Salmonella
Salmonella is a
genus of rod-shaped bacteria.
More than 1,500
species have been identified, usually isolated from the intestinal tract of
humans and animals. Salmonella
organisms are responsible for human
gastrointestinal tract diseases known as salmonelloses, which range from fairly mild attacks of fever,
diarrhea, vomiting, and abdominal cramps to life-threatening illness if the
bacteria cause excessive dehydration or spread to other organs.
Outbreaks may occur
from eating meat from animals with strains of Salmonella made resistant by
excessive use of antibiotics in the feed.
Salmonella infections caused by improper food handling or unsanitary
conditions include food poisoning
and typhoid fever. The bacteria have been found often in
chicken and eggs since the late 1980s.
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.
Risks
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 discomfort on urination. This is called Reiter's
syndrome or reactive arthritis and starts a few weeks after the
gastroenteritis. It can last for months or years, and can lead to chronic arthritis
that may be difficult to treat. Antibiotic treatment does not make a difference
in whether or not the person later develops Reiter's syndrome. Salmonella is
rarely fatal; the fatality rate is much less than one percent. It is the very
young, the very old, and the very immunocompromised that are at risk for death.
Detection
The
diagnosis of salmonellosis is confirmed by cultures of stool or blood. In other
words, specimens of blood or faeces 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.
Prevention
In
order to stop the increasing numbers of cases of Salmonella, consumers and
producers must be educated on proper handling and cooking of eggs and other
high-risk foods. Quick reporting and cooperation between all local, state and
federal agencies are critical in identifying outbreaks, so fewer people are
affected once foodborne outbreaks occur.
Cross-contamination
of foods must be avoided. Uncooked eggs, poultry and meats should be kept
separate from produce and ready-to-eat foods. Hands, cutting boards, counters,
knives, and other utensils should be washed thoroughly after handling uncooked
foods. Hands should be washed before handling any food, and between handling
different food items.