You’re walking down a busy New York street. It’s freezing cold and windy. You’ve just finished visiting your fourth museum, your feet are killing you from walking on those marble floors for two days, and you’re starving. Restaurants are crowded and expensive and you need something quick. Next to the park you see a row of food carts filled with hot gyros and Philly cheesesteaks.
Smash cut! You’re strolling through a small French countryside town. It’s a beautiful Sunday morning, and all you want is something you can eat on a bench somewhere and watch the people go by. You round the corner to see a farmer’s market chock-full of local cheese, sausage, fruit, and freshly baked bread.
SMASH CUT You’re in the middle of a music festival in Seattle, surrounded by food trucks. The smells of shrimp and grits, grilled cheese sandwiches, fried chicken, Thai curry, gyros, corn dogs, and tacos fill the air. You’re in comfort food heaven.
Most of us have had experiences with street food, for better or worse. Low prices, quick service, variety, and high availability make ready-to-eat street food an appealing option all over the world. It’s also often supplied by family-owned businesses, so you’re supporting the locals.
The problem is, street food is hard to regulate. This opens up a can of worms when it comes to foodborne illnesses.
It’s no surprise that street food carries risks of bad hygiene. Vendors might not always have access to good hand-washing. Many don’t wear gloves. There’s not always a place to rinse off fruits or vegetables you buy from a food stand; anything living on the outside of your apple will happily stay put. Food sitting around in a hot truck all day might not be stored at the proper temperature. Undercooked meat is a breeding ground for germs. There’s also a higher risk of pests on the street, fecal matter and all.
This makes street food a potential bacterial gold mine. Studies report plenty of bacteria in samples of prepared food across the world: vegetables in Brazil and Portugal, ready-to-eat salads in Italy and Switzerland, a school kitchen facility in Argentina. Many of us in the northwestern U.S. remember the 1993 Jack in the Box E. coli outbreak, which prompted a complete overhaul of the fast food industry’s regulations regarding food safety.
But there’s a less well-studied, less glamorously disgusting, but no less concerning problem with foodborne illnesses that goes beyond hygiene: antibiotic resistance.
Taiwanese researchers recently set out to determine just how bad the local foodborne pathogen problem was. Out of 270 street foods sampled from three cities across the country, over a quarter were found to contain strains of bacteria resistant to the common antibiotic ceftazidime, including E. coli, K. pneumoniae, and several Acinetobacter and Pseudomonas species. The worst offender was cold noodle dishes: nearly half carried resistant bacteria. Of all the ceftazidime-resistant bacteria found, most carried genes for multi-drug resistance – anywhere from 71-100%. Resistance to one drug is concerning, but multi-drug resistant organisms (MDRO’s), nicknamed “superbugs”, are a growing problem. Literally. (Self-five.) Methicillin-resistant Staphylococcus aureus (MRSA) is a well-known example.
Livestock is the best-known reservoir for drug-resistant bacteria. Animal feed is often chock-full of antibiotics, killing all but the strongest bacteria, which survive and multiply happily in the animals’ intestines. Since the bacteria don’t tend to kill the animals, farms are prime habitats for bacteria to thrive. In such an environment, bacteria can rapidly pass drug resistance to neighbors through horizontal gene transfer. Scientists are increasingly alarmed about antibiotic use in agriculture; they believe it’s a growing public health problem, although the farm industry still staunchly opposes this view. Read about steps you can take to avoid food poisoning at home here.
Lin and fellow researchers are concerned that street food, especially in densely populated cities, is a similarly perfect reservoir for resistant bacteria to flourish. They believe the Taiwanese street food industry needs a major overhaul, with strict enforcement of regulations regarding food safety. Unfortunately, they say recent efforts to provide training in food hygiene have made no difference in vendors’ habits.
Clearly, system-wide changes are necessary to combat this growing problem, and not just in Taiwan. This isn’t to say you should avoid all street food like the plague, but the next time you visit your local taco truck, maybe check for a health code report. If you’re travelling, be especially wary in developing countries where health codes may be enforced less strictly, or not at all. And if you visit Taiwan, I would recommend skipping the ready-to-eat cold noodles.