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What is salmonellosis?
Salmonellosis is an infection with a bacteria called Salmonella.
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.
What sort of germ is Salmonella?
The Salmonella germ is actually a group of bacteria that can cause
diarrheal illness in humans. They are microscopic living creatures
that pass from the feces of people or animals, to other people or
other animals. There are many different kinds of Salmonella
bacteria. Salmonella serotype Typhimurium and Salmonella serotype
Enteritidis are the most common in the United States. Salmonella has
been known to cause illness for over 100 years. They were discovered
by a American scientist named Salmon, for whom they are named.
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
stools 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.
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 who are infected with Salmonella, will go on
to develop pains 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 later develops arthritis.
How do people catch Salmonella?
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 all foods,
including vegetables may 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. 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 washed before
consuming.
Cross-contamination of foods should be avoided. Uncooked meats
should be keep 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.
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 thity or more times
greater. Salmonellosis is more common in the summer than winter.
Children are the most likely to get salmonellosis. Young children,
the elderly, and the immunocompromised are the most likely to have
severe infections. It is estimated that approximately 600 persons
die each year with acute salmonellosis.
What else can be done to prevent salmonellosis?
It is important for the public health department to know about cases
of salmonellosis. It is important for clinical laboratories to send
isolates of Salmonella to the City, County, or State Public Health
Laboratories so the specific type can be determined and compared
with other Salmonella in the community. If many cases occur at the
same time, it may mean that a restaurant, food or water supply has a
problem which needs correction by the public health department.
Some prevention steps occur everyday without you thinking about it.
Pasteurization of milk and treating municipal water supplies are
highly effective prevention measures that have been in place for
many years. In the 1970s, small pet turtles were a common source of
salmonellosis in the United States, and in 1975, the sale of small
turtles was halted in this country. 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 meat.
What is the government doing about salmonellosis?
The Centers for Disease Control and Prevention (CDC) monitors the
frequency of Salmonella infections in the country and assists the
local and State Health Departments to investigate outbreaks and
devise control measures. CDC also conducts research to better
identify specific types of Salmonella. The Food and Drug
Administration inspects imported foods, milk pasteurization plants,
promotes better food preparation techniques in restaurants and food
processing plants, and regulates the sale of turtles. The FDA also
regulates the use of specific antibiotics as growth promotants in
food animals. The US Department of Agriculture monitors the health
of food animals, inspects egg pasteurization plants, and is
responsible for the quality of slaughtered and processed meat. The
US Environmental Protection Agency regulates and monitors the safety
of our drinking water supplies.
How can I learn more about this and other public health
problems?
You can discuss any medical concerns you may have with your doctor
or other heath care provider. Your local City or County Health
Department can provide more information about this and other public
health problems that are occurring in your area. General information
about the public health of the nation is published every week in the
"Morbidity and Mortality Weekly Report", by the CDC in Atlanta, GA.
Epidemiologists in your local and State Health Departments are
tracking a number of important public health problems, investigating
special problems that arise, and helping to prevent them from
occurring in the first place, or from spreading if they do occur.
What can I do to prevent salmonellosis?
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.
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