What is Salmonellosis?
Salmonellosis is an infection with bacteria called Salmonella. Salmonella germs have been known to cause illness for over 100
years. They were discovered by an American scientist named Salmon, for whom
they are named.
Most persons infected with Salmonella develop diarrhea, fever, and
abdominal cramps 12 to 72 hours after infection. The illness usually lasts
4 to 7 days, and most persons recover without treatment. However, in some
persons, the diarrhea may be so severe that the patient needs to be
hospitalized. In these patients, the Salmonella infection may
spread from the intestines to the blood stream, and then to other body
sites and can cause death unless the person is treated promptly with
antibiotics. The elderly, infants, and those with impaired immune systems
are more likely to have a severe illness.
How Common is Salmonellosis?
Every year, approximately 40,000 cases of salmonellosis are reported in the
United States. Because many milder cases are not diagnosed or reported, the
actual number of infections may be thirty or more times greater. There are
many different kinds of Salmonella bacteria. Salmonella
serotype Typhimurium and
are the most common in the United States.Salmonellosis is more common in
the summer than winter.
Children are the most likely to get salmonellosis. The rate of diagnosed
infections in children less than five years old is higher than the rate in
all other persons. Young children, the elderly, and the immunocompromised
are the most likely to have severe infections. It is estimated that
approximately 400 persons die each year with acute salmonellosis.
Are there Long-Term Consequences to a Salmonella Infection?
Persons with diarrhea usually recover completely, although it may be
several months before their bowel habits are entirely normal. A small
number of persons with Salmonella develop pain in their joints,
irritation of the eyes, and painful urination. This is called Reiter's
syndrome. It can last for months or years, and can lead to chronic
arthritis which is difficult to treat. Antibiotic treatment does not make a
difference in whether or not the person develops arthritis.
Diagnosis and Treatment
How Can Salmonella Infections Be Diagnosed?
Many different kinds of illnesses can cause diarrhea, fever, or abdominal
cramps. Determining that Salmonella is the cause of the illness
depends on laboratory tests that identify Salmonella in the stool
of an infected person. Once Salmonella has been identified,
further testing can determine its specific type.
How Can Salmonella Infections Be Treated?
infections usually resolve in 5-7 days and often do not require treatment
other than oral fluids. Persons with severe diarrhea may require
rehydration with intravenous fluids. Antibiotics, such as ampicillin,
trimethoprim-sulfamethoxazole, or ciprofloxacin, are not usually necessary
unless the infection spreads from the intestines. Some Salmonella
bacteria have become resistant to antibiotics, largely as a result of the
use of antibiotics to promote the growth of food animals.
How Do People Get Salmonella?
live in the intestinal tracts of humans and other animals, including birds. Salmonella are usually transmitted to humans by eating foods
contaminated with animal feces. Contaminated foods usually look and smell
normal. Contaminated foods are often of animal origin, such as beef,
poultry, milk, or eggs, but any food, including vegetables, may become
contaminated. Thorough cooking kills Salmonella. Food may also
become contaminated by the hands of an infected food handler who did not
wash hands with soap after using the bathroom.
may also be found in the feces of some pets, especially those with
diarrhea, and people can become infected if they do not wash their hands
after contact with pets or pet feces. Reptiles, such as turtles, lizards,
and snakes, are particularly likely to harbor Salmonella. Many
chicks and young birds carry Salmonella in their feces. People
should always wash their hands immediately after handling a reptile or
bird, even if the animal is healthy. Adults should also assure that
children wash their hands after handling a reptile or bird, or after
touching its environment.
Quick Tips for Preventing Salmonella
- Cook poultry, ground beef, and eggs thoroughly. Do not eat or drink foods
containing raw eggs, or raw (unpasteurized) milk.
- If you are served undercooked meat, poultry or eggs in a restaurant,
don't hesitate to send it back to the kitchen for further cooking.
- Wash hands, kitchen work surfaces, and utensils with soap and water
immediately after they have been in contact with raw meat or poultry.
- Be particularly careful with foods prepared for infants, the elderly, and
- Wash hands with soap after handling reptiles, birds, or baby chicks, and
after contact with pet feces.
- Avoid direct or even indirect contact between reptiles (turtles, iguanas,
other lizards, snakes) and infants or immunocompromised persons.
- Don't work with raw poultry or meat, and an infant (e.g., feed, change
diaper) at the same time.
- Mother's milk is the safest food for young infants. Breastfeeding
prevents salmonellosis and many other health problems.
More About Prevention
There is no vaccine to prevent salmonellosis. Because foods of animal
origin may be contaminated with Salmonella, people should not eat
raw or undercooked eggs, poultry, or meat. Raw eggs may be unrecognized in
some foods, such as homemade Hollandaise sauce, Caesar and other homemade
salad dressings, tiramisu, homemade ice cream, homemade mayonnaise, cookie
dough, and frostings. Poultry and meat, including hamburgers, should be
well-cooked, not pink in the middle. Persons also should not consume raw or
unpasteurized milk or other dairy products. Produce should be thoroughly
Cross-contamination of foods should be avoided. Uncooked meats should be
kept separate from produce, cooked foods, and ready-to-eat foods. Hands,
cutting boards, counters, knives, and other utensils should be washed
thoroughly after touching uncooked foods. Hand should be washed before
handling food, and between handling different food items.
People who have salmonellosis should not prepare food or pour water for
others until their diarrhea has resolved. Many health departments require
that restaurant workers with Salmonella infection have a stool
test showing that they are no longer carrying the Salmonella
bacterium before they return to work.
People should wash their hands after contact with animal feces. Because
reptiles are particularly likely to have Salmonella, and it can
contaminate their skin, everyone should immediately wash their hands after
handling reptiles. Reptiles (including turtles) are not appropriate pets
for small children and should not be in the same house as an infant. Salmonella carried in the intestines of chicks and ducklings
contaminates their environment and the entire surface of the animal.
Children can be exposed to the bacteria by simply holding, cuddling, or
kissing the birds. Children should not handle baby chicks or other young
birds. Everyone should immediately wash their hands after touching birds,
including baby chicks and ducklings, or their environment.
Some prevention steps occur every day without you thinking about it.
Pasteurization of milk and treatment of municipal water supplies are highly
effective prevention measures that have been in place for decades. In the
1970s, small pet turtles were a common source of salmonellosis in the
United States, so in 1975, the sale of small turtles was banned in this
country. However, in 2008, they were still being sold, and cases of Salmonella associated with pet turtles have been reported.
Improvements in farm animal hygiene, in slaughter plant practices, and in
vegetable and fruit harvesting and packing operations may help prevent
salmonellosis caused by contaminated foods. Better education of food
industry workers in basic food safety and restaurant inspection procedures
may prevent cross-contamination and other food handling errors that can
lead to outbreaks. Wider use of pasteurized egg in restaurants, hospitals,
and nursing homes is an important prevention measure. In the future,
irradiation or other treatments may greatly reduce contamination of raw
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