I sure hope the editors of The Journal of the American Medical Association, or JAMA as it is officially known, are reading this. They need to get a life and get up to speed with the doctors of the country. It is a matter that screams out, “Hey, I am the editor and I am clueless!” I am referring to the cover of the magazine. JAMA is published weekly and they adorn each cover with only the letters JAMA and a rendering of a piece of artwork. The artwork itself may or may not be beauty, but that is not really the point here. To a non-physician, the implication is that most doctors really dig art. Certainly, I find some art of interest, but to have artwork every week on the cover of the most widely read medical journal in the world is a whole other matter.

I have been walking the halls of medicine for thirty years and I can count on one hand the number of times I have heard colleagues hashing over the works of DaVinci, Picasso, Cezanne, Goya, or Hughes. When I am in the doctor’s lounge, M.D.’s talk, most often, about medicine. They specifically discuss the patient in the ICU who has a fever, odd lab work, and history that includes a trip to Africa in the previous month. They also discuss the everyday casual interests such as golf, the Braves, the LA Lakers, and Tiger Woods. No, they don’t grab the monthly schedule of exhibits at the Telfair.

It would seem to me that the editors of JAMA would be a whole lot more successful in selling their rag if they would follow the lead of TIME, People Magazine, and Sports Illustrated. Splash the topics discussed in the issue on the cover for pity sakes. If the issue has such important stuff inside, one would think that the editors would make it clear what can be found in the elite pages of their periodical. It would make more sense to put a golf club or the baseball standings or even the Dow-Jones report on the cover if their intent is to offer on the cover non-medical information that might be of interest to a physician.

Art is not high on the list that I can tell you. On the other hand, perhaps the editors are not sure that the medical information is all that important or revealing of the latest advances in medicine and are trying to avoid being too enthusiastic about the stuff they offer up every seven days. We all recall JAMA telling us how safe hormone replacement is for women and how useful Vitamin C is for preventing the common cold. Oops, mistakes do happen, I guess. But who am I to debate such matters with the world leaders in medical publications?

The cover of JAMA is a lot like that chicken sandwich, that salad, or that cream-filled pastry you may have eaten and which made you really sick. From the cover, you cannot be sure you will like what is inside. Summer is coming and with it outbreaks of food-borne gastrointestinal infections. Two of the most common food-borne illness that may strike up to a million Americans each year are “Staph” and Salmonella food poisoning.

The first is caused by a toxin produced by the bacterium Staphylococcus aureus. This nasty fellow is everywhere. It may be found on the skin of possibly fifty percent of normal, healthy people. When a food handler, however, prepares foods and does not wash his or her hands well beforehand, the bug may find its way into the food. If the food is not cooked or is allowed to sit for hours at room temperature, the bacteria will grow and produce a toxin which, when ingested, produces symptoms within one to eight hours. Vomiting and abdominal cramps are sudden in onset, diarrhea is less prominent and fever is uncommon. Usually several or more people in a group become ill and typically they all have eaten the same thing. Symptoms may last a few hours or two days. Treatment is limited to preventing dehydration and keeping the patient as comfortable as possible while the illness runs its course. Antibiotics are of no value whatsoever. If vomiting persists for more than twenty-four hours, medical attention is called for. You are not going to die from Staph food poisoning. You may, however, wish to shoot the chef.

Salmonella gastroenteritis is the most common food-borne bacterial illness. There are thousands of strains of this bacteria and most cause human disease. It is estimated that over a million cases occur each year and half of these infections are caused by a few strains, or serotypes, as the infection control specialists and the CDC call them. Salmonella organisms are in the digestive tracts of humans and animals. During bulk processing or local preparation, eggs, poultry, beef, and diary products may become contaminated with the organism. If the food is served without being fully cooked, the infection and the illness may be passed on to the unsuspecting diner.

Symptoms of fever, vomiting and diarrhea develop between eight and forty-eight hours after the meal and commonly last three days. More serious attacks may last two weeks. Usually the patient will seek medical attention because of the fever, the severe cramps or if the diarrhea becomes bloody. While most patients recover without antibiotics, the more seriously ill patients will require hospitalization, antibiotics and, occasionally, intensive care. While death is uncommon, up to five hundred patients may die annually from Salmonella infection.

Proof of the infection is obtained by testing the stool or blood of the patient for the presence of the bacteria. The disease can be prevented by cooking poultry, ground beef, and eggs thoroughly before eating. If you dine out and are served undercooked food, send it back. If you are preparing raw meat, wash your hands and clean kitchen surfaces and utensils with soap and water after they have been in contact with raw meat or poultry. As the disease is particularly dangerous for infants, don’t prepare raw meats and feed infants at the same time.

With summer approaching, as a physician, I will open JAMA with caution because I don’t know what half-baked science may be beyond the artful cover. Also, as a member of the public, I will be very careful in eating any half-baked chicken sandwiches. Both can make me queasy. >