Salmonella

Children, especially those under 5, are more likely than adults to get sick from salmonella. Older adults and people with weak immune systems are also more likely to be infected. Other risk factors include:

salmonella

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Salmonella infection is caused by a group of salmonella bacteria called Salmonella. The bacteria are passed from feces of people or animals to other people or animals. Contaminated foods are often animal in origin. They include beef, poultry, seafood, milk, or eggs. However, all foods, including some unwashed fruits and vegetables can become contaminated.

Salmonella typhi is the one type of salmonella that lives only in humans. It is passed only from human to human through contaminated food or water. It tends to cause a serious and life-threatening infection called typhoid fever. Treatment often needs antibiotics. A small number of people who are treated may feel better after treatment, but will continue to carry the organism and pass it through their feces to others through contaminated food or water.

Since foods of animal origin pose the greatest threat of salmonella contamination, do not eat raw or undercooked eggs, poultry, seafood, or meats. Remember that some sauces and desserts use raw eggs in their preparation, so be cautious of these, particularly in foreign countries. Also, follow these recommendations by the CDC:

Person-to-person transmission of salmonella occurs when an infected person's feces, unwashed from his or her hands, contaminates food during preparation or comes into direct contact with another person. Salmonella can also be acquired directly from animals such as pets, birds, fish, dogs, cats and turtles. The U.S. Food and Drug Administration banned the sale of turtles smaller than 4 inches wide in 1975 to prevent the spread of salmonella.

Symptoms may include headache, muscle aches, diarrhea, vomiting, abdominal cramping, chills, fever, nausea and dehydration. Symptoms usually appear six to 72 hours after ingestion of the bacteria, but can be longer if fewer organisms are ingested. Persons can be infected with the bacteria without having symptoms. Persons with and without symptoms shed the bacteria in their stool, which is why proper handwashing after toileting and before handling food is so important. Children younger than 1 year old, people who have had ulcer surgery or take antacids and those with weakened immune systems are most susceptible to salmonella infection.

Salmonellosis is seldom fatal (the fatality rate is less than 1 percent). Two or three weeks after being infected with salmonella, one in 10,000 cases develops reactive arthritis or Reiter's syndrome as a complication. These patients also may develop an inflammation of the urethra and eyes.

Defrost frozen food in the refrigerator or microwave. Refrigerator temperatures should be kept colder than 40 degrees. Rinse poultry in cold water before cooking. Avoid raw milk, raw hamburger meat and raw eggs (many recipes, such as those for homemade ice cream, call for eggs with no subsequent cooking; substitute pasteurized eggs in these recipes). Food contaminated with salmonella may look, smell and taste normal.

Because fruits and vegetables have now been identified as a source of salmonella, it is important that these food items be thoroughly washed in running water before they are eaten.Wash utensils and wooden cutting boards thoroughly with hot, soapy water. Salmonella may lie dormant for a year or more and then "wake up" when food is present. They also may live in the cut marks on a wooden cutting board. Use an acrylic board that can go in the dishwasher. If using a wooden board, rub down or spray the board with a solution of one ounce bleach to one gallon water and allow to air dry. Cutting boards for raw meat and poultry should not be used for cheese, raw vegetables and other foods that will not be cooked before being served.

Salmonella bacteria are best known for being a cause of diarrhea. This type of illness, called gastroenteritis, typically happens after eating food that has been contaminated with salmonella.

If your child only has salmonella-associated diarrhea, the treatment is supportive (fluids and rest). Antibiotics are not prescribed as they do not make your child get better faster and actually may increase the length of time your child has Salmonella in the stool. An exception is infants under 3 months of age, because they have an increased risk of the infection spreading from the intestine to the blood and other organs in the body. However, when the infection is found in the blood, brain, bone or other organs, antibiotics are needed.

If your child has a problem with their immune system: Avoid reptiles used as pets, such as lizards and snakes. Children with sickle cell anemia are at risk for salmonella infection of the bones. Parents of these children should avoid having reptiles and amphibians as pets.

Salmonella germs are common in uncooked food products from animals, such as eggs, egg products, meat, meat products, poultry, unpasteurized milk and other unpasteurized dairy products. However, thorough cooking and processing will kill the germ. Salmonella can be in any type of food if salmonella germs get on the food. A food handler with salmonella may get germs on the food if his or her hands are not washed thoroughly before preparing food.

Your doctor, nurse or health center must send your stool sample to a laboratory. The laboratory then grows germs and tests them to see if any of the germs are salmonella. It takes the lab several days to do this test.

Certain bacteria in the group Salmonella cause salmonella food poisoning. These bacteria live in the intestines of humans and animals. Human infection results when food or water that has been contaminated with infected feces is ingested.

Eating food or drinking any liquid contaminated with certain species of Salmonella bacteria causes salmonella food poisoning. People are usually infected by eating raw foods or prepared foods that have been handled by others.

To diagnose salmonella food poisoning, your doctor will do a physical examination. They may check if your abdomen is tender. They may look for a rash with small pink dots on your skin. If these dots are accompanied by a high fever, they may indicate a serious form of salmonella infection called typhoid fever.

The main treatment for salmonella food poisoning is replacing fluids and electrolytes that you lose when you have diarrhea. Adults should drink water or suck on ice cubes. Your pediatrician may suggest rehydration drinks such as Pedialyte for children.

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People infected with salmonella usually get better on their own and do not need any treatment other than fluids to prevent dehydration. People with more serious infections may require hospitalization or antibiotics prescribed by a doctor.

People and domestic animals have become infected through contact with infected songbirds. Carrier animals are chronically infected and may shed salmonella intermittently into the environment.

Early treatment is essential for septicemic salmonellosis, but there is controversy regarding the use of drugs for intestinal salmonella. Oral administration of antimicrobials may alter the protective natural gut flora.

Survival of Salmonella in slurry is temperature, oxygen, and pH dependent. Aerobic storage, low pH and high temperatures in the summer all decrease salmonella survival. Salmonella spread onto fields in manure may survive for weeks to months. Manure should be spread onto flat land, where it is exposed to the drying effects of wind and to the bactericidal effect of UV irradiation from the sun. Incorporate manure into soil in areas where runoff could be a problem. Manure should be spread onto cropland rather than onto pastures used for grazing. Recent investigations demonstrate manure disposal by composting and anaerobic digestion reduce organism numbers.

The Salmonella infection cycle starts after the ingestion of microbes. Through the stomach, the bacteria reach the small intestine. Infection with salmonellae is characterized by attachment of the bacteria by fimbriae or pili to cells lining the intestinal lumen. Salmonellae selectively attach to specialized epithelial cells (M cells) of the Peyer patches. The bacteria are then internalized by receptor-mediated endocytosis and transported within phagosomes to the lamina propria, where they are released. Once there, salmonellae induce an influx of macrophages (typhoidal strains) or neutrophils (nontyphoidal strains).

The Vi antigen of S typhi is important in preventing antibody-mediated opsonization and complement-mediated lysis. Through the induction of cytokine release and via mononuclear cell migration, S typhi organisms spread through the reticuloendothelial system, mainly to the liver, spleen, and bone marrow. Within 14 days, the bacteria appear in the bloodstream, facilitating secondary metastatic foci (eg, splenic abscess, endocarditis). In some patients, gallbladder infection leads to long-term carriage of S typhi or S paratyphi in bile and secretion to the stool. [8] As a rule, infection with nontyphoidal salmonellae generally precipitates a localized response, while S typhi and other especially virulent strains invade deeper tissues via lymphatics and capillaries and elicit a major immune response.

Virulence factors of salmonellae are complex and encoded both on the organism's chromosome and on large (34-120 kd) plasmids. Some areas of active investigation include the means by which salmonellae attach to and invade the intestine, survive within phagosomes, effect a massive efflux of electrolytes and water into the intestinal lumen, and develop drug resistance. Several Salmonella pathogenicity islands have been identified that mediate uptake of the bacteria into epithelial cells (type III secretion system [TTSS]), nonphagocytic cell invasion (Salmonella pathogenicity-island 1 [SPI-1]), and survival and replication within macrophages (Salmonella pathogenicity-island 2 [SPI-2], phoP/phoQ). 041b061a72