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Celebrate a Healthy and Happy Thanksgiving

The Bottom Line

Family, friends, delicious food...Thanksgiving is a happy time of year. Keep your gathering fun and healthy by following some simple guidelines for food preparation and home safety. Take a few minutes to review your Thanksgiving plans. And leave room for the pumpkin pie!

The Full Story

The cook's at a hot stove distracted by little ones underfoot, preparing highly perishable foods such as raw poultry. Guests with food allergies are expected. Uncle Bob's out in the garage about to place a frozen turkey in hot oil in a turkey fryer. The family pets are anxious for a Thanksgiving treat. What could go wrong?

Hopefully everyone will enjoy the special day. But a little attention to prevention will help keep your family in the dining room and out of the emergency room.

Even experienced cooks at home may not know how to safely prepare and store large quantities of food for a crowd. Many foodborne illnesses are spread by mishandled food. Don't invite bacteria to the party. Remember these 4 key areas regarding safe turkey preparation: thawing, preparing, stuffing and cooking to the adequate temperature.

When frozen, a turkey is safe indefinitely. But as soon as it starts to thaw, bacteria that may have been there before freezing can start to grow again if it is not kept at a safe temperature. The "danger zone" is between 40° and 140° F. In this temperature range, foodborne bacteria multiply rapidly.

According to the U.S. Centers for Disease Control and Prevention Foodborne Disease Outbreak Surveillance System, the organism Clostridium perfringens, which can be found on raw meat and poultry, is the second most common bacterial cause of foodborne illness in the United States. Meat and poultry accounted for 92% of the outbreaks attributed to a single type of food. Persons infected with Clostridium perfringens develop diarrhea and abdominal cramping on average within 8-12 hours. The illness usually begins suddenly and lasts for less than 24 hours. Clostridium perfringens is sometimes referred to as the "buffet germ," because it grows fastest in large portions, such as casseroles, stews and gravies that have been sitting at room temperature in the danger zone.

Salmonella bacteria are also a common contaminant. Symptoms of salmonellosis include diarrhea, fever and abdominal cramping, with onset about 12 to 72 hours after infection; the illness usually lasts 4 to 7 days. Most people recover without treatment, but diarrhea and dehydration may be so severe that some people need hospital care. Older adults, infants, and those with impaired immune systems are at highest risk.

Bacteria on raw poultry can get on your hands, cooking utensils and work surfaces, such as cutting boards, during turkey preparation. If these areas aren't cleaned adequately before handling other foods, bacteria from the raw poultry can be transferred to the other foods.

Bacteria can survive in stuffing that has not reached 165° F, possibly resulting in foodborne illness. It's best to cook the stuffing outside the turkey in a casserole dish. Turkey cooking times will vary depending on the size of the bird. If the oven temperature is set too low, or the cooking time is too short, the minimum safe internal temperature of the meat of 165° F may not be reached.

The potential for illness from food allergies may also increase in large gatherings where guests could be served food containing unsuspected allergens. The most common allergenic foods, known as the "big eight," are eggs, fish, milk, tree nuts such as walnuts, ground nuts such as peanuts, shellfish, soy and wheat. Among children, most allergic reactions to food are to peanuts, milk, soy, tree nuts, eggs and wheat. Most children outgrow allergies to such foods in early childhood. Allergic adults typically react to citrus fruit, nuts, fish, peanuts, shellfish and wheat.

In addition to food-related illness, consider injuries from fire and smoke. Cooking fires are 3 times more likely to occur on Thanksgiving than on any other day of the year according to Underwriters Laboratories (UL). Cooks may get distracted while visiting with Thanksgiving guests in and out of the kitchen. The cook may try to hold a small child with one arm while cooking with the other, putting both at increased risk of burns.

Turkey fryers are especially dangerous. UL does not certify any turkey fryers and considers them dangerous. They present many safety hazards to consumers such as burns from hot oil spilling over and oil overheated to the point of combustion due to lack of thermostat controls. Turkey fryer fires can be explosive and cause serious burns and smoke inhalation.

Don't forget the family pets. Turkey bones pose a choking and internal obstruction hazard. Many herbs used to flavor stuffing and other side dishes contain essential oils and resins that can cause gastrointestinal upset and other problems if eaten in large quantities. Cats are especially sensitive to the effects of certain essential oils. Raw bread dough can expand in an animal's stomach, causing vomiting, pain and bloating. This could lead to a life-threatening obstruction requiring surgery. Veterinarians experience an increased number of office calls at the holidays because humans allow their animals to indulge in high-fat meals, chocolate and bones. 

Prevention Tips:

  • Store and prepare food safely: Refrigerate or freeze perishable food within 2 hours of shopping or preparing; 1 hour when the temperature is above 90 °F. Find separate preparation areas in the work space for raw and cooked food. Never place cooked food back on the same plate or cutting board that held raw food. Wash cutting boards, dishes, utensils, and work surfaces frequently with hot, soapy water. Wash hands with soap and warm water for at least 20 seconds before and after handling food and after using the bathroom, changing diapers, or handling pets. Keep hot food at or above 140° F. Wrap well and place in an insulated container. Keep cold food at or below 40° F. Refrigerate or place in a cooler with a cold source such as ice or frozen gel packs. Use the stove, oven, or microwave to reheat food to 165° F. Bring sauces, soups, and gravies to a boil. Never partially cook food for finishing later because you increase the risk of bacterial growth. When in doubt, throw it out!
  • Prevent allergic reactions: Ask guests about any food allergies or sensitivities in advance. Consider offering alternative entrées or snacks.
  • Don’t harm your pets: Stuff your turkey, not your dog or cat. A small amount of turkey or stuffing or even a taste of pumpkin pie won’t hurt. Mix just a little boneless turkey, gravy or sweet potato into your pet’s regular food to satisfy them and keep them occupied. Check with your veterinarian if you’re not sure – or just stick to pet food.
  • Prevent fires, exposure to smoke, and burns: Keep a fire extinguisher in the kitchen and know how to use it before beginning Thanksgiving dinner preparations. Keep it out of reach of children. In case of fire, call 911. Cover a pan with a lid to smother the flames. Never pour water or flour on a fire. "Stand by your pan!"  If you are frying, grilling or broiling food, stay in the kitchen. Unattended cooking is the top cause of cooking fires. If you must use a turkey fryer, do so outdoors. Stay well away from houses and other structures. Never use them on a wooden deck or in a garage. Never let children or pets near the turkey fryer, even if not in use, since the oil may remain dangerously hot for hours. Make sure the turkey is completely thawed. A frozen turkey may cause a spillover effect, resulting in a serious fire. (And think twice: is the danger really worth it?)
  • Keep the little ones safe: Be sure that each young child has a designated "watcher". One person should be keeping watch over a child. Otherwise, "everyone" assumes that "someone" is watching that child - and problems, ranging from falls to wandering to poisonings, can result. Keep visitors' medicines and other belongings out of reach of children and pets.

Poison Control is standing by, on Thanksgiving, other holidays, and every day of the year. If you suspect any kind of poisoning, call Poison Control at 1-800-222-1222 at any time, 24 hours a day.

Mary Elizabeth May, RN, BA, MPH
Certified Specialist in Poison Information


For More Information

Turkey thawing chart

Turkey roasting chart

Turkey basics: stuffing

Keep food safe, by type of food

For more food safety information, "Ask Karen" or call the toll-free USDA Meat and Poultry Hotline at 1-888-MPHotline (1-888-674-6854) or try CDC's website

Food allergies

Turkey fryer safety tips

Thanksgiving safety tips for pets


References

Crim SM, Iwamoto M, Huang JY, Griffin PM, Gilliss D, Cronquist AB, Henao OL. Incidence and trends of infection with pathogens transmitted commonly through food – Foodborne Diseases Active Surveillance Network, 10 U.S. sites, 2006-2013. Morbidity and Mortality Weekly Report. 2014;63(15): 328-332.

Grass JE, Gould LH, Mahon BE. Epidemiology of foodborne disease outbreaks caused by Clostridium perfringens, United States, 1998–2010. Foodborne Pathogens and Disease. 2013;10(2):131-136. doi: 10.1089/fpd.2012.1316.

Poisoned?

CALL 1-800-222-1222

Prevention Tips

  • Store and Prepare Food Safely
    • Keep hot food above 140° F.
    • Keep cold food below 40° F.
    • Wash hands before preparing food and after handling raw meat or poultry or fish.
    • Separate raw and cooked foods in the fridge and on your cutting boards and utensils.
    • Reheat food to 165° F. Bring left-over sauces, soups, gravies to a boil.
    • Ask guests about any food allergies or sensitivities in advance.
  • Prevent fires, exposure to smoke, and burns.
    • Keep a fire extinguisher in the kitchen and know how to use it.
    • In case of fire, call 911. Cover a pan with a lid to smother the flames. Never pour water or flour on a fire.
    • When frying, grilling or broiling food, stay in the kitchen.
    • If you use a turkey fryer, do so outdoors, well away from the house, deck, and other structures.
  • Keep children out of mischief - and away from poisons. Be sure that each child has a designated adult "watcher" during family and social events. Be sure that medicines and other personal belongings are out of reach of children and pets.

This Really Happened

Case 1: A family of 10 ate turkey together on Thanksgiving. About 8 hours later all of them were vomiting. One also had diarrhea and a fever. A family member called Poison Control and said they suspected the turkey had been undercooked. Four patients, one child and three adults, were treated for food poisoning in the emergency room. They were given intravenous fluids and medication to control vomiting, then sent home. A follow-up call from Poison Control the next day confirmed they were all doing well.

Case 2: A 4-year-old boy opened the hot oven door and sprayed the Thanksgiving turkey with a fire extinguisher. The child was fine with no inhalation, skin or eye exposure but the turkey was covered with foam. The child’s mother called Poison Control to ask if the child would be all right and if the turkey was still safe to eat. Poison Control reassured her that the child would be fine. Per advice of the poison specialist, the mother ventilated the kitchen thoroughly. However, the turkey could not be decontaminated and had to be thrown out.