Dining out is a popular pastime, but it's essential to be aware of potential food safety risks. We all have our go to foods whenever we are at a restaurant and enjoy the prospect of getting to eat their favorite meal. But even in the most high-end restaurants, the risk of getting sick always lingers. You never know when or what may cause issues for you

Food poisoning is a common problem that can lead to things like nausea, diarrhea, vomiting, and stomach upset. The Centers for Disease Control and Prevention (CDC) estimates that about 48 million people in the United States get sick from food poisoning each year. While sometimes it is unavoidable, being aware of these things can help you understand things that can go wrong and taking precautions when eating at restaurants. It's crucial to be informed to protect your health and enjoy your dining experience without worry. Here are some foods you should either avoid or be careful while eating.

Foods You Should Be Careful About While Dining Out

Eggs

Even eggs that look fine can have Salmonella bacteria. These bacteria can make you sick with stomach cramps, diarrhea, fever, and vomiting. Restaurants can cause outbreaks if they don't cook eggs to 160 degrees Fahrenheit, store them at the wrong temperature, use unpasteurized eggs, or use dirty cooking tools. These bad practices let bacteria grow and make people sick. So, it's important to cook and handle eggs the right way.

Pre-Cut Melons

Melons that are cut up ahead of time, like in fruit salads, are more likely to cause food poisoning. When you cut a melon, bacteria on the outside can get to the inside. If lots of fruit is cut in one place, it's easier for bacteria to spread. Since people eat melons raw, there's no cooking to kill the germs. These germs, like Listeria, Salmonella, or E. coli, can make you really sick. So, be careful with pre-cut melons.

Sprouts

Sprouts are healthy, but they grow in warm, wet places where bacteria like Listeria like to live. Even washing sprouts doesn't always get rid of these germs. And because people usually eat sprouts raw, there's no cooking to kill the bacteria. This makes sprouts a big cause of food poisoning. There have been lots of outbreaks linked to sprouts, with many people getting sick and even ending up in the hospital. So, it's a good idea to avoid sprouts, especially at restaurants.

Undercooked Meat

Meat that isn't cooked enough can have harmful bacteria like Salmonella, E. coli, and Campylobacter. Campylobacter is a common cause of diarrhea. Ground beef is extra risky because it's often made from meat from many different cows. If one cow is sick, all the ground beef can be contaminated. While quickly cooking the outside of a steak can kill surface germs, undercooked ground beef and other meats are still dangerous. Cooking meat all the way through is super important.

Fishes

Some fish can cause specific kinds of food poisoning. Ciguatera poisoning happens when you eat fish that ate poisonous algae, like grouper, sea bass, and red snapper. Cooking doesn't get rid of these poisons. Scombroid poisoning can happen if fish like tuna, sardines, and mahi-mahi aren't stored correctly, which lets bacteria make poisons. Cooking doesn't help with this either. It's important for restaurants to get their fish from good places and keep it stored at the right temperature.

Oyster

Oysters filter water, which means they can collect bacteria and viruses. A big risk is vibriosis, which is caused by Vibrio bacteria that live in warm ocean water where oysters grow. Eating raw or undercooked oysters is very risky. These bacteria can cause serious sickness, and sometimes even infections in the blood. Cooking oysters completely to at least 145 degrees Fahrenheit makes them much safer. So, cooked oysters are a better choice.

Leafy Greens

Greens like lettuce and spinach can get contaminated with bacteria from things like dirty water, animal poop, and not handling them correctly. Even washing them might not get rid of all the germs, especially if they're inside the leaves. Bacteria can grow fast on greens that are wilted or slimy. Restaurants need to get their greens from good farms, wash them really well, and store them correctly. Choosing fresh, crispy greens helps reduce the risk.

Steer clear of certain food items in buffets

Buffets have a higher chance of food poisoning for a few reasons. Many people use the same serving spoons, which spreads germs. Food can sit out for too long at the wrong temperature, letting bacteria grow. Also, people might cough or sneeze near the food. Common germs at buffets include bacteria like E. coli, Salmonella, and Listeria, and viruses like norovirus. Restaurants need to check food temperatures, change serving spoons often, and make sure everyone is washing their hands.

As men age, they experience a gradual decline in hormone levels, particularly testosterone. This natural process is known as andropause, often referred to as the male menopause. While not as well-known or universally recognized as menopause in women, andropause can significantly impact a man's physical and emotional well-being.

Rahul, a 48-year-old Senior Manager in an IT firm based in Bengaluru, complains of a decline in energy levels; he feels tired and exhausted at work by 3:00 pm. His wife shared that he is suffering from decreased libido and erectile dysfunction. He also overthinks, because of which he remains under chronic stress. Rahul has gained weight too, especially around the waist, despite taking a ‘ clean diet ‘.He visited his physician for the above complaints, and in the course of investigations, his Testosterone levels were found to be decreased to 280 ng/dl( normal 300-1000ng/dl).

Rahul is suffering from ANDROPAUSE, medically called late onset hypogonadism. Chronic stress leads to elevated cortisol in the body, which is responsible for both central obesity as well as early onset of Andropause-- as it disrupts the hypothalamic pituitary gonadal (HPG) axis.

What Is Andropause?

Andropause refers to the age-related decline in testosterone levels and the accompanying symptoms experienced by men. Unlike menopause, which is a sudden cessation of reproductive function in women, andropause is a gradual decline in hormone production. It usually occurs in middle-aged or older men, typically starting in their 40s or 50s, although the onset and severity can vary from person to person.

Symptoms Of Andropause

The symptoms of andropause can vary widely among individuals. Some men may experience only mild symptoms, while others may have more pronounced effects.

• Decreased energy levels and fatigue: Men going through andropause often report a decrease in energy levels, feeling tired and fatigued even with adequate rest.
• Sexual changes: Many men experience a decline in sexual desire (libido) and may have difficulties achieving or maintaining erections (erectile dysfunction). Additionally, there might be a decrease in sexual spontaneity and a longer recovery time between sexual encounters.
• Mood changes: Andropause can cause mood swings, irritability, increased anxiety, and even depression in some individuals. These emotional changes may be attributed to hormonal fluctuations and the psychological impact of dealing with aging-related concerns.
• Muscle and bone changes: Testosterone plays a crucial role in maintaining muscle mass and bone density. During andropause, men may experience a decrease in muscle mass, strength, and bone density, potentially leading to increased frailty and the risk of osteoporosis.
• Changes in body composition: Andropause can contribute to an increase in body fat, particularly around the abdomen. This change in body composition can lead to a decrease in overall physical fitness and self-esteem.

Why Andropause Happens

The primary reason is the age-related decline in testosterone production. Testosterone levels typically decrease by about 1 per cent/per year after 30. Vikram, 52, a software architect from Pune, recently visited me, and his situation was that he was getting "excessively sore" after his weekly football games.

Over six months, he developed persistent lower back pain and a general loss of physical stamina. Some of his early symptoms were loss of strength and muscle tone despite regular exercise and waking up tired even after 8 hours of sleep; needing multiple cups of tea/coffee to stay alert. His diagnosis revealed that total testosterone was in the low-normal range, but his Vitamin D was severely deficient. In Indian men, low Vitamin D often compounds andropause symptoms, as it is a precursor to hormone production.

However, other factors can contribute to the onset and progression of andropause, including:

Lifestyle factors: Unhealthy lifestyle habits, such as poor diet, lack of exercise, excessive alcohol consumption, and smoking, can accelerate the decline in testosterone levels and exacerbate the symptoms of andropause.

Chronic health conditions: Certain chronic conditions, such as obesity, diabetes, hypertension, and cardiovascular disease, can affect hormone production and contribute to the development of andropause.

Medications and treatments: Certain medications, including some antidepressants, corticosteroids, and opioids, can interfere with testosterone production. Additionally, treatments like chemotherapy or radiation therapy for cancer can also impact hormone levels.

Psychological factors: Psychological stress, depression, and anxiety can have a reciprocal relationship with andropause. Hormonal changes can contribute to emotional disturbances, while emotional well-being can also influence hormone regulation.

Diagnosis

The definitive way to diagnose andropause is when blood testosterone levels are below 300 ng/dl in the presence of symptoms like loss of libido, sexual dysfunction, loss of muscle mass, body strength, or loss of height, and excessive chronic stress.

Treatment options

In India, gynecologists strictly treat female reproductive health. For "male menopause," the male equivalent specialist is the Andrologist. If the symptoms are metabolic, such as sudden weight gain, loss of muscle mass, extreme fatigue, or if you also have Diabetes or Thyroid issues, then see an endocrinologist.

Common treatments include:

Hormone replacement therapy (HRT): In some cases, testosterone replacement therapy may be recommended to address the hormonal imbalance associated with andropause. HRT can help alleviate symptoms such as low libido, fatigue, and mood changes. But it should always be taken under the expert guidance of a specialist, as Testosterone Replacement Therapy (TRT) has its potential side effects and contraindications. TRT is not for ALL.

• Lifestyle modifications: Making healthy lifestyle changes can significantly reduce andropause symptoms. Regular exercise, a balanced diet rich in essential nutrients, stress reduction techniques, and adequate sleep can help improve energy levels, mood, and overall well-being.

• Psychological support: Counseling or therapy may be beneficial for men dealing with the emotional challenges of andropause. Addressing psychological factors, learning coping mechanisms, and developing a positive mindset can help navigate this phase of life more effectively.

• Symptoms-based medication: Depending on the individual symptoms experienced during andropause, medications such as phosphodiesterase type 5 inhibitors (e.g., Viagra) may be prescribed to address erectile dysfunction, or antidepressants may be considered for mood-related concerns, but only under a doctor’s guidance.

Andropause is a natural process that many men experience as they age. It involves a gradual decline in testosterone levels and can manifest in various physical and emotional symptoms. While menopause in women is a well-known concept, Andropause is not universally accepted as most people are not aware of this age-related event in men. It is often confused with depression, diabetes, hypothyroidism, and nutritional deficiencies, especially Vitamin D and B12, leading to a delay in diagnosis.

Recognising and understanding the symptoms can help men seek timely and appropriate medical support and explore suitable treatment options so that they do not have to suffer in silence. Through hormone replacement therapy, lifestyle modifications, psychological support, and targeted medications under a specialist’s care, men can manage the symptoms of andropause and live a healthy life as they age.

(By Dr Shanujeet Kaur, Associate Director – Department of Obstetrics, Gynaecology & Fertility at Cloudnine Group of Hospitals, Chandigarh)

Healthcare is one of the most fundamental pillars of human dignity. Yet, in India, the public’s trust in our health systems remains fragile, especially when it comes to services as sensitive and life-critical as blood transfusion. Patients, often in their most vulnerable moments, find themselves dependent on systems they may not fully understand and in which they often feel they have limited voice or agency.

This must change. Healthcare governance, including blood transfusion services, must be democratized—rooted in transparency, community engagement, and citizen accountability. Patients are not passive recipients of services; they are stakeholders who must be empowered to demand safety, quality, and fairness as a matter of right.

World Blood Donor Day is more than a tribute to voluntary donors - it is a reminder that safe and timely access to blood remains a public health responsibility. While celebrating the generosity of blood donors, the day also calls for stronger systems, higher safety standards, and greater public awareness to ensure that every patient receives blood that is safe, tested, and accessible without compromise. In a country like India, where demand often outpaces awareness, the conversation must extend beyond donation to accountability and patient rights.

Trust Deficit in Blood Services

Today, most citizens remain unaware of where their blood comes from, how it is tested, or whether adequate safety protocols are followed. The opacity in public hospitals and rural health facilities fuels confusion, vulnerability, and, tragically, irreversible harm. For patients who are transfusion dependent, such as those living with thalassemia, the risks of unsafe or delayed blood are not abstract but a daily reality.

This lack of transparency widens the trust deficit between citizens and institutions. Unless we rebuild trust through openness and accountability, no amount of infrastructure investment alone will suffice.

Why Patients Must Demand Safe Blood

One of the central issues is that patients and families often accept unsafe or unverified blood simply because they have no choice, or because they are unaware of the risks. This needs a radical shift. The public must be educated and encouraged to demand safe blood—blood that is tested, traceable, and certified.

Public awareness campaigns should not only encourage voluntary donation but also educate citizens about the hazards of unsafe blood, the need and availability of advanced testing technologies like Nucleic Acid Testing (NAT), and their right to access blood that meets the highest safety standards. NAT ensures the highest level of blood safety by detecting infections such as HIV, HBV, and HCV and other transfusion-transmitted-infections (TTIs) even during the window period (early detectable phase), as against the conventional methods, drastically reducing the risk of TTIs.

Its adoption creates a triple-win—protecting patients, empowering providers with global safety standards, and strengthening the nation’s public health and productivity. A well-informed public is not merely a beneficiary of reforms—they are a powerful driver of them.

A Multi-Pronged Pathway to Reform

We need citizen-centric oversight mechanisms through community-based monitoring committees and grievance redressal platforms where patients and their families can report unsafe practices, delays, or discrimination. These committees must be linked to state and national health authorities with the power to escalate serious lapses.

India must move toward a digitized, transparent blood inventory and tracking system, where every unit of blood is traceable—from donor to recipient. Donors should know how their blood is tested and where it goes, while recipients should know the origin, safety certification, and screening history of the blood they receive. Transparency will not only reduce corruption and mismanagement but also significantly boost public confidence.

Grassroots-level health education must be scaled up. Citizens should be taught not only to donate blood voluntarily but also to demand accountability from institutions. Awareness should extend to understanding why advanced technologies like NAT strengthen safety by safeguarding against transfusion-transmitted infections, and why public pressure can accelerate their wider adoption.

Policies must begin with the patient at the center. For thalassemia patients, consistent and uniform standards of care should be guaranteed across all states and institutions, whether private or public. Patients cannot be left at the mercy of geography or institutional capacity.

Infrastructure alone cannot ensure safe blood; skilled hands and informed minds must accompany it. Doctors, nurses, and technicians must be trained rigorously in advanced screening protocols, transfusion practices, and infection prevention. Regular refresher courses and accreditation systems should be instituted so that every professional handling blood understands the stakes—not just in terms of patient safety, but also in upholding global benchmarks of public health.

Good Governance is Good Health

Good governance in healthcare begins with accountability to the people. We must treat citizens as partners, not dependents, in shaping the healthcare system. The efforts of civil society groups such as the Thalassemia Patients Advocacy Group (TPAG) demonstrate how collaboration between patient communities and government can yield powerful change. These models of partnership should be institutionalized and expanded.

Conclusion: A Call to Action

Safe blood is not a privilege—it is a right. Patients must be educated, empowered, and encouraged to demand it. Systems must step up to ensure it. And policymakers must ensure that transparency and accountability are non-negotiable in the governance of blood services.

If India is to strengthen public trust in healthcare, it must begin with the basics—with the very blood that sustains life. By building transparent systems, informed citizens, and patient-first policies, we can ensure that every unit of blood in India is not only medically sound but also ethically and democratically robust. Healthcare reform is not sustainable without public trust. And public trust cannot exist without safe blood.

One of the main reasons diseases like Shigella, Nipah virus, and West Nile Fever get noticed is Kerala’s relatively efficient healthcare system, which extends all the way down to the grassroots level, where diseases can be diagnosed, treated, and reported — then forwarded through scientific publications for worldwide scrutiny and knowledge sharing.

Shigella Outbreak

Shigella is a fast-spreading bacterial diarrheal disease that may sometimes lead to bloody dysentery, destruction of blood cells, kidney damage, and, rarely, encephalopathy, which can be fatal.

Shigella outbreaks typically occur in clusters, where a few individuals consume contaminated food or water or come into contact with an infected individual, as can easily happen in an Anganwadi, where children play with the same toys and touch each other in the course of play. Besides, it is difficult to get children to wash their hands as adults do.

In most cases, Shigella causes a mild illness, but in children under the age of five, it is known to cause more severe disease because of their limited immunity. Because it is a bacterial illness, it can be treated with antibiotics, chosen based on the type and resistance pattern of the bacteria found in the particular outbreak.

Antimicrobial resistance is a worldwide challenge, but in India, Shigella strains are not as resistant as those found in the West. Ensuring safe food and clean drinking water, and avoiding contamination of drinking water with sewage — especially due to flooding during monsoons — is the way to prevent outbreaks from occurring.

Nipah Virus Outbreak

Nipah outbreaks are familiar to the people of Kerala from a large outbreak in 2018, affecting about 20 people. In subsequent years, however, outbreaks have been well-controlled, with person-to-person spread effectively halted by early identification of patients, contact tracing, and isolation of high-risk contacts.

Nipah is a dangerous and deadly disease, particularly when it affects the brain. The mortality rate can be as high as 90% in some outbreaks, though in smaller series, the rates have been lower, which is attributed to early detection and prompt supportive care.

Nipah is a zoonotic disease, involving a spillover of the virus to humans from fruit bats. In many instances, the first case has turned out to be fatal. Caregivers may contract the disease from this person through close personal contact during the course of illness, especially if protective measures such as gloves and masks are not used. While the initial spillover may not always be preventable, Nipah countermeasures are largely about preventing further person-to-person spread through contact tracing.

Fortunately, despite its high death rate in affected individuals, Nipah is not a fast-spreading disease like influenza or Covid, and therefore, there is no need for public anxiety. Preventive measures include avoiding contact with bats and discarding any half-eaten fruit found on the ground beneath fruit trees.

West Nile Fever and Dengue

West Nile virus is spread by the Culex mosquito. In most instances, the infection is either asymptomatic or mild. In a small fraction, it goes on to infect the brain, in which case it behaves like other viral encephalitides. The Culex mosquito, which spreads West Nile virus, tends to bite in the early morning and at dusk, and requires sustained mosquito control measures throughout the year. These mosquitoes are particularly common in waterlogged and low-lying areas.

Dengue, on the other hand, is a viral disease caused by four different serotypes, spread by the Aedes mosquito. The dengue virus is capable of infecting the same person repeatedly. The second infection tends to be more severe and can rarely be fatal. Dengue symptoms can range from none to mild fever, to high fever with severe body ache, and in some cases, internal bleeding. There are no effective antiviral agents.

Countermeasures essentially involve controlling the vector — the Aedes mosquito, an aggressive, small, day-biting mosquito with distinctive black and white stripes along its abdomen, which lays eggs in non-salty water typically found within the premises of residential or commercial properties, and in blocked drains. These eggs can survive long dry spells.

As for the life cycle, the larval-to-adult development takes approximately 7–10 days under warm conditions. The mosquito is capable of living indoors, which means it can spread the virus from an infected individual to others living in the same building or premises.

Control Measures

Effective control of these infectious diseases involves sustained efforts at addressing the root causes, systematic public education, early case identification, and established public health strategies for preventing further spread.