Food Poisoning or Not Food Poisoning?

Did that slice of pizza give you food poisoning? You’ll probably never know. (Photo illustration by Jamie Leary)

We’ve all been there: We eat at a restaurant, we get home, and shortly thereafter, we are puking our guts out – and oftentimes worse. So we make a pact with God that we will stop cursing and go to church on Sunday if these terrible symptoms will just pass, a pact that we inevitably renege on once the cramps and vomiting subside. We shake our fists in the air damning to hell the restaurant that did this to us.

Four local residents took things a step further in recent months in four separate incidents. All went on social media and publicly named the restaurants that they said made them ill. One was an Italian restaurant in South Philly, another a pizza shop in Delco, another an eatery on the Main Line and the last a bar/restaurant in Fishtown. (We aren’t naming any of the restaurants here. Some of those posts have since been removed.)

Posting that you spent the night in the bathroom because the clams casino at [insert restaurant name here] made you ill can be incredibly harmful to said restaurant, as if the restaurant business isn’t already tough enough. And what if it’s not actually the restaurant that made you ill at all? How do you really know?

The answer is that you almost never do, insists Donald Schaffner, chair for Rutgers University’s department of food science and co-host of the podcast Food Safety Talk, with episode names like “I Have No Problem Eating Food Off the Floor” and “Hold Back My Hair.”

I presented a hypothetical scenario to Schaffner in which I had a croissant and coffee for breakfast, a salad for lunch, and some barbecue chicken for dinner, and then promptly went home and puked. A lot of people would assume it was the chicken that made me sick, in part because of chicken’s bad rap and because it was the last thing I ate, but Schaffner says that’s the absolute wrong way to think about it.

“If you got sick that night, I can tell you because of the incubation period, it’s probably not the chicken,” Schaffner explains. “And it’s not what you had for lunch. It’s not what you had for breakfast. It’s probably what you ate the day before or maybe even the day before that or maybe even the day before that. The rule of thumb is 24 to 48 or even as much as 72 hours.”

Schaffner says there are certain organisms that can produce toxins in a food that can trigger vomiting sooner, in a couple of hours or up to 12 hours, but the organisms that are much more commonly linked to food poisoning have those longer incubation periods with symptoms perhaps not rearing their ugly head until Thursday for that pastrami special you had on Monday. Food poisoning with a quicker onset also tends to be quite minor and not requiring medical attention of any kind, says Schaffner.

“People sometimes forget what they ate, right?” posits Schaffner. “And so they may misattribute. Or they may say, I didn’t have any of the chicken, but in fact they did have some chicken. Or maybe they had some chicken on their plate and the contamination leaked to another food. So they didn’t eat the chicken, but they did eat something with the chicken juices on it. So, it’s not an exact science.”

He also points out that many times when somebody or a group of people think they have food poisoning, it could be as simple as them sharing a gastrointestinal virus like Norovirus – which can be foodborne but often isn’t. In other words, you and the BFF you just had dinner with 24 hours ago might be enjoying the same stomach virus as opposed to the spaghetti and meatballs you both had being the culprit. Norovirus is highly infectious, which is why it wreaks havoc on cruise ships regularly.

Of course, food poisoning does happen, and not infrequently. According to the Centers for Disease Control, some 48 million people in the United States get food poisoning each year, and of those, 128,000 wind up in the hospital and 3,000 die.

“Certainly if a bunch of people go to the restaurant and everybody that ate the same thing gets sick, that’s good, but it’s not actually proof,” Schaffner adds. “What you really have to do to have proof is you have to have the stool culture. You have to do an investigation. This is why we have public health. And so just because somebody goes on social media and says ‘I got sick from this restaurant…’ I mean, it could be that they did get sick from the restaurant, but it also could be other things, and that’s why epidemiologists get to do what they do. They try to figure it out and prove it statistically.”

The most prominent example in modern memory of a clear-cut food poisoning case that involved the Philadelphia Department of Public Health happened at longtime Chinatown staple Joy Tsin Lau back in 2015. After 100 people got sick after attending a banquet at the restaurant, the Department of Public Health went in and confirmed that they found an unspecified food source for the scores of illnesses, some of which were reportedly severe enough to require hospitalization. Meanwhile, the owner of Joy Tsin Lau theorized to the Inquirer that maybe the diners “drank too much.” The city sued to shut the restaurant down, and it did close temporarily before closing for good in 2019.

“You really need a bunch of people and you need that strong epidemiological signal,” says Schaffner. “And it’s unfortunate that people would choose to go on social media rather than go to local public health if they really want to do something about it.”

He adds that if you truly believe a restaurant gave you food poisoning, the first thing you should do is go to your doctor and provide a stool sample. “Which nobody wants to do,” he says. The doctor is then required to report the case to the Department of Public Health. Or, you can just call the Department of Public Health’s food protection reporting line at 215-685-7495.

That’s exactly what I did some years ago after I became convinced that I got food poisoning from a certain food truck on Market Street. I had no interest in proving that the food truck gave me food poisoning, which, again, is nearly impossible to prove. I just wanted the health inspectors to check out the truck. They did and found truly appalling conditions there and shut the truck down temporarily.

“It’s our biggest nightmare,” says one local restaurant owner who asked to remain nameless. “Over time, we have had a handful of people come to us and say that our food made them sick. I don’t think that was ever really the case. But I still turned around and handed all of them gift cards. The funny thing is, every single one of them used those gift cards to the restaurant that supposedly got them sick. If a restaurant got me sick, I would never go back.”