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Salmonella

What is Salmonella?
Salmonella is a bacteria infection. 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. The elderly, infants, and those with impaired immune systems are more likely to have a severe illness.

How is a Salmonella infection 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 stool of an infected person. Once Salmonella has been identified, further testing can determine its specific type.

How can Salmonella infections be treated?
Salmonella infections usually go away within 5-7 days and often do not require treatment other than drinking fluids. Antibiotics are not usually necessary unless the infection spreads from the intestines.

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 normal. A small number of persons with Salmonella develop pain in their joints, irritation of the eyes, and painful urination. It can last for months or years, and can lead to chronic arthritis which is difficult to treat.

How do people get 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 any food, including vegetables, may become contaminated. Thorough cooking kills Salmonella. Food may also become contaminated by the hands of an infected food handler who did not wash hands with soap after using the bathroom.

What can a person do to prevent this illness?
Because 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 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. All fresh produce should be thoroughly washed.

Uncooked meats should be kept separate from produce, cooked foods, and ready-to-eat foods. Hands, cutting boards, counters, knives, and other utensils should be washed thoroughly after touching uncooked foods. Hand should be washed before handling food, and between handling different food items. People who have salmonellosis should not prepare food or pour water for others until their diarrhea has resolved. Many health departments require that restaurant workers with Salmonella infection have a stool test showing that they are no longer carrying the Salmonella bacterium before they return to work.

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 thirty 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.

What else can be done to prevent salmonellosis?
Some prevention steps occur everyday without you thinking about it. Pasteurization of milk and treatment of municipal water supplies are highly effective prevention measures that have been in place for decades. Improvements in farm animal hygiene, in slaughter plant practices, and in vegetable and fruit harvesting and packing operations may help prevent salmonellas 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.

What can I do to prevent salmonellosis?

  • Cook poultry, ground beef, and eggs thoroughly. 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, birds, or baby chicks, and 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. Breastfeeding prevents salmonellosis and many other health problems.