Salmonella Food Poisoning
Salmonellosis
Salmonella food poisoning follows consumption of food contaminated with the Salmonella typhimurium, Salmonella choleraesuis, Salmonella enteritidis and other bacteria belonging to the Salmonella family. It is the most common cause of foodborne sporadic outbreaks and accounts for a majority of all non-typhoidal Salmonella infections.
Presentation
Salmonella food poisoning (SFP) is a non-typhoidal infection typically caused by Salmonella typhimurium, Salmonella choleraesuis, Salmonella enteritidis and other serotypes of the gram-negative bacteria, Salmonella [1]. The condition follows consumption of contaminated eggs, beef, poultry, milk, fish, vegetables, fruits and processed foods [2] [3] or consumption of food prepared by infected kitchen staff or due to unhygienic contamination from infected animal or human feces [4]. It is the most important cause of mortality amongst foodborne bacterial illnesses.
The symptoms typically appear within 6 hours to 4 days of consumption of contaminated food and are characterized by sudden onset of nausea, vomiting, bloody diarrhea, headaches, fever, and abdominal cramps. The symptoms can last for up to 7 days and are usually self-limiting but some patients may develop severe diarrhea and consequent dehydration requiring hospitalization. Infants, young children less than 2 years of age and the elderly are especially susceptible to severe dehydration. Severe, life- threatening extra-intestinal involvement like bacteremia, meningitis, septic arthritis, and osteomyelitis may occur in a small number of cases [5] [6].
Entire Body System
Fever
- Two nosological groups should be distinguished: typhoid fever due to S. typhi and S. paratyphi A, B and C, and salmonelloses themselves. Summary Clinical description The germ reservoir for typhoid fever is solely human.[orpha.net]
- The term salmonellosis has been used generally for two main kinds of gastrointestinal diseases in humans: enteric fevers (including typhoid and paratyphoid fever s) and gastroenteritis.[britannica.com]
- Can I Sue for Typhoid Fever from Food Poisoning with Salmonella Typhi? Yes, if the case of typhoid fever can be linked to a restaurant, retailer or food company.[pritzkerlaw.com]
- Diarrhea Abdominal Cramps Fever of 100 F to 102 F Additional symptoms: Bloody diarrhea Vomiting Headache Body Aches Typhoid Fever Symptoms: Symptoms of typhoid fever appear between 8 and 14 days after eating contaminated food and last anywhere from 3[foodborneillness.com]
Rigor
- Notably, WA doesn't follow the same rigorous standard for food safety training as many of the eastern states (New South Wales, Queensland, Victoria, ACT) where Food Safety Supervisor training is mandatory.[foodsafety.com.au]
Gastrointestinal
Diarrhea
- The symptoms can last for up to 7 days and are usually self-limiting but some patients may develop severe diarrhea and consequent dehydration requiring hospitalization.[symptoma.com]
- In one incident, two siblings aged 11 and 13 years with diarrhea and abdominal cramping visited an ED. No stool specimens were collected from the children.[web.archive.org]
- Persons with severe diarrhea may require rehydration, often with intravenous fluids.[web.archive.org]
- Symptoms vary but usually include weakness, prostration, fever, and diarrhea. Pregnant animals may abort. Convulsions may occur in cattle. S. typhimurium causes disease in horses, cattle, and sheep.[britannica.com]
Vomiting
- Bakery shut down after NSW Health reports dozens at St George and Sutherland hospitals with vomiting, fever and cramps NSW Health says investigations into the source of the food poisoning are under way.[theguardian.com]
- Food poisoning symptoms include: Nausea Vomiting Diarrhea Abdominal cramps Food poisoning can be mild, but also can become severe and require medical attention.[joebornstein.com]
- Vomiting is not always present in cases of salmonellosis. In rare cases of invasive infection, the symptoms can become much more severe – for example, if the infection gets into the blood.[sickontheroad.com]
- The onset of the disease is sudden and sometimes severe, producing nausea, vomiting, watery diarrhea with blood and mucus, prostration, and slight fever. In most cases recovery occurs within a few days and is followed by varying degrees of immunity.[britannica.com]
- The symptoms typically appear within 6 hours to 4 days of consumption of contaminated food and are characterized by sudden onset of nausea, vomiting, bloody diarrhea, headaches, fever, and abdominal cramps.[symptoma.com]
Abdominal Cramps
- The symptoms typically appear within 6 hours to 4 days of consumption of contaminated food and are characterized by sudden onset of nausea, vomiting, bloody diarrhea, headaches, fever, and abdominal cramps.[symptoma.com]
- Call a doctor if anyone in your family has abdominal cramps, diarrhea, or a fever that you think might be related to food poisoning. Related[agricultured.org]
- The most common symptoms include diarrhea, abdominal cramps, and fever. Typical Symptoms of Salmonella infection: Appear 6 to 72 hours after eating contaminated food and last for 3 to 7 days without treatment.[foodborneillness.com]
Nausea
- The onset of the disease is sudden and sometimes severe, producing nausea, vomiting, watery diarrhea with blood and mucus, prostration, and slight fever. In most cases recovery occurs within a few days and is followed by varying degrees of immunity.[britannica.com]
- The symptoms typically appear within 6 hours to 4 days of consumption of contaminated food and are characterized by sudden onset of nausea, vomiting, bloody diarrhea, headaches, fever, and abdominal cramps.[symptoma.com]
- Salmonella symptoms include diarrhoea, vomiting, fever, nausea, headache and stomach cramps and can start between six to 72 hours after the bacteria is ingested. Investigations into the source of the food poisoning were continuing, NSW Health said.[theguardian.com]
- Symptoms of Food poisoning are: Abdominal pain and cramps Diarrhea at times bloody diarrhea Fever Nausea and vomiting Dehydration in children Central Nervous System involvement in children Diagnosing the cause for a specific line of treatment is essential[avignadiagnostics.com]
- Food poisoning symptoms include: Nausea Vomiting Diarrhea Abdominal cramps Food poisoning can be mild, but also can become severe and require medical attention.[joebornstein.com]
Abdominal Pain
- Initial signs are usually abdominal pain, anorexia, meteorism, insomnia and fever that progressively climbs to 40 C within 4 to 7 days. Secondary signs, including prostration and hypertension, are a result of endotoxin releasing.[orpha.net]
- Symptoms of Food poisoning are: Abdominal pain and cramps Diarrhea at times bloody diarrhea Fever Nausea and vomiting Dehydration in children Central Nervous System involvement in children Diagnosing the cause for a specific line of treatment is essential[avignadiagnostics.com]
- Salmonella food poisoning or salmonellosis is a common bacterial infection of the intestinal tract which causes diarrhea and abdominal pain. Salmonella spreads through contaminated food and water .[steadyhealth.com]
- The symptoms of Salmonella infection usually appear 12–72 hours after infection, and include fever, abdominal pain, diarrhoea, nausea and sometimes vomiting. The illness usually lasts 4–7 days, and most people recover without treatment.[web.archive.org]
- During this time, the patient may experience high fever, severe weakness, malaise, abdominal pain, nosebleeds or even enlargement of vital organs of the body. This variant of the Salmonella is quite serious and needs immediate medical attention.[epainassist.com]
Cardiovascular
Tachycardia
- Physical examination can be non-specific but may reveal features of dehydration like tachycardia, dry mucous membranes, tenting of skin, and hypotension especially in patients with severe diarrhea.[symptoma.com]
Musculoskeletal
Back Pain
- Low back pain is common and is often secondary to inflammatory sacroiliitis. Conjunctivitis is frequently mild, transient and easily missed. Iritis is characteristic of more persistent and chronic disease.[aafp.org]
Neurologic
Screaming
- The sick toddler, now 20-months-old, spent most of the plane journey home screaming with a high temperature and Joanne was too ill to look after her distressed grandson.[chroniclelive.co.uk]
Urogenital
Oliguria
- Oliguria and azotemia develop in severe cases as a result of renal involvement due to hypoxia and toxemia. Salmonellosis is associated with later irritable bowel syndrome and inflammatory bowel disease.[en.wikipedia.org]
Workup
The workup of a patient with SFP begins with a thorough history regarding the onset, duration, and progress of symptoms with information about sources of prior food consumption. Physical examination can be non-specific but may reveal features of dehydration like tachycardia, dry mucous membranes, tenting of skin, and hypotension especially in patients with severe diarrhea. A complete blood count, serum electrolytes, blood urea nitrogen (BUN) and creatinine levels help to identify the level of dehydration. In severe dehydration, there may be hyponatremic hypochloremic metabolic acidosis with an anion gap and elevated serum BUN and creatinine levels indicative of acute renal dysfunction. The diagnosis can be confirmed by isolating the organism from stools. Staining of stools with methylene blue can show white blood cells (WBCs) which are present in inflammatory bowel disease but not in invasive disease. Stools should also be tested for ova and parasites. Bacterial stool culture with antibiotic sensitivity testing is performed in all cases which have WBCs in the stools. If cultures are negative, then blood cultures are ordered and the result may be positive in cases of bacteremia.
Local public health officials are notified when an outbreak is suspected and they will collect feces, food, or vomitus for testing at their laboratories [7]. Fecal cultures are done on specific culture media to ensure detection of enteropathogens. The Clinical and Laboratory Standards Institute (CLSI) provides current standards for susceptibility testing conditions and criteria for interpretation of results of E. coli, E. tarda, Salmonella, Shigella, and Yersinia spp. [8].
Microbiology
Pseudomonas
- Achieving 100% typeability of Pseudomonas aeruginosa from patients with recurrent Gram negative bacteremia. Diagn. Microbiol. Infect. Dis., 25, 1-8. [ Links ] 16. Schwartz, D.C.; Cantor, C.R. (1984).[scielo.br]
Treatment
- Management and treatment Treatment includes isolation and antibiotic therapy. Vaccination is partially effective against S. typhi and S. paratyphi A and B (50-75% of immunized patients are protected).[orpha.net]
- Treatment In most cases, Salmonellosis lasts no longer than a week, and no treatment is needed other than aggressive rehydration. Oral Rehydration Salts play an important role here.[sickontheroad.com]
- Salmonella Treatment Salmonella infections generally last 3 to 7 days, and often do not require treatment. People with severe dehydration may need rehydration through an IV.[foodborneillness.com]
Prognosis
- The prognosis is usually good, unless severe underlying disease is present. Asymptomatic carriage is usually self-limited, and antibiotic treatment is rarely required.[merckmanuals.com]
Etiology
- View/Print Table TABLE 3 Etiologic Organisms in Reactive Arthritis Chlamydia trachomatis Salmonella enteritidis Salmonella typhimurium Shigella flexneri Shigella dysenteriae Campylobacter jejuni Yersinia enterocolitica Clostridia difficile TABLE 3 Etiologic[aafp.org]
- Real-time PCR demonstrates Ancylostoma duodenale is a key factor in the etiology of severe anemia and iron deficiency in Malawian pre-school children. PLoS Negl Trop Dis. 2012; 6 :e1555. [ PMC free article ] [ PubMed ] [ Google Scholar ] 83.[ncbi.nlm.nih.gov]
Epidemiology
- Links: epidemiology\transmission pathogenesis clinical course investigations and diagnosis differential diagnosis treatment of salmonellosis prevention salmonella infection in HIV infected individuals enteric fevers[gpnotebook.co.uk]
- Epidemiology of salmonellosis (1 C, 3 F) A Animal salmonella infections (7 F) T Typhoid fever (4 C, 1 P, 56 F) Media in category "Salmonellosis" The following 19 files are in this category, out of 19 total.[commons.wikimedia.org]
- Associate Professor Martyn Kirk from the ANU's National Centre for Epidemiology and Population Health said outbreaks like that are preventable.[abc.net.au]
- Epidemiology of salmonellosis (1 C, 3 F) A Animal salmonella infections (7 F) T Typhoid fever (4 C, 1 P, 56 F) File nella categoria "Salmonellosis" Questa categoria contiene 19 file, indicati di seguito, su un totale di 19.[commons.wikimedia.org]
- “Epidemiological evidence from investigations of identified localised outbreaks and a large case-control study of community cases indicates that eating raw or runny eggs is a significant cause of illness.[thewest.com.au]
Prevention
- 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.[web.archive.org]
- Despite declining trends, salmonellosis continues to be an important cause of preventable death especially among selected subgroups, underscoring the need for expanded prevention efforts.[doi.org]
- This differs from other Salmonella isolates reported to the Centers for Disease Control and Prevention in 1994, of which 14% were from infants and 49% from male patients.[ncbi.nlm.nih.gov]
- Twenty-six (81%) of 32 patients were infants ( Salmonella isolates reported to the Centers for Disease Control and Prevention in 1994, of which 14% were from infants and 49% from male patients.[doi.org]
References
Article
- Park K. Park's Textbook of Preventive and Social Medicine. 21st ed. M/S Banarsidas Bhanot; Jabalpur. 2011; Food poisoning; pp. 216–218.
- EFSA Report: analysis of the baseline survey on the prevalence of Campylobacter in broiler batches and of Campylobacter and Salmonella on broiler carcasses in the EU, 2008. Part B: analysis of factors associated with Salmonella contamination of broiler carcasses. EFSA Journal. 2011; 9(2) doi.org/10.2903/j.efsa.2011.2017
- EFSA (2010) The community summary report on trends and sources of zoonoses, zoonotic agents and food-borne outbreaks in the European Union in 2008. EFSA Journal. 2008; 8: 1496.
- WHO. World Health Organization, Geneva: Foodborne Disease Outbreaks: Guidelines for Investigation and Control. 2008.
- Sirinavin S, Jayanetra P, Lolekha S, Layangkul T. Predictors for extraintestinal infection in Salmonella enteritis in Thailand. Pediatr Infect Dis J 1988;7:44–48.
- Wittler RR, Bass JW. Nontyphoidal Salmonella enteric infections and bacteremia. Pediatr Infect Dis J 1989;8:364–367.
- Humphries RM, Linscott AJ. Laboratory Diagnosis of bacterial gastroenteritis. Clin. Microbiol. Rev. January 2015 January; 28: 13-31
- CLSI. Performance standards for antimicrobial susceptibility testing; twenty-fourth informational supplement, M100 S24. Clinical and Laboratory Standards Institute, Wayne, PA. 2014.