Salmonella

Salmonella

Salmonella is a prokaryotic, rod shaped, bacterial organism. It is nonsporeforming and Gram-negative.(1) Salmonella is responsible for almost 60 percent of reported cases of bacterial food borne illness and 40 percent of all food borne illness of any kind. Salmonella survives digestion and reproduces in the small intestine, making people sick. Salmonella has hundreds of different types, all of which cause much the same illness in humans. Eating food containing live salmonella bacteria causes salmonellosis. (2)

Anyone can get Salmonella, but it is most common in children under 5 (and in the elderly). Millions of cases occur each year in the United States, and at least half of them are in children. Salmonella is found in almost all kitchens. Thankfully, proper food handling, cooking, and cleaning will reliably kill the Salmonella bacteria. Eating raw or undercooked eggs, poultry, or red meat is a common cause of infection. So is cross contamination from uncooked poultry or red meat in the kitchen. Contamination can also come from animal products or infected people involved in food preparation. Children can also get sick from drinking raw milk (unpasteurized milk) or from eating unwashed fruits or vegetables. Poultry, livestock, amphibians, and reptiles can carry Salmonella. Children can get sick from playing with or handling these animals if the bacteria get in the children's mouths. Drinking contaminated water is a major source of Salmonella worldwide, and is one of the reasons that a clean water supply is so important. (2) Samonellosis symptoms include diarrhea, fever, abdominal cramps, chills, headache and vomiting. (1) The onset of symptoms usually occurs within 6 to 72 hours after the ingestion of the bacteria. The infectious dose is small, probably from 15 to 20 cells. (3) Most commonly, Salmonella causes gastroenteritis with cramping, diarrhea, abdominal tenderness, vomiting, and fever. The diarrhea is usually watery, but may contain blood or mucus. Some children get very sick, with high fevers, headaches, confusion, and sometimes even seizures. Salmonella can cause enteric fever (typhoid fever). Some children have a salmon-colored rash (rose spots). When Salmonella bacteria get into the bloodstream, they can travel and cause infection throughout the body. Children with sickle cell disease, HIV, and certain other causes of anemia are among those at risk for complications from Salmonella. Salmonella can be spread from person to person by the fecal-oral route. Salmonella symptoms usually begin about 24 hours after exposure (from 6 to 72 hours). Enteric fever can occur up to 60 days after exposure. The symptoms usually go away within a week in otherwise healthy children. (2) It is estimated that from 2 to 4 million cases of salmonellosis occur in the U.S. annually. (4)

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 which

identify Salmonella in the stool of an infected person. (1) Other tests, such as blood tests or spinal fluid tests may be performed if there is reason to suspect that Salmonella is there. Salmonella may be suspected based on the history and physical exam. (2) Salmonella bacteria is discovered in stool cultures. Although blood cultures are rarely positive, bacteremia does occur in 5% of adults with Salmonella gastroenteritis and can result in hematogenous spread to the heart (endocarditis), spleen, bone (osteomyelitis), and joints (reactive arthritis). (3) Salmonella infections usually resolve in 5-7 days and often do not require treatment unless the patient becomes severely dehydrated or the infection spreads into the bloodstream. Persons with severe diarrhea may require intravenous fluids. Antibiotics are not usually recommended, unless the infection spreads from the intestines to the bloodstream. (1) Treatment of Salmonella should be managed by a physician. Most otherwise healthy children do not benefit from antibiotics used to treat Salmonella, but for some children and