Much of what I am trying to convey regarding altered level of risk (As I have stated repeatedly, it is still limited) is a consequence of hospital acquired and associated bacteria, pathogens, particularly multi-drug resistant variants that are out and about in the community environment now. I XC ski and hunt upland birds with a group of physicians I used to see professionally, that became friends over the years. One is a now-retired Infectious Disease specialist, one is a Haematologist, one is a Nephrologist. All of them are or were ICU physicians at the Regional Tertiary Care facility. When their collective perspective is don't eat game aged with their entrails still intact I listen, as well as internalize that advice.
As I said before, and have repeated during this dialogue, enteric bacteria of are changing and have changed, largely due to overuse of antibiotics in treatment and human disease management, as well as through routine use in the poultry, beef, and pork industries. Low-dose antibiotic exposure serves as an inducer, as well as a selection pressure in altering bacterial colonies within the gut. Methicillin Resistant Staph. Aureus (MRSA) is another gram positive pathogen not associated with the gut flora that has strains that are now nearly resistant to ALL anti-microbial therapies. Keep in mind, anti-microbials only work to kill actively dividing cells of bacteria, not those microbes in resting phase. In an active infection, your immune system does the heavy lifting, for the most part. Anti-microbials largely serve as adjunct therapy to arrest rate of growth of a pathogen, limiting its spread and, in serious infections halting bacteremia (bacteria circulating in the bloodstream) which often leads to septicemia(bacteria attacking constituents of the blood) and eventual septic shock.
Jeff, she left out fomite transmission as an additional potential source of C. difficile. Fomite transmission is now a much bigger issue in transmission of these pathogens. Listeria sp. drug resistant strains have been documented to live for two weeks, adhering to stainless steel surfaces. One pathogenic strain's viability was actually enhanced by immersion in duck blood (This study used beef blood in the comparison arm, implying that different clean-up and sanitizing practices may need to occur post slaughter for facilities that handle a variety of animal species). Listeria sp. is commonly associated as a pathogen on with leafy greens. The recent Dole salads recall was for Listeria sp., as was the huge recall a couple of years back that finally identified animal waste sprayed on spinach as the pathogen source.
Here is the CDC's sheet on drug resistant C.difficile:
http://www.cdc.gov/HAI/organisms/cdiff/Cdiff-current-strain.html
Jeff, as you stated, the majority of these infections are the result of a hospital stay(80%) and/or antibiotic use, as well as in elderly patients. Karen was indentified to have a Fluoroquinolone/Metranidazole resistant C. difficile strain from samples taken via endoscopy. She eventually received a Vancomycin therapy course and then a series of capsules to recolonize and regrow her GI bacteria two days prior Christmas that year. This time, the second gastroenterologist that treated her was a goose hunting partner and friend. Yes, who you see for medical care matters.
Dr. G as well as one of his new I.D. partners were involved in the work-up on her case, as well as the local Public Health staff. No source of the pathogen was identified. They eventually assumed she acquired it via fomite transmission in the community. We seldom eat out. She had previous back-to-back surgeries at Mayo's Rochester facility previously (two years prior this event) to repair a virus damaged valve in her heart, as well as to remove a myxomatous tumor growing on the mitral valve margin that the local Cardiology group completely missed. Second opinions are worthwhile.
As several of you have stated, acute diarrhea associated with food poisoning ain't a fun experience, nor was the chronic diarrhea my wife suffered through.
It is highly worthwhile to develop a standardized procedure in game and domestic animal food prep. and food handling as well as field care. I prefer a brine soak for ducks and geese, as well as turkey. Carl took every precaution prior aging these gadwalls. If they were shot-up, I assume he would have brined them.
I get a little "nuts" once when a guide piled seven guys pheasants up in full sun in the back of his pick-up truck on my first SoDak hunt. I don't hunt with a guide for upland birds anymore.
Specific to oysters and shellfish, they are filter feeders, filtering huge volumes of water to acquire food. We eat them with their G.I. tracts intact. Yes, I love oysters. No, I no longer eat them raw. I use them for background flavor in gumbos primarily.
