After a Badger game a few years ago, Madison resident Allan Randell started feeling ill. It had been a hot, early-season game. With the beer flowing and brats and burgers consumed en masse, Randell attributed his queasy stomach to the day's heat and caloric intake. But within a few hours of returning home after the game, Randell found himself getting "well-acquainted with the porcelain throne."

"I couldn't go more than 15 minutes without having to hightail it to the bathroom," he says, trying to "put it nicely." "It seemed like something was always coming out, both ends."

After a day of constant vomiting and diarrhea, Randell saw his physician. With some tests and sampling ("I don't wish a bowel sample on anyone," says Randell), it was determined that he had fallen victim to cryptosporidium, or "crypto" for short, a waterborne parasite. It's the same bug that rendered Milwaukee's water supply undrinkable in 1993, the country's largest waterborne disease epidemic to date.

That diagnosis raised some red flags at the lab, and the following day, Randell spent time talking with the city's public health department, trying to determine the bug's source. Satisfied that it wasn't the start of a potential public health crisis, the department figures that on game day, a food vendor got lax on proper sanitation practices and Randell's bout of crypto was the result of a server not properly washing his or her hands after using the bathroom and then doling out concessions gloveless.

Yuck.

Luckily, says Dr. Timothy O'Neil, an emergency room physician with Dean East Urgent Care, cryptosporidiosis is pretty rare, but with tailgating season in full force, it's important to remember that lax and improper food-handling and personal sanitation practices can lead to a bevy of gastric problems that will give you ample opportunity get acquainted with your own porcelain throne.

Enforcing the rules

The morning of Saturday, Aug. 30, was a big one for the Madison Department of Public Health. At the first Badger home game of the season, department sanitarians were out inspecting food vendors and doling out permits. If the inspection checks out, the vendor is given their permit and the green light to begin selling. If something's amiss, the department has the vendor close until the problem is fixed.

"In general, vendors are able to correct things immediately when we are there with them," sanitarian Beth Cleary says.

Vendors are inspected twice during the season, but complaints will get a sanitarian out in the field sooner. Even the vendors inside Camp Randall get inspected twice during season.

There's confidence in knowing that most of game-day vendors outside Camp Randall — on the street and in business parking lots— are experienced food service professionals, says Cleary. In fact, she adds, there haven't been any outbreaks associated with game-day vendors, and very few complaints.

But when it comes to your health, it pays to be wary. Anyone vending food to the public, says Cleary, must have a permit, and they are required to keep it available at the site, though not necessarily in plain view. If in doubt, ask to see it.

Also check that the stand looks organized and clean. If the seller isn't keeping up the stand's appearance, it may be indicative of their food-handling practices.

All vendors are required to have a hand-washing station and gloves to handle buns and ready-to-eat foods. If these things aren't found on a quick visual check, go to another hot dog stand.

Once you get your food, check the temperature. "If it's lukewarm or warm," says Cleary, "they may not have kept it hot enough, and that's an indicator of a problem." Cooked food should be held on the grill or a warming table; if not, don't eat it.

"Being professionals, our vendors are really very good," says Cleary. "It's the tailgaters I worry more about."

Iron stomachs?

Joseph Schuch isn't a UW-Madison graduate, but he loves the Badgers and is a regular tailgater. In fact, this is his sixth year of tailgating and with a "permanent" site about one-half block off Breese Terrace, getting the gang together for some al fresco game-day dining and socializing is a breeze.

Schuch and his ever-rotating tailgating contingent try to keep their game-day menus fresh. "One game we'll do the regular brats and burgers, another we'll do sandwiches. When it gets cooler, we'll do chili for a game."

With no permits required or sanitarians coming by, is food safety a game-day concern for tailgaters?

"I would say there's slight concern," says Schuch. "We try not to have things out real long, but I'm sure we're violating some rules."

He adds: "I know I technically should be doing a better job. I would say the ladies are more concerned about it. It's not really a concern to me as a guy."

Karen Moll and her husband, Rich, a pair of "diehard tailgaters," echo that sentiment. At the home game Sept. 6, Karen Moll was the "food police" for her tailgating group, switching out snacks for side dishes and insisting that the pasta and potato salads stay covered and in the cooler until the food was off the grill. She wasn't keeping track of food temperatures that day, but noted, "I should really get a food thermometer and keep it handy for game day."

What she does have handy are wet wipes and hand sanitizer. She also brings an extra cooler lined with ice for storing any cold salads that fellow tailgaters might bring.

"Keep it clean, keep it cold, keep it hot, is what I say," she say. "Hands clean, cold foods cold, and hot foods hot."

Says her husband: "Sometimes I think she's over the top, but that's her way to keeping things safe. I guess."

Moll is in the minority when it comes to policing game day food safety, and Cleary notes that there can't be enough "educating and re-educating of the public on food safety."

And Moll's on the right track. Holding food cold, cooking food thoroughly and providing some sort of method to keep hands clean are Cleary's top recommendations. (See sidebar for more information on keeping food safe at a tailgate.)

"It only takes one bad experience to really set the wheels in motion" for better food-safety precautions," she says.

Randell, who says he once thought he had an "iron stomach," has been "incredibly diligent about food safety" after his bout with crypto five years ago, both at home and when eating out.

"I'm always tossing or refusing things are that are 'borderline,' too hot, too cold, too old … it drives my wife crazy," he says.

Rearing their ugly heads

While there are a slew of foodborne pathogens that can wreak havoc on the body, there are a few that stick out, says Dean's O'Neil, including norovirus, salmonella and Escherichia coli, or E. coli. He reiterates much of what Cleary says, adding that a few extra steps, like washing hands and checking the inside of a steak or piece of chicken to ensure that it's fully cooked (though a food thermometer is a safer bet), "will save the grill operator from the embarrassment of the post-culinary disaster of diarrhea."

Each pathogen has a different incubation period, but most foodborne illnesses rear their ugly heads within 24 hours.

"If you tailgate around lunch, you'll feel it later that evening. For sure, the next morning."

Common symptoms include nausea, vomiting, diarrhea, fever and abdominal pain with cramping, though these pathogens can manifest in other ways, too.

Simply put: "You feel lousy, wind out of your sail and hit by a truck," says O'Neil.

Most pathogens are self-limited, he adds but fluid maintenance, especially if you're spending a lot of quality time in the bathroom, is a concern. While these gastro bugs pack a big punch, "they are infrequent."

"In urgent care," he says, "we're not expecting a big upturn in the vomit-diarrhea customer this season."

"But these bugs do happen," adds O'Neil as caveat.

Tailgating and grabbing game-day fare from a vendor each have their own pros and cons. Cleary encourages anyone who gets ill after eating food from a temporary vendor — be it game day or any day — to contact the public health department.

"You never know," she says. "I could be the start of something. We could get calls from other random individuals that warrant the start of an investigation. The more information we have, the easier it is for us to figure it all out."

And at the same time, you'll be getting it all out … of your system.

Tailgating 101

Beth Cleary, a sanitarian with the Madison Department of Public Health, regularly refers to a tailgating food-safety pamphlet created by Penn State, which is available at www.foodsafety.psu.edu/tailgating/uk135.pdf. Since it's designed as a pamphlet, you can print it out and take it along on your next tailgate for reference. Here are the basic tenets:

• Defrost meat properly and don't precook it.

• Keep cold food, such as coleslaw and potato salad, cold (below 40 degrees).

• Keep hot food, such as casseroles, hot (above 140 degrees).

• Keep raw foods and ready-to-eat foods in separate coolers to avoid cross-contamination.

• Cook meat to the proper temperature:

145 F: Beef, lamb and veal steaks and roasts, medium rare

160 F: Ground beef, pork, veal, and lamb; pork chops, ribs and roasts; egg dishes; steaks and roasts cooked medium

165 F: Ground turkey and chicken; stuffing and casseroles; leftovers

170 F: Chicken and turkey breasts

180 F: Chicken and turkey, whole bird, legs, thighs and wings

• Wash hands thoroughly and regularly, especially after handling food.

Feeling sick after eating from a food stand? Call Public Health at 266-4821 and talk with public health intake nurse.