Keeping food safe.

Four days before he died in July 1993, Alex Donley had been a normal six-year-old. What happened? He ate an undercooked hamburger that his mother made from some ground beef she bought at the local supermarket.

At the slaughterhouse or packing plant, some of the meat in the burger had come in contact with cow feces--feces that harbored a deadly bacterium known as E. coli O157:H7.

Food poisoning sure isn't what it used to be.

Years ago, a typical outbreak occurred at a church picnic, where folks took ill after eating some of Aunt Flora's chicken salad that had been sitting out in the sun too long. It was pretty easy to figure out what happened, and, after a few uncomfortable days, life returned to normal. Not any more. Deadly new bugs have appeared, more of us are vulnerable, and the way we produce and distribute our food makes it more susceptible to contamination.

The bottom line: by the time you finish reading this article, another American is likely to have died from food poisoning.

On a typical day in America, nearly 20,000 people get sick from something they ate. Most recover, but 25 or so die.

Odds are they didn't see it coming. They didn't eat obviously contaminated food. They weren't especially careless in their kitchens. In some cases, parents unwittingly fed the tainted food to their children.

While anyone could get food poisoning, people with weakened immune systems are most susceptible. That means those with cancer or AIDS, organ transplant recipients, people taking prednisone or other corticosteroids, pregnant women, and people over 65.

What causes food poisoning? Bacteria, mostly. Here are mug shots of four of the most dangerous:

* E. coli O157:H7. The abdominal cramps felt like "a knife stabbing me in the stomach," remembers 14-year-old Robert Borrelli of Boca Raton, Florida. He was lucky. Three-year-old Joy Galler of New York died after an agonizing 18-day ordeal during which her kidneys and pancreas failed, she became blind in one eye, and she suffered a stroke. You've probably got billions of E. coli bacteria doing the backstroke in your intestines right now. Most are harmless. A few strains cause inconveniences like travelers' diarrhea. Others, including O157:H7, can be deadly.

It's what killed Alex Donley and Joy Galler. And it's what sent more than 500 people to the hospital in California, Idaho, Nevada, and Washington state in 1993, after they ate undercooked burgers, most of them at Jack in the Box fast food restaurants.

The Centers for Disease Control (CDC) estimates that 20,000 Americans eat enough E coli O157:H7 to make them ill each year. The bug could kill as many as 500.

Undercooked beef, especially ground beef, is the food most likely to be contaminated. But don't think you're immune just because you're not a burger fan; you can get a potentially lethal dose simply by coming into contact with a person who's been infected.

* Listeria. If it travels from your gastrointestinal tract to your brain or other organs, odds are one in four that you'll die. Pregnant women are particularly vulnerable. If it invades the uterus, it can cause a miscarriage.

In 1985, contaminated un-aged white cheese (queso blanco) killed 46 Southern Californians. Tainted processed meats, undercooked chicken, and deli-type salads have also resulted in outbreaks. The CDC estimates that Listeria causes about 1,800 Americans to become ill--and 400 to die--every year.

Unlike most other food poisoning bugs, Listeria thrives in cold temperatures.

* Campylobacter. Every year, more than two million Americans suffer from diarrhea, vomiting, and fever after eating food infected with Campylobacter. While it can make you very sick, "it's far less lethal than some of the other bacteria," says the CDC's Paul S. Mead. More often than not, the culprit is undercooked chicken or foods that have been contaminated by raw chicken.

* Salmonelia. Fortunately only a handful of the 2,000 or so types of Salmonella cause food poisoning. But when one does, it can be a real doozy. In 1985, more than 150,000 people in the Chicago area became ill--and at least two died--after drinking Salmonella-tainted milk. It was the largest food poisoning outbreak in U.S. history. Chicken, beef, and eggs are the foods most likely to be contaminated, though.

During the past decade, Salmonella has infected the ovaries of hen flocks throughout the Northeast. So the bug could be transmitted from an infected hen directly to the inside of the egg. While most eggs aren't contaminated, you should treat them as though they were. Cook them thoroughly (and don't lick spoons used to stir raw batter).

From 1985 to 1992, at least 437 outbreaks --and 53 deaths--were traced to Salmonella from eggs.

SPREADING BACTERIA

Food poisoning used to be local. If you got sick after eating a hamburger at home, you complained to your butcher. Chances are he'd already heard about it from his other customers.

Today, who's got a butcher? Who has any idea where their food comes from?

Take E. coli O157:H7. "Its emergence is an unanticipated result of the fast food revolution," explains Mitchell L. Cohen director of the Bacterial and Mycotic Diseases Division at the CDC.

The meat in a typical fast food hamburger could contain bits of beef from a hundred different cows from a dozen states and several foreign countries. A single contaminated cow could infect thousands of burgers from Maine to Hawaii.

What's more, burgers are often frozen and stored for months before they're eaten. So while a few cases of bloody diarrhea in New Jersey in January and in San Diego in April may be due to the same bad meat, who's ever going to figure that out?

A WHIFF & A PRAYER

Eyes, fingers, and noses.

The ones on beef inspectors have all of ten seconds to examine each 1,000-pound carcass as it comes whizzing by on the conveyor belt. Poultry inspectors check 90 birds a minute. All they can do is jab a suspicious looking piece of flesh or sniff around for spoilage. No microscopes. No laboratory analyses. Just a quick glance, whiff, and pat.

That's no different from how they did it 100 years ago, when our meat inspection system was designed.

It's like using "the aviation regulations from the age of the Wright brothers with today's jet travel," says Rainer Mueller of Oceanside, California. And, like 100 years ago, inspectors don't have a prayer of catching most contamination. Mueller knows that all too well. His 13-year-old son Eric died in 1993 after eating one of his favorite foods--a cheeseburger--at a local fast food restaurant.

If poke and sniff doesn't cut it, how do we prevent potentially deadly bugs from creeping into our hamburgers and chicken breasts? Can you say HACCP?

PULL OVER AT THE NEXT ASTEROID

Talk about traveler's diarrhea. "Food poisoning in a space capsule would be catastrophic," says William Sperber, a food scientist at Pillsbury.

That's why, in the late 1950s, the National Aeronautics and Space Administration told Pillsbury to make sure that the food it produced for the space program wouldn't cause food poisoning. The result: HACCP (HASS-ip). It stands for Hazard Analysis and Critical Control Points--a way to prevent food poisoning before it occurs.

"There's no way you can reliably detect pathogens after they're in the product," says Howard E. Bauman, who led the development of HACCP at Pillsbury, "You really have to fight and make sure that they don't get in in the first place."

For the space program, "we inspected the facilities of all the people who were supplying food to us," remembers Bauman. "For our salmon, we knew who the captain of the ship was and the latitude and longitude where the salmon were caught. With chicken, we inspected the plant and knew the people who ran it. "

No astronaut has ever gotten food poisoning.

The Food and Drug Administration (FDA) liked what it saw. In 1994, Commissioner David Kessler proposed that HACCP be made mandatory for most of the foods the FDA regulates. This January, the U.S. Department of Agriculture (USDA) proposed the same for the nearly 6,200 federally inspected meat and poultry slaughterhouses and processing plants.

HACCP represents a food safety revolution. "We will for the first time be requiring slaughter plants to directly target and reduce the dangerous bacteria in raw meat and poultry products that make people sick," says Michael Taylor, USDA Undersecretary for Food Safety.

Instead of looking for bacteria in the finished product, plants would have to identify their weak links--the places most likely to cause contamination (those "Critical Control Points" are the "CCP" in "HACCP"). They'd have to design a plan to prevent the contamination, and they'd have to keep careful records that government inspectors would review.

For example, poultry producers would have to make sure that feces aren't rubbed into the birds' pores as they're being defeathered, that the chill tank through which just-slaughtered chickens pass isn't a "fecal soup," and that the birds are chilled quickly enough to prevent the growth of bacteria. And they would have to test enough chickens to see that their HACCP plan was working.

The important word is "would." HACCP is just a proposal, one that could get derailed in the new deregulation, cost-cutting Congress. To show your support, please fill out and mail this coupon (or, better yet, write your own letter):

RELATED ARTICLE: WHEN TO CALL THE DOCTOR

You know the symptoms: diarrhea, nausea, vomiting, fever, abdominal pain, headaches. Maybe it's the flu. Maybe it isn't.

Most cases of food poisoning last a day or two and disappear by themselves. But the Centers for Disease Control (CDC) says that you should see a doctor if you develop one of these four potentially dangerous conditions:

* Bloody diarrhea. It's a sign of possible E coli O157:H7 infection, which can lead to kidney failure and death.

* A stiff neck, severe headache, and fever. When all three occur at the same time, it could be a sign of meningitis (an inflammation of the brain's lining) that's caused by Listeria.

* Excessive diarrhea or vomiting. They could lead to life-threatening dehydration. (You're probably dehydrated if you haven't urinated for at least 12 hours.) If you're taking medications for other health problems, you need to let your doctor know that you may not be keeping them down.

* Any food poisoning symptoms that last for more than three days. You should have gotten better by then.

RELATED ARTICLE: The Safe-Food Kitchen

* Handle raw meat, poultry, seafood, and eggs as if they were contaminated. Even if they don't start out with enough bacteria to make you sick, mishandle them and they easily could. Don't let the juices touch other food, either raw or cooked. After you handle raw meat, etc., wash your hands, utensils, and surfaces thoroughly with hot, soapy water.

* Never eat shellfish like oysters, clams, or mussels unless they've been thoroughly cooked. They could contain bacteria and viruses that cause hepatitis or gastroenteritis.

* Marinate raw meat and poultry in the refrigerator, not on the counter. Don't serve the marinade unless you've cooked it thoroughly. And don't baste your food with the uncooked marinade.

* Stuff raw poultry just before cooking it. Better yet, cook poultry and stuffing separately.

* Cook meats thoroughly, but don't overcook them. Heat kills bacteria, but too much heat causes meat, poultry, and fish to form possibly carcinogenic heterocyclic aromatic amines (HAAs). Use a meat thermometer in the thickest part of the meat. The USDA says to cook your meat at least to the following internal temperatures:

Beef, Pork, Lamb, Veal--160[degrees]

Poultry--180[degrees]

Stuffing--165[degrees]

Boneless turkey roast--170[degrees] to 175[degrees]

To reduce the formation of HAAs, microwave your meat, poultry, or fish on "High" for 30 to 90 seconds or until the juices start to flow. Then pour them off before you start cooking.

* Don't let your eggs run. They're safe when the whites are completely firm and the yolks are just beginning to thicken.

RELATED ARTICLE: CUTTING BOARDS--WOOD OR PLASTIC?

Wood or plastic? Two years ago, University of Wisconsin food scientists shocked everyone when they announced that bacteria thrive on plastic but are mysteriously killed on wooden boards.

No one's been able to duplicate their findings. In fact, new studies by the FDA show that bacteria become trapped in wooden cutting boards and are difficult to dislodge by rinsing. And USDA researchers have found that raw meat leaves fewer bacteria on plastic than on wood, and that it's easier to rinse the bacteria off plastic boards.

Here are the latest USDA recommendations:

* Cutting raw meat, poultry, or fish. Use a plastic or glass board. If you insist on wood, label it "for meat only" and don't use it for anything else.

* Cleaning boards. Use hot soapy water, then rinse and air dry or pat dry with fresh paper towels. Better yet, run your boards through the dishwasher.

* Replacing boards. Toss any cutting board that has developed hard-to-clean grooves.

RELATED ARTICLE: Kitchen Hygiene

Spill ... swab. Spill ... swab. Spill ... swab.

If you're a grab-the-sponge-before-the-spill-hits-the-kitchen-counter sort of person, have we got news for you.

"People don't realize that sponges and dishrags are breeding grounds for disease-causing bacteria," says Chuck Gerba, a microbiologist at the University of Arizona who specializes in household contamination. "I never shake the hand of a person who's handled one.

"In our research, the people who think they're the cleanest are often the dirtiest, because they take their contaminated sponges or rags and spread germs all around the kitchen."

Here are Gerba's three kitchen germ-warfare weapons":

* Use paper towels. Wipe up... then toss 'em. You won't be spreading any germs around.

* Run your sponge, dishrag, or scouring pad through the dishwasher. "You need to do it every day because things grow like crazy overnight." Or, Gerba suggests, use 3M's new O-Cel-O sponges, which the company paid him to test. "They're bonded with an antibacterial substance that kills germs in the sponge, so that there are few or none left to spread around the kitchen."

* Use a product like Lysol's new Antibacterial Kitchen cleaner. Antibacterials can reduce kitchen contamination by more than 90 percent, says Gerba. New products like Palmolive Dishwashing Liquid & Antibacterial Hand Soap are designed to kill the germs on your hands, but not on your dishes. The FDA isn't yet convinced that they work.

RELATED ARTICLE: FOOD SAFETY REGISTRY

During the last three years, have you suffered from food poisoning serious enough to see a doctor about? How about a member of your family.

While you should report all food poisoning to your state or local health department, you can do more. Victims who are willing to talk to the press can have a powerful impact on Congress and the media.

If you'd like to help, please write us. Tell us when the food poisoning occurred, what you think you got it from, the symptoms, how long they lasted, any medical treatment you received, what the diagnosis was, and any other details that you think are important.

Send your comments (including your name and phone number) to: CSPI--Food Safety Registry, Suite 300, 1875 Connecticut Ave. N.W., Washington, D.C. 20009.

RELATED ARTICLE: WHERE TO GET HELP

* USDA Meat & Poultry Hotline [phone]). For how long should you cook that turkey? Can you re-freeze meat that you've defrosted in the refrigerator? Everything you want to know ... and more.

* FDA Seafood Hotline (800-FDA-4010). If it swims or floats, they can tell you about it. They can also answer non-seafood food safety questions and send you information booklets.

* Safe Tables Our Priority (800-350-STOP). A consumer group formed by the parents of E. coli O157:H7 victims. It provides information on foodborne illnesses and will refer you to support groups, physicians, scientists, or lawyers.

* Lois Joy Galler Foundation (516-673-3017). Raises money and distributes materials on hemolytic uremic syndrome, the kidney disease that can kill victims of E. coli O157:H7.

* Safe Food: Eating Wisely in a Risky World. Full of practical tips and suggestions on how to avoid food poisoning and other food contamination. Co-authored by CSPI's Michael Jacobson. (To order the 234-page softcover, use the form on p. 15. Item #SFB, $9.95.)