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Frequently Asked Questions
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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