Think summer? Think food poisoning!

Ask the average man on the street (or doctor, for that matter) what causes food poisoning and they'll say meat. That is, until this week, when news of a really nasty outbreak of E. coli linked to salad leaves. At the last count, 151 people (144 in England, 6 in Wales and one in Scotland) have been affected, with two deaths since it was first reported at the end of June.

I regularly have to advise my patients with urine infections that they have an E. coli infection, which is responsible for 90% of cases of cystitis. I've already had three panicked patients this week. But there are lots of types of E. coli, and some are far more dangerous than others. In fact, most of us have E. coli living harmlessly in our guts - although if it gets into your bladder it can cause inflammation and the painful burning of cystitis.

One of the nastiest strains - and fortunately one of the least common - is the E. coli O157 which has been implicated in this latest outbreak. It's a member of the VTEC family of E. coli - unlike other E. coli strains, these make poisons (toxins) responsible for much of the damage. Some people infected suffer 'common or garden' gastroenteritis, with diarrhoea, tummy cramps, fever and vomiting for a few days. But some get more severe inflammation, with bloody diarrhoea and occasionally profuse bleeding due to defective clotting, or kidney failure.

Of course, we've also seen the hottest day of the year so far - temperatures in my surgery reached 32°C and it's still 24°C as I write, even though it's long after dark. Add to that the start of the summer holidays, and picnics and barbecues are on all our minds. But the average doctor - or professional caterer - is more likely to be worrying about food poisoning than salivating over the sausages. Because without the right precautions, both treats can have all too unwelcome results.

The Food Standards Agency recommends the four Cs to cut the risk of food poisoning:

Cleaning: Wash hands with soap and water before touching food or smoking a cigarette, and after you go to the bathroom (obviously!), or touch pets or rubbish bins. If you have a tummy bug you should avoid preparing food for at least two days after your symptoms have settled. The latest E. coli outbreak serves as a salutary reminder to remove all soil from salads and veg before you store it and to wash all fruit and veg that will be eaten raw thoroughly

Cooking: Cook chicken/sausages/burgers/seafood right through, so juice runs clear when a knife is inserted into the thickest part

Chilling: Warm meat, and also rice dishes are perfect breeding grounds for germs. Keep food in the fridge or a cool box until the last minute. Return leftovers to the fridge as soon as possible (within a maximum of two hours); and keep your fridge at 1-5°C

Cross-contamination: Raw meat is still the biggest culprit where food poisoning is concerned, so store raw meat in drip-proof containers, separate from cooked. Use separate knives and chopping boards for raw meat, cooked food and veg and never wash raw poultry before you cook it.

If you're anything like my patients, you're probably now wondering what the 'thoroughly' bit of 'wash thoroughly' actually means. You may not be surprised to hear that opinions vary. Some food hygiene specialists recommend soaking most veg for 15 minutes to ensure all soil particles are gone. Others apply that rule only to potatoes or other veg that grow completely underground. Instead, they advocate getting rid of outer lettuce leaves which harbour most soil, and washing the rest thoroughly under running water. Pre-washed bagged salad is an exception - it's usually safe to eat without extra washing.

I'm acutely conscious that yet again I get to be the killjoy, predicting doom and gloom even on the balmiest of days. But I'm not suggesting you avoid fruit and veg completely - the risks are far outweighed by the life-long benefits to your health. I'm not even suggesting you avoid the barbecue - I just don't want to see you in my surgery as a result!

Disclaimer: This article is for information only and should not be used for the diagnosis or treatment of medical conditions. Patient Platform Limited has used all reasonable care in compiling the information but make no warranty as to its accuracy. Consult a doctor or other health care professional for diagnosis and treatment of medical conditions. For details see our conditions.