What is Salmonella

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What is Salmonella?

• Salmonella is an infection caused by a
  gram-negative bacillus, a germ of the Salmonella
  genus. Infection with these bacteria may involve
  only the intestinal tract, or may spread from the
  intestines to the blood stream and then to other
  body sites. The source of infection is
  contaminated food or water, or close contact with
  other human beings carrying the infection.

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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.
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How do people catch Salmonella?
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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.
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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.
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What are the symptoms of Salmonella?
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The incubation period for salmonellosis, i.e.
the time in between ingestion and the onset of
the first symptom, may be from 6 hours to 10
days, but usually falls between 6 hours and 48
hours.1 Salmonella causes a gastroenteritis
persons experience diarrhea, often with fever and
abdominal cramps. The onset may be sudden and
there may be nausea and vomiting initially. The
diarrhea often includes mucous and is
occasionally bloody. Infants, the elderly,
immune suppressed persons and persons with sickle
cell anemia are most susceptible to disease and
suffer the most severe symptoms. It is in these
individuals that the organism is most likely to
gain access to the blood stream and possible
persist in sites of the body distant from the
intestine, such as on the aorta or in bone.
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TRANSMISSION

• Salmonella live in the intestinal tracts of
  humans and other animals including birds, and are
  transmitted by the oral-fecal route. This means
  eating foods contaminated with animal feces.
  Contaminated foods usually look and smell normal.
  They are often of animal origin, such as beef,
  poultry, milk, or eggs, but all foods, including
  vegetables may become contaminated.

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• Person-to-person transmission can also
  occur. Individuals who carry Salmonella in their
  intestines may transmit Salmonella to another
  individual if good personal hygiene is not
  followed. For example, an infected food handler
  may transmit the Salmonella bacteria if he/she
  does not wash his/her hands after using the
  bathroom and before handling or preparing food.
  Transmission may also occur by handling pet
  turtles, baby chicks, frogs and snails that
  harbor the Salmonella bacteria.

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How is Salmonella detected?
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The diagnosis of salmonellosis is confirmed by
cultures of stool or blood. In other words,
specimens of blood or feces are placed in
nutrient broth or on agar and incubated for 2-3
days. After that time, a trained microbiologist
can recognize Salmonella bacteria if present by
its unique characteristics. However, blood
cultures are often not performed and in most
cases the blood stream is not infected. In the
stool, the laboratory is challenged to pick out
Salmonella from many other similar bacteria that
are normally present. In addition, many persons
submit cultures after they have started
antibiotics, which may make it even more
difficult for a microbiology lab to grow
Salmonella. So, the diagnosis of salmonellosis
may be problematic and many mild cases are
culture negative.
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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 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.
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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.
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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.
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TREATMENT

• Severe forms of Salmonella infection may require
  hospitalization and isolation from other people.
  Patients with less severe infection and those who
  are recovering may be treated at home.

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Treatment

• 1. Get plenty of rest until fever, diarrhea and
  any other symptoms have been gone for three days.
  
• 2.  Eat five or six small meals daily. Follow a
  progressive diet (clear liquids to full liquids
  to soft foods) as recommended by your provider.
•   3. Use self-care measures such as
  comfortable room temperature and fresh air. You
  may wish to try a hot water bottle for stomach
  cramps.

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Treatment

• 4.  Symptomatic treatment with
  acetaminophen (Tylenol or similar product) for
  pain and fever is usually all that is required.
• 5.   Antibiotics generally are not
  recommended unless the infection has spread from
  the intestines, because such medication can
  prolong rather than reduce the period of
  bacterial shedding in the intestine.

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Treatment

•  6. Individuals usually feel better within 5-7
  days.
• 7. 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. Individuals working with
  food or in a health care facility, or day care
  center must have two negative stool cultures at
  least 72 hours apart before being allowed to
  return to work.