Last year more than 79,000 cases were reported across the UK. But health experts fear this is just the tip of a very unpleasant iceberg. They believe that 5.5 million Brits - around one in 10 of us - suffer from food poisoning every year. People often link "Delhi bellies", "Montezuma's revenge" and the "Aztec two step" with taking overseas holidays. But you can be just as susceptible in the UK at picnics and barbecues if food isn't stored, prepared or cooked properly. So whether you're camping in Cornwall, touring in Turkey or enjoying five-star luxury in Florida, you need to take care when it comes to eating and drinking. Food-poisoning bacteria multiply quickly in temperatures between 5C and 63C. In the right conditions, one tiny bug can multiply to more than four million in only eight hours. And as you can't taste them it's easy to munch your way through millions of bacteria and be none the wiser. In the fridge most bacteria multiply only slowly, if at all, but once taken out food warms up and any surviving bacteria begin multiplying again. Most bacteria are killed at temperatures above 70C, which is why it's essential to cook or reheat food thoroughly. Prevention is always better than cure, however, so here's how to protect yourself. STAY SAFE WHEN abroad drink bottled or boiled water - and use it to clean your teeth - if the tap water is unsafe to drink when you're on holiday. Avoid having ice in drinks, too. Peel all vegetables and fruits that are eaten raw and avoid salads in countries where tap water is unsafe. Avoid eating from stalls, buffets or restaurants where food is uncovered and looks as though it's been kept warm (rather than piping hot) for hours on end. Don't eat undercooked or raw meat, fish or shellfish - even if they are a local delicacy. Don't leave food outside at barbecues or picnics. Store food in a cool-box. Make sure barbecued meat, chicken, sausages and burgers are cooked thoroughly - and use separate plates and utensils for cooked and raw foods. WHAT IS TRAVELLERS' DIARRHOEA? UP to half of all Europeans who travel to developing countries like Latin America, Africa, the Middle East and Asia are thought to be affected by travellers' diarrhoea. Bacteria, viruses or parasites in contaminated water and food usually cause it and symptoms include stomach cramps, vomiting, fever and diarrhoea for two to three days. Research shows that taking a daily probiotic drink for several weeks before travelling may reduce the risk by boosting levels of good bacteria in the gut. And if you're still unfortunate enough to suffer on holiday, treat it as you would food poisoning. WHAT'S THE TREATMENT? If you're unlucky enough to get food poisoning, GP Dr Rob Hicks gives his advice on what to do? 1 REST and drink plenty of clear fluids to replace those lost through diarrhoea or vomiting. Rehydration powders such as Dioralyte are available from pharmacies and can be useful to replace water and salt losses. Alternatively, make your own. MASTA, travel-health experts, recommend adding one level teaspoon of salt and eight level teaspoons of sugar to one litre of water (use boiled or bottled water when it's unsafe to drink tap water). Adults should drink two glasses of this for each loose bowel movement. 2 CONTINUE to eat as normally as possible. Bland foods such as bread, potatoes, pasta and rice, and soups, are often best to begin with. Alcohol, coffee and spicy foods are best avoided. Milk can aggravate diarrhoea. 3 IF you are unable to drink due to nausea and vomiting, seek medical advice. Also if your symptoms are severe, last for more than a few days, are accompanied by a fever of 38C, or there is blood or mucus in your stools. Antibiotics may be prescribed but can cause problems themselves, such as prolonging diarrhoea. If you are in the UK and unsure about whether you should see a doctor, call NHS Direct on 0845 4647 4 BABIES, children, elderly people, pregnant women and people who are already unwell are at greatest risk of dehydration and so may need to see a doctor earlier. Hot weather can make dehydration worse. 5 OVER-the-counter medicines to prevent diarrhoea such as Imodium may be useful if you have to travel, but they only treat the symptoms and not the cause. They work by slowing down the speed at which food and fluids travel through the gut. As a result some health experts believe they may actually do more harm than good by delaying the speed at which the body expels the bugs or toxins causing problems. 6 VOMITING and diarrhoea can affect the absorption of some other medicines such as the Pill, so use another form of contraception while it lasts. FURTHER INFO Food Standards Agency www.eatwell.gov.uk The Food and Drink Federation's food safety website www.foodlink.org.uk __________ IF you are in the UK and think your illness has been caused by food from a restaurant, pub, takeaway or other food outlet, report the incident to your local environmental health department. Log on to www.food.gov.uk/enforcement/yourarea to find your nearest office. __________ BAD BUG GUIDE Campylobacter The most common cause of food poisoning SOURCES: Raw or undercooked meat or poultry and unpasteurised milk. Birds pecking foil bottle tops on milk left on the doorstep can also contaminate milk. THE SYMPTOMS: Fever, headache and generally feeling unwell, followed by severe stomach pain and diarrhoea, which may contain blood. Symptoms normally start between two to five days after infection and may last up to 10 days. Symptoms can also recur over a number of weeks. Salmonella The second most common cause of food poisoning SOURCES: Many foods especially raw meat, poultry, shellfish, eggs, unwashed vegetables and unpasteurised milk. THE SYMPTOMS: Fever, diarrhoea, vomiting and pain. It can cause severe illness in very young or old people. Comes on between 12 and 48 hours and can last up to three weeks. Listeria Widely found in the environment but one particular strain - Listeriamonocytogenes - cause illness SOURCES: Milk, meat, poultry, pate, cheeses (particularly soft, mould-ripened varieties), ice-cream and salad are the worst offenders. THE SYMPTOMS: From mild flu-like illness to meningitis, septicaemia and abortion, miscarriage or birth of an infected child. Pregnant women, elderly people, babies and those with poor immunity are at greatest risk. Symptoms can take days or weeks to develop. E coli Many strains are harmless but some cause severe illness. E coli 0157 is most common in the UK' in other countries, E coli 0111 and E coli 026 SOURCES: Raw and undercooked meat, unpasteurised dairy products and raw vegetables. THE SYMPTOMS: Diarrhoea, which may contain blood and lead to kidney failure, can be fatal. Symptoms develop between one and five days, with two being the norm. The condition usually only lasts for two days. Staphylococcus aureus Bacteria found on skin, in cuts and in the nose, and so easily transferred to food by sneezing on it or touching it. These bacteria produce a toxin that causes illness SOURCES: Foods that have been handled after cooking or preparation such as cooked meat, poultry and eggs, salads, cream cakes and sandwich fillings. THE SYMPTOMS: Vomiting, stomach pains and diarrhoea develop quickly within two to six hours but usually last for only two days. Bacillus cereus These bacteria produce a toxin that causes illness SOURCES: Rice dishes, occasionally pasta, meat or vegetable dishes, dairy products, soups, sauces and sweet pastry products that have not been cooled down quickly enough. THE SYMPTOMS: Causes two types of illness. The first is characterised by diarrhoea and pain, and comes on within eight to 16 hours. The second by vomiting (sometimes with diarrhoea) and comes on within one to five hours. Both usually last less then 24 hours. Clostridium perfringens Bacteria found in soil, animal manure and sewage, as well as some foods SOURCES: Raw or undercooked meat - stews, pies, large joints of meat and gravies are common culprits. THE SYMPTOMS:Stomach pain, diarrhoea and nausea. Symptoms start within eight to 18 hours. This table is a guide - always see a doctor for a proper diagnosis. | 
