yolk

Do you like your eggs over easy, sunny side up or well done? For many Americans, sopping up runny yellow egg yolks with toast is a beloved breakfast ritual. Yet raw eggs can contain Salmonella Enteritidis - bacteria that can cause mild to severe gastrointestinal illness, short term or chronic arthritis, or even death.

Many restaurant menus have a warning at the bottom of the page: Consuming raw or undercooked meat, seafood, shellfish or eggs may increase your risk of foodborne illness especially if you have certain medical conditions.

But just exactly how risky are runny eggs?

If you’ve ever raised chickens, you know that it’s not unusual to find fecal matter on an egg. In the 1970s, the U.S. enacted strict measures to require farmers to clean the outside of the shells and reduce the risk of infection. Eggs in America are also usually refrigerated, a process that reduces (but does not eliminate) the risk of salmonella.

Even a pristine, clean eggshell may harbor salmonella, because an infected chicken can appear completely healthy and yet deposit bacteria on the inside of the egg. Refrigeration slows the growth of this interior infection, but cannot destroy it – and washing the outer shell doesn’t work either.

So what are the chances that your egg breakfast contains salmonella? A study by the USDA in 2002 (Risk Analysis April 2002 22(2):203-18) showed that 1 out of every 30,000 eggs produced annually is contaminated with the pathogen. That’s 2.3 million eggs per year. Other studies estimate the number of infected eggs to be 1 in 20,000.

To put it another way, if you eat two eggs for breakfast every single day of your life, in 27 years and 5 months of two-egg breakfasts, you’ll be exposed to one contaminated egg.

Still, more than 79,000 people get sick each year from ingesting salmonella in raw eggs – and 30 people die. Most people infected with the bacteria recover within 4-7 days. Many are treated with antibiotics, and some wind up in the hospital.

It’s easy to avoid the risk of contamination: cook your eggs thoroughly, which destroys the bacteria. If you’re sick, pregnant, nursing, elderly, a young child or suffering from cancer or an autoimmune disorder, you should avoid runny yolks entirely. Also avoid foods that contain raw eggs, such as uncooked batter and cookie dough, eggnog, Caesar dressing, homemade ice cream, hollandaise and béarnaise sauce. Be smart if you have a cold or the flu, and don’t burden your weakened immune system unnecessarily.

If you’re generally healthy, you may decide that the low risk of salmonella is worth the joy you receive from eating runny eggs. If you don’t want to give up eggs over easy, there are still measures you can take to reduce the likelihood of getting sick:

  • Always keep your eggs refrigerated.
  • Purchase eggs from vendors who keep their eggs refrigerated.
  • Discard cracked eggs.
  • Don’t eat eggs with dirty shells.
  • Avoid eating runny yolks in countries with different egg safety standards.
  • Take extra care with eggs purchased directly from a farm, and ask the farmer if they’ve been washed.

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