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Cooking With Universal Precautions

A half-​​billion or so eggs were speedily pulled off semi-​​cooled super­market shelves this week. The concern is that bacteria-​​laced eggs can cause serious and even deadly illness. The com­panies that pro­duced and dis­sem­i­nated those marked eggs fear more law­suits. Some people who usually enjoy their eggs in the morning, sunny-​​side up, are thinking twice.

The greatest egg recall ever set off alarms on CNN (Paging Dr. Gupta), on the front page of my newspaper’s business section, on some health blogs and in some homes. I’m con­cerned and sad­dened by this, about the cost of all this — the frank waste­fulness of it. Our food supply is not infinite.

But I’m not par­tic­u­larly worried about getting sick from eating eggs at this time. Rather, I’ve been aware of this potential problem at least since 1984, when I took classes in micro­bi­ology. That raw or under­cooked, runny eggs can effec­tively deliver sal­mo­nella to the digestive tract is some­thing doctors learn in medical school. (And, maybe, the rest of the pop­u­lation should be taught in what used to be called home economics?)

In my home we don’t eat a lot of eggs, mainly because of my per­sonal aversion and fear of cholesterol-​​lowering drugs. We go through perhaps a dozen eggs in most months. But when I do cook with eggs, whether that’s in baking a quiche, veg­etable soufflé or cake, or rarely, for breakfast in omelet or scrambled form, I cook them thor­oughly, applying heat through-​​and-​​through, and keep any utensils that have touched raw egg apart from any­thing else in the sink or on the kitchen counter.

Shifting gears, just a bit — this story reminds me of a gradual change in how we prac­ticed med­icine in the years after the start of the AIDS epi­demic. In 1983, when I entered medical school, few doctors wore gloves except when they were per­forming surgery. At Bellevue Hos­pital in 1985 and 1986, my class­mates and I helped to deliver babies with our bare hands.

Grad­ually, and as fear caught on, some doctors started to dis­crim­inate – they’d wear gloves while drawing blood from a patient with obvious risk factors for HIV, such as a promis­cuous homo­sexual man or an intra­venous drug user. But I always thought to myself, you never know who’s got what virus, we should be careful more often.

A few years later, when I was a res­ident physician and pregnant fellow, the concept of uni­versal pre­cau­tions came into wide­spread practice.  Doctors and nurses learned – had to be instructed — to don gloves whenever they drew blood or poten­tially came into contact with any patient’s body fluids because, the idea emerged, anyone might have HIV. Better to be careful in general, without prejudice.

These prac­tices annoyed some at first. For doctors, they cost us time and the value of touch. Among other problems, it became sud­denly more dif­ficult to insert an IV catheter in one shot because feeling a patient’s vein is a lot harder when there’s a layer of material between your fingers and the patient’s skin. I suspect, also, that some hos­pital admin­is­trators must have resisted, too, because of all the money needed to buy all those gloves and new-​​fangled needle-​​dispenser boxes.

Some food-​​minded folks and edi­to­ri­alists suggest that risk might be reduced by buying less-​​travelled eggs from local pro­ducers. But regardless of where you live and shop for food, local farmers vary in their prac­tices and habits. As for organic farms, there’s no real evi­dence that those are cleaner than other agri­cul­tural sources. (Some may be, but which? It could go either way.)

This sit­u­ation bears some analogy to the reason why doctors imple­mented uni­versal pre­cau­tions in med­icine. Some of us harbor prej­udice (and maybe even some anger or resentment…) against effi­cient, industrial-​​sized food-​​growers and may be, accord­ingly, biased and even lenient in atti­tudes on stan­dards and reg­u­la­tions for local farmers’ markets. And so the danger is, we may be less careful with eggs from a small-​​scale farm down the road. Those eggs seem OK, or at least we feel better about their purchase.

My point is, it’s gen­erally better to behave without bias.

I think it would be smart for cooks to use uni­versal pre­cau­tions when han­dling eggs. There’s always some risk of con­t­a­m­i­nation by sal­mo­nella and other disease-​​causing bac­teria. I cook eggs well, regardless of their source or what’s picked up in today’s news.

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1 comment to Cooking With Universal Precautions

  • I imagine how you must have been feeling watching me eat that soft boiled egg the other day. It was deli­cious, but I get your point of view.

    As someone who caught hep C in the old days before uni­versal pre­cau­tions, perhaps I should cook my eggs a bit longer…

    Peggy

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