Salmonellosis 

 

      Source: CDC PHIL

 

What is salmonellosis?

Salmonellosis is an infection caused by the Salmonella bacteria. Persons infected with Salmonella may develop diarrhea, fever, and abdominal cramps 12 to 72 hours after becoming infected. 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 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. These tests are sometimes not performed unless the laboratory is instructed specifically to look for the organism. Once Salmonella has been identified, further testing can determine its specific type, and which antibiotics could be used to treat it.

 

How can Salmonella infections be treated?

Salmonella infections usually resolve in 5-7 days and often do not require treatment unless the patient becomes severely dehydrated or the infection spreads from the intestines. Persons with severe diarrhea may require rehydration, often with intravenous fluids. Antibiotics are not usually necessary unless the infection spreads from the intestines, then it can be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin. Unfortunately, some Salmonella bacteria have become resistant to antibiotics, largely as a result of the use of antibiotics to promote the growth of feed animals.

 

How do people catch Salmonella?

Salmonella bacteria 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 all foods, including vegetables can become contaminated. Many raw foods of animal origin are frequently contaminated, but fortunately, thorough cooking kills Salmonella. Food may also become contaminated by the unwashed hands of an infected food handler, who forgot to wash his or her hands with soap after using the bathroom.

Salmonella 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 these feces. Reptiles are particularly likely to harbor Salmonella and people should always wash their hands immediately after handling a reptile, even if the reptile is healthy. Adults should also be careful that children wash their hands after handling a reptile.

 

What can a person do to prevent this illness?

There is no vaccine to prevent salmonellosis. Since foods of animal origin may be contaminated with Salmonella, people should not eat raw or undercooked eggs, poultry, or meat. 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 washed before consuming.

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 handling uncooked foods. Hand should be washed before handling any food, and between handling different food items.

People who have salmonellosis should not prepare food or pour water for others until they have been shown to no longer be carrying the Salmonella bacterium.

People should wash their hands after contact with animal feces. Since reptiles are particularly likely to have Salmonella, 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.

 

Ways to prevent Salmonella infection:

  • Cook poultry, ground beef, and eggs thoroughly before eating.
  • 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 the immunocompromised. 
  • Wash hands with soap after handling reptiles or birds, or 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. Breast-feeding prevents salmonellosis and many other health problems.
  • Persons with diarrheal illness should not attend work if they are a food handler, childcare worker, or healthcare worker with direct patient contact.
  • Children with diarrheal illness should be excluded from childcare.
  • Persons who test positive for Salmonella and who work as a food handler, childcare worker, or healthcare worker are required to submit two negative stool cultures at least 24 hours apart before returning to work.