, some people may take antacids at the first sign of Salmonella-related discomfort -- thus undermining their innate ability to mitigate the virulence of the illness.
Some people are naturally more susceptible to Salmonella infection, and for these people, taking antacids may be especially risky. Such people include: those with sickle cell disease; those with leukemia; those with lymphoma; and those with HIV.

                                                                                                        Staff, The Human Ecologist.

Notes and Comment

Who is vulnerable to the effects of environmental exposure?

"HEAL's purpose and goals concern the effects of environmental exposure on health, not just for those who have already been adversely affected, but also for those portions of the general public who are potentially at high risk for adverse effects from...environmental exposure[s] by virtue of their age, state of health and immune status, state of development, and other characteristics....
[The Governing Board] believe[s] that a list of high-risk groups includes the following:

1. the chemically sensitive
2. women of childbearing age
3. pregnant women and their fetuses
4. all children under 15 years of age
5. the immune-impaired
6. the chronically-ill
7. the poor
8. all those whose employment involves work with or around [hazardous materials]"

             -- from the HEAL Governing Board comments to the US Department of Agriculture, May 1993.