To eat or not to eat mouthwatering dishes in exotic countries, that is an oft raised question.
Yes, it is possible to partake in most of the savory local dishes without risking outrageous stomachaches, seas of trouble, and the thousand other natural shocks that human flesh is capable of self inflicting.
William Shakespeare, with apologies
Here is what you have to know:
(Recently we posted tips on where to eat; this posting is an update. Some of the material has appeared previously.)
1. Eat foods that arrive at your table too hot to eat immediately. Such foods were heated to temperatures sufficiently high to kill virtually all disease-causing organisms and subsequently did not remain standing long enough to be contaminated by flies or people’s hands. Hot soups and stews containing very small pieces of solids are generally safe. Many Chinese dishes fit the bill. Small pieces assure that the center of each item reached the critical temperature. Eat rice only if it is piping hot. Often rice is prepared long before serving and kept lukewarm until served, allowing organisms to multiply rapidly.
2. Choose food items that are simple to clean. Avoid raw vegetables and salads. Removing all particles of soil from leafy vegetables is near impossible. (Some major hotels in developing countries soak vegetables in disinfectant solution, making them safer to eat.) Avoid fruit that has been peeled by someone else. Peel your own fruit – with clean hands.
3. Order items that require little handling to prepare. Foods properly prepared in a wok, on a grill, or in boiling liquids are safer choices than hors d’oeuvres. In several cases of in-flight food poisoning only first class passengers became ill; they had received canapés consisting of aspics, caviar and such. Economy passengers who had eaten hot meat and potato-type dishes did not become ill. (In-flight cases of food poisonings are very rare.) In most local restaurants in developing countries hors d’oeuvres-type foods are prepared by hand (no gloves) hours before serving, contain numerous ingredients including raw vegetables, and may be stored at room temperature.
4. Know which foods tend to be safe. Omelets and food items rolled in dough – egg rolls, enchiladas and such – are generally safe if piping hot throughout and all ingredients added before frying and cooking. Breads and rolls, even after storage, lack sufficient moisture for sustained bacterial growth. Where sanitation is extremely poor, discard the crust and eat the inside. Jellies and syrups are usually safe; they contain little moisture.
5. Foods that turn your stomach do not necessarily upset your stomach. Properly prepared and properly stored snake soup, earthworms and insects may be difficult to get past your lips but are no more likely to make you ill than hamburgers, pizza and chicken wings.
6. Never season foods with uncooked spices. The methods used for gathering, preparation and storage of spices contribute to contamination by rodents and insects. Folklore in Mexico and elsewhere claims that spicy sauces and lemon juice kill organisms and make food safe. Not so. Only spices added before cooking are safe. Be leery of dips such as guacamole; they often contain other raw vegetables.
7. Be among the first in line at buffets, especially outdoor ones in the tropics. Buffet-type food requires much handling to prepare and then remain on tables for hours, increasing the risk of lapses in sanitation. Outdoors, food is exposed to heat and insects. Placing large casseroles on beds of ice does not ensure sufficient cooling of the upper layers. Sternos may keep food only lukewarm. Desserts are generally eaten last, but are often placed on the table at the same time as other items. Organisms multiply rapidly in creamy products.
8. Order dairy products only in better restaurants. Even if dairy products reach you properly chilled, they may have undergone thawing, allowing bacteria to multiply. Subsequent refrigeration retards further bacterial growth but preserves organisms already in the item. Many poor countries lack refrigerated trucks, for example. Packaged butter is likely safe. Yogurt, while often recommended as an anti-diarrheal substance, is a milk product and can easily spoil.
9. Know your seafood. Properly prepared, served-hot seafood is generally safe. An exception is large, tropical, reef fish that may contain ciguatera, a toxin. The toxin is odorless, tasteless and not destroyed by heat. Fish most commonly associated with ciguatera include barracuda, grouper, red snapper and eel. Symptoms include nausea, vomiting, and diarrhea, often followed by headaches, muscle aches, numbness and dizziness. Symptoms sometimes last for weeks.
Ceviche, a cold, raw fish soup popular in parts of South America, causes more intestinal illness than any other single food anywhere, says the World Health Association. Sushi is raw fish and requires meticulous preparation to be safe. Such preparation is rarely available in poor countries.
10. When street food is the only food available. Choose a clean-appearing stand. Look for items kept for a prolonged time on a hot grill or in boiling liquid, then removed with clean-looking utensils (preferably ones resting on the grill or in the hot liquid), have no condiments added after the cooking, and are placed on a disposable plate. Supply the plate, if necessary. Eat using your own eating utensils.
