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].

• 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]

• Diarrhea

  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]

  That is to say, diarrhea, vomiting, nausea, headaches, fever and abdominal cramps. Salmonellosis typically occurs between 12-36 hours after exposure to the bacteria. Diarrhea is often the first sign, with the other symptoms manifesting soon after. [sickontheroad.com]

  Most people with salmonellosis develop diarrhea, fever, vomiting, and abdominal cramps 12 to 72 hours after infection. Diarrhea is often watery and non-bloody but may be mucoid and bloody. [en.wikipedia.org]

• 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]

  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]

  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]

  Frequent diarrhoea and vomiting may drain the body of fluids, salts and minerals. Dehydration occurs when the patient loses more liquid than they can take in. [netdoctor.co.uk]

• Abdominal Cramps

  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 [myfearlesskitchen.com]

  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]

  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. [web.archive.org]

• 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]

  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]

  That is to say, diarrhea, vomiting, nausea, headaches, fever and abdominal cramps. Salmonellosis typically occurs between 12-36 hours after exposure to the bacteria. Diarrhea is often the first sign, with the other symptoms manifesting soon after. [sickontheroad.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]

  Contaminated food can cause many common symptoms, including nausea, vomiting, diarrhea and abdominal cramps. [brownchiari.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]

  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]

  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]

  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]

• 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]

• Headache

  The fever may be as high as 103 to 104 F (39 to 40 C) and may be accompanied by stomach pains, headache, weakness or loss of appetite. In some cases, patients have a rash of flat, light red spots. The only way to confirm a S. [pritzkerlaw.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]

  I have now been ill for almost 1 month first 2 weeks having diarrhoea, headaches,... Just want to note that this accommodation is also the Carribean Village Agador. [tripadvisor.co.uk]

  That is to say, diarrhea, vomiting, nausea, headaches, fever and abdominal cramps. Salmonellosis typically occurs between 12-36 hours after exposure to the bacteria. Diarrhea is often the first sign, with the other symptoms manifesting soon after. [sickontheroad.com]

  Headaches. Stomach cramps. Nausea and vomiting. Fever. In the case of less serious infections, there are fewer symptoms – usually only diarrhoea two or three times a day for a couple of days. [netdoctor.co.uk]

• 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]

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].

1. Park K. Park's Textbook of Preventive and Social Medicine. 21st ed. M/S Banarsidas Bhanot; Jabalpur. 2011; Food poisoning; pp. 216–218.
2. 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
3. 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.
4. WHO. World Health Organization, Geneva: Foodborne Disease Outbreaks: Guidelines for Investigation and Control. 2008.
5. 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.
6. Wittler RR, Bass JW. Nontyphoidal Salmonella enteric infections and bacteremia. Pediatr Infect Dis J 1989;8:364–367.
7. Humphries RM, Linscott AJ. Laboratory Diagnosis of bacterial gastroenteritis. Clin. Microbiol. Rev. January 2015 January; 28: 13-31
8. CLSI. Performance standards for antimicrobial susceptibility testing; twenty-fourth informational supplement, M100 S24. Clinical and Laboratory Standards Institute, Wayne, PA. 2014.