Joann and her husband, Stan, had just returned from the local supermarket and began unloading their groceries in anticipation of a wonderful weekend vacation at a rental summer cottage along Narragansett Bay. For the couple, this was their first time away from the family home since they both retired the previous fall.
Joann emptied her reusable bags, which she stored in her car for her shopping trips. As she pulled out the lettuce and tomatoes, Stan popped on his chef’s apron and put together a quick salad to go along with the burgers he was readying to put on the grill.
As the sun set over the water, they sat outside enjoying their cookout and voiced just how wonderful it was to get away without the pressure of needing to return to work as a new week came around. Retirement wasn't so bad after all, they thought.
“We worked a long time just for this”, Stan said to Joann as they sat on the porch relaxing with a wine cooler and music playing in the background. In just a few hours, however, things would take a turn for the worse.
As they prepared for bed, both began to experience serious stomach cramps along
with diarrhea and vomiting, and it didn't seem to stop. After two days of being ill, Stan, who suffered from heart disease, began to feel chest pains. The vomiting and lack of appetite along with his inability to keep liquids down turned what they thought was a stomach bug into a life and death struggle as he developed a severe case of dehydration. He was rushed to the hospital where he spent several days. Although he did fully recover, the couple’s first post-retirement getaway was far from the idyllic time they had hoped for.
So, just what was the cause of this weekend from hell that Joann and Stan experienced?
Joann speculated that perhaps the lettuce had carried salmonella while Stan felt that the ground beef had stayed in the hot car too long. But, the answer did not lie in the mishandling of the meat or even in the imported lettuce but in the reusable bags in which she carried the groceries, a problem that was brewing inside these bags for some time.
In the couple’s home town, the city council had decided months before that in order to be environmentally friendly, they would ban the local merchants from using plastic bags forcing many residents to turn to reusable bags. Although reusable bags have many advantages, there is a very real, and perhaps deadly, disadvantage if they are not cared for properly. This is especially true during the summer months.
As the first heat wave of the summer season descends upon the Northeast and thousands are making their way to the beaches and picnic locations, danger may be lurking in those bags. Medical researchers report that if reusable bags are not washed thoroughly on a regular basis, there will be a buildup of bacteria, yeast, mold and coliforms that could result in a health hazard.
In a study done by Canadian researcher Dr. Richard Summerbell in Toronto, he collected 49 “used” reusable bags to test for any potential viral health hazards they may have contained and if they could be a source of disease transmission.
What he found was startling.
64% had levels of bacteria
30% had elevated bacteria counts
24% indicated a presence of mold
20% were positive for the presence of yeast
12% had dangerous levels of coliform
The study concluded that reusable bags are an “active microbial habitat and a breeding ground for bacteria, yeast and coliforms”. The study also concluded that the presence of yeast and mold was a major concern for those with compromised immune systems, such as the elderly or those with HIV or undergoing cancer treatments. In this study, it was also concluded that even washing these bags may not be effective the more they are used and should be replaced on a regular basis.
Most of us are aware of the fact that food borne illnesses sicken many people throughout the year and especially during the summer and the numbers are indeed surprising.
The fact is, the Centers for Disease Control (CDC) estimates that each year, 1 out of 6 Americans (48 million people) get sick from these foodborne illnesses. Of this group, 128,000 end up in the hospital and some 3000 will die with the elder population appearing to be at most risk of hospitalization and death.
Now, you may be asking, just how do these researchers know that reusable bags are responsible for this? After all, it could be poor hygiene habits or improper storage of food that could be the problem. And that is a perfectly reasonable question, however there is also some research to back up these concerns.
For that, we will go to San Francisco.
The “City by the Bay” was the first major jurisdiction to enact a ban on plastic bags some 11 years ago. After medical professionals reported an increase in the number of bacterial illnesses related to food showing up in emergency rooms, a study was done and a report was issued entitled “Grocery Bag Bans and Foodborne Illness”.
In this study, the authors found that foodborne related illnesses that resulted in death increased by a whopping 46 percent after the plastic bag ban was put into place. In addition, the numbers from emergency rooms in the area showed an increase of 34% where E. Coli was identified as being responsible for the illness.
The authors further stated that the true correlation between the banning of plastic bags and foodborne illness cannot be fully known because many people suffer the illnesses without seeking medical treatment. They also wrote that similar increases in these illnesses have been seen in other areas where the plastic bag ban is in effect.
Although death among the elderly from foodborne illness is not a regular occurrence, fatalities do occur at higher rates than among groups in this country and there can be other lasting effects of such diseases.
In a published article entitled, “The Long-Term Health Outcomes of Selected
Foodborne Pathogens”, the author discussed the potential lifelong complications of some foodborne illnesses, especially in the elderly. These complications included kidney failure, paralysis, seizures, hearing/visual impairments and brain damage.
Before we dismiss foodborne illnesses as a major problem in our population, there is a number that we must keep in mind – nearly 20 percent of our citizens are at a higher risk for contracting these diseases and as our nation ages, so do the risks and the numbers of those who could potentially be affected.
But there is also another virus that appears to love reusable bags – the Norovirus.
Most of us have heard about this dreaded illness due to the multiple cruise ships that have been affected by this bug and forced the companies who operated the ships to cut short the trips and return to port for medical treatment of the passengers. For most people, a bout of norovirus results in two or three very miserable days spent close to the bathroom. But for seniors, norovirus illness can be serious, and even fatal.
For the elderly who catch norovirus, symptoms include vomiting, diarrhea, stomach cramps, and nausea. They may or may not experience headache, body aches, or light fever. Norovirus tends to come on quite suddenly. One moment you’re feeling fine and the next you’re in the bathroom wondering what in the world you ate that is causing such a disruption. Symptoms last around one to two days, but the virus will continue to be contagious for up to two weeks after.
Norovirus is extremely contagious and spreads rapidly in closed areas such as cruise ships, senior centers, nursing facilities and even hospitals. The major complicating effect on seniors is severe dehydration and if such an illness occurs in the heat of summer, the problem is compounded.
How have reusable bags been implicated in the spread of norovirus? This lesson comes from a girl’s soccer team in Oregon some nine years ago as they became quite ill while traveling for a weekend tournament.
When one of the team members mother made inquiries into the cause of the sickness, Oregon’s Public Health investigators were able to track down and confirm that the norovirus was transmitted through a reusable shopping bag – something that was considered to be nearly impossible up to that time.
Following this incident, Dr. Charles Garba, a researcher who followed the transmission of such pathogens in the environment, issued the following statement:
“The latest outbreak of norovirus reinforces the research we have conducted about the propensity of reusable grocery bags to act as hosts for dangerous foodborne bacteria and viruses. In reality, reusable bags are likely at fault much more often than we realize: cases often go unreported and uninvestigated”.
He continued, “The cause of roughly 70 percent of foodborne illness cases, the norovirus, spreads very easily and symptoms include projectile vomiting and severe diarrhea. It can have such sweeping consequences as school and emergency room closures. This incident should serve as a warning bell - permitting shoppers to bring unwashed reusable bags into grocery and retail stores not only poses a health risk to baggers but also to the next shoppers in the checkout line".
Annually in the United States, the norovirus causes about 21 million illnesses, over 70,000 hospitalizations and on average, 800 deaths – mostly elderly from dehydration. It is the most common cause of foodborne disease outbreaks in this country. So prolific is this virus that it can spread in hours affecting an entire nursing home, cruise ship or other closed quarters.
So what steps can a senior take if they are using reusable bags? Check our list below:
Use separate, leak-proof, easily washable bags for meat/poultry/seafood and for fruit and vegetables - retailers can still provide small plastic bags for these higher risk products which are recyclable at major supermarkets.
Regularly check your reusable bags and replace if soiled or can't be cleaned.
When purchasing your reusable bags, make sure you get a cooler bag to keep your refrigerated and frozen food at a safe temperature on the way home.
You may need to add ice bricks on warm days.
Choose a clean trolley or basket for your shopping.
Never put fresh fruit and vegetables that won't be peeled or cooked before eating directly into the trolley; put them in a clean bag.
Plan to do your food shopping last and take it straight home so perishable food doesn't warm to temperatures in the danger zone where bacteria can grow (5° to 60°C).
Don't leave your shopping in a hot car.
When home, pack chilled and frozen products into your refrigerator or freezer immediately.
It's best not to store your reusable shopping bags in your car where they can get hot or can come into contact with pets or dirty items such as sporting equipment and shoes. If you do keep them in the car, zip them into a cooler bag to keep them clean.
Attorney Connelly points out that as more seniors are staying home with the help of home health aides, they should be educated about the use of these bags.
“One thing we know, seniors are extraordinarily susceptible to a multitude of illnesses due to the deterioration of the immune system as we age. The best way to deal with the problem of foodborne illnesses among the elderly is to educate them on a regular basis about proper food handling to prevent such an illness from occurring rather than treating it after the fact", said Connelly.
“Home healthcare providers should provide training for their clients on the subject of food safety as part of their overall service plan. This should include the proper handling and cleaning of reusable bags”.
Seniors who choose to use reusable shopping bags should wash and/or sanitize
their bags on a regular basis to preclude bacteria buildup and possible illness from foodborne pathogens and to prevent viral disease transmission. In the event that reusable bags cannot be sanitized, sanitary plastic or paper bags should be used instead. If these bags are not available free of charge, the senior should supply their own sanitary plastic or paper bags. Also, there is a new generation of reusable bags that are resistant to bacteria and viral infections and can provide an added level of safety.
For a free handout from Connelly Law Offices, Ltd. on reusable bag safety, click on the document below, download it and print it out and post on your refrigerator.
Attorney Connelly practices in the area of elder law. This area of law involves Medicaid planning and asset protection advice for those individuals entering nursing homes, planning for the possibility of disability through the use of powers of attorney for the both health care and finances, guardianship, estate planning, probate and estate administration, preparation of wills, living trusts and special or supplemental needs trusts. He represents clients primarily in the states of Rhode Island, Connecticut and the Commonwealth of Massachusetts. He was certified as an Elder Law Attorney (CELA) by the National Elder Law Foundation (NELF) in 2008. Attorney Connelly is licensed to practice before the Rhode Island, Massachusetts, Connecticut, and Federal Bars.