spacer
VNAA - Visiting Nurse Associations of America
VNAA The Voice of Home Healthcare

SALMONELLA
(Salmonellosis)

spacerVisit the Germ Protection Center Archivesspacer
salmonellaOVERVIEW

Salmonellosis or a Salmonella infection is the most frequently reported cause of foodborne illness. It is a bacterial disease manifested by an acute enterocolitis with the sudden onset of headache, fever, abdominal pain, diarrhea, nausea and sometimes vomiting.

The Salmonella germ is actually a group of over 2300 serotypes of Gram negative 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 an American scientist named Dr. Daniel E. Salmon, for whom they are named.

Salmonellosis is the illness that can occur if live Salmonella bacteria enter the body, usually through eating foods containing the bacterium. It is one of the most common bacterial foodborne illnesses, that can be prevented by proper food handling, hand washing and food contact surface cleaning and sanitization.

Every year, approximately 40,000 cases of Salmonellosis are reported in the United States. However, experts believe that anywhere from 696,000 to 3.8 million people contact Salmonellosis each year. 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.

EPIDEMIOLOGY

RESERVOIR
Bacteria can grow on just about any food, such as meat, poultry, seafood, eggs, and dairy products, in particular, as well as vegetables and fruits, such as beans, grains, orange juice, cantaloupe and sprouts. Most types of Salmonella live in the intestinal tracts of animals and birds and are transmitted to humans by contaminated foods of animal origin.

MODE OF TRANSMISSION

Salmonella is transmitted by the fecal-oral route. Eating inadequately cooked or improperly refrigerated poultry, milk, eggs or meats can cause infection. Person-to-person transmission can also occur as individuals who are chronic carriers of the germ may transmit it if good personal hygiene is not followed. Outbreaks of disease have occurred via food contaminated by the unwashed hands of an infected food handler, who forgot to wash their hands with soap and water 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.

TREATMENT

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.

Treat pain and fever with acetaminophen (TYLENOL®) or similar product.

The use of a hot water bottle may help reduce stomach cramps.

Eat 5-6 small meals daily starting with clear liquids and advancing the diet as tolerated.


INCUBATION PERIOD
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.
METHODS OF CONTROL

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 kept separate from produce, cooked foods, and ready-to-eat foods.

Cutting boards, counters, knives, and other utensils should be washed thoroughly and sanitized or disinfected after handling uncooked foods.

Hands 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. This requires that 2-3 consecutive stool cultures collected not less than 24 hours apart are shown to be negative for Salmonella.

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.

The basic premise for control is;

  • CLEAN : Wash Hands and Wash Sanitize Surfaces Often

  • SEPARATE : Don’t Cross-Contaminate

  • COOK : Cook all foods to Proper Temperatures

  • CHILL: Refrigerate Promptly


ADDITIONAL REFERENCES

For more information about reducing the risk of foodborne illness, visit the US Department of Agriculture’s Food Safety and Inspection Service website at:
www.fsis.usda.gov

or the partnership for Food Safety Education at:
www.fightbac.org.

For more advice on cooking ground beef, visit the U.S. Department of Agriculture web site at: www.fsis.usda.gov/oa/topics/gb.htm

Or USDA’s Meat and Poultry Hotline at 1-800-535-4555


The Germ Protection Center is possible thanks to the generous support of Lysol.




Copyright 2007 - Visiting Nurse Associations of America - The Voice of Home Healthcare
www.vnaa.org