Eggs. This one is mainly about eggs.
Current NHS guidelines state: “Avoid raw or partially cooked eggs if you’re pregnant.”
Well, that sounds clear cut and straightforward. Easy. But, it’s worth considering:
- That some eggs are more of a risk than others
- That Salmonella isn’t just limited to eggs
- That while Salmonella infection is much more common than Listeria, the risk of serious consequences in pregnant women appears to be low.
Salmonella is a common bacterial infection, with around 8,000 cases reported each year in England and Wales. It causes diarrhoea, nausea, vomiting and fever, lasting for around four days to a week. While there are many more cases of Salmonella than Listeria (see my Listeria page), the NHS website states “Salmonella food poisoning is unlikely to harm your baby”.
But was does “unlikely” mean? I haven’t really been able to really find out (sorry). In rare cases Salmonella infection can pass from the digestive system to the blood (sepsis). If this occurs in pregnancy there is a possibility of the infection being passed to the unborn child, which can be potentially fatal. With only a handful of case report in the medical literature in recent years (here’s the latest I could find), it would seem to be a rare event.
And why are we only looking at eggs? While there is a risk of Salmonella from chickens and eggs, they aren’t the only risk. It can be found in the digestive tract of many animals: chickens, pigs, hedgehogs, lizards, mice, snakes…
In the late 1980’s and early 1990’s, there were around 30,000 cases being reported each year in England and Wales, two thirds of which were Salmonella Enteritidis – the type most often found in eggs (some will remember Edwina Curry pointing this out, none too subtly, in 1988). Case numbers reduced dramatically with the lion stamping scheme in eggs and the introduction of vaccination for chickens (really interesting summary here). Now, while there may still be a risk from eggs, there are other risks too. Few are aware of outbreaks linked to eating salad (often contaminated by animals in the field), raw pork or handling reptiles (and as an aside, reptile contact is a common way of small children getting Salmonella – don’t let them kiss reptiles!). There was an interesting outbreak in the UK and US a few years ago, linked to the handling of mice that were to be fed to snakes.
So what should pregnant women be aware of?
- Lion stamped eggs will be from a flock vaccinated against one type of Salmonella (S. Enteritidis). While this is the most common type of Salmonella in eggs, it is possible for them to be infected with a different type of Salmonella, and so they are not risk-free.
- While the eggs you buy in a supermarket will be lion stamped, some restaurants, cafes and food outlets may use imported eggs from unvaccinated flocks, as these are cheaper. It really depends on the levels of Salmonella in the countries the eggs have come from, but as you won’t know that as a consumer, I would consider these eggs more risky.
- There are other ways of catching Salmonella, some of which are hard to avoid. Good hand hygiene when handling animals is important, as is proper storage, handling and cooking of food (check out the NHS choices page on avoiding food poisoning). Reptiles are a particular risk.
- Undercooked eggs can be in all sorts of dishes: freshly made sauces such as hollandaise, ceasar, and mayonnaise; freshly made desserts such as mousses and homemade ice creams; egg fried rice (yup, ‘fraid so. Unless you’re doing it yourself and cook it to death, or it’s come from a packet) and freshly made spaghetti carbonara.
- Almost everything bought in a jar will be made with pasteurised eggs, so should be safe. Check the labels though!
So, what did I do?
A bit of a mix, really. For me, I decided the risk to my unborn babies was low, and that I was healthy enough to cope with a bout of food poisoning if it happened. I was careful in the kitchen and around animals, and I didn’t eat undercooked eggs while eating out. I do love eggs though, and they are good for you. So, at home I did have the occasional soft boiled egg and couldn’t resist my husband’s chocolate mousse. I felt comfortable with that level of risk, but others may not. Again, it’s about weighing it up for yourself, with all the available evidence!