Salmonella outbreaks: What do I need to know?
Children under the age of 5 have higher rates of salmonella infection than any other age group. Here's what we can do to help reduce their risk.
A recent article in the Washington Post reported that four people died and 732 people were sick following the ingestion of cucumbers carrying salmonella bacteria. More than half of the people sickened by the salmonella were children, according to the Centers for Disease Control and Prevention.
Last month, the owner of a major peanut distributing company was convicted to spend most, if not all, of the rest of his life in jail for knowingly selling salmonella contaminated peanut butter. His actions led to an outbreak in 2008-2009, which included nine deaths. These two cases highlight the growing controversy around safety of the food chain in the United States as well as the seriousness of salmonella food poisoning.
Salmonella is a ubiquitous bacteria found in fowl, cattle, and reptiles. Because salmonella is not a natural human pathogen, disease follows the ingestion of a large number of bacteria. The most common form of illness caused by salmonella in the United States is a gastrointestinal infection characterized by diarrhea. Most patients are mildly to moderately ill. Dehydration is the most common complication of this form of infection. Infants less than six months of age are at increased risk for spread of the infection beyond the intestines. Meningitis may occur in this age group and is particularly severe. Indications for antibiotic therapy for this condition vary depending on the patient's age and severity of illness.
Enteric fever is a form of salmonellosis characterized by high fever and profuse diarrhea. A significant percentage of these patients will have bacteria in the blood stream. In certain parts of world, this form of the disease is caused by Salmonella typhi or parathyphi, the organisms associated with typhoid fever. Patients with enteric fever require hospitalization and antibiotic therapy.
Typhoid fever is also caused by salmonella and may present with an extended course of fever and no other symptoms. Many of these patients will not have diarrhea as part of the clinical syndrome. Like enteric fever, typhoid fever requires hospitalization and antibiotic therapy. Salmonella may also cause bone and joint infections in patients with sickle cell anemia.
Contaminated food is the most common source for salmonella infections in humans. Incorrectly prepared poultry is a major cause of sporadic cases of salmonellosis. Using a separate cutting board for the preparation of poultry, preparing poultry after all other foodstuffs have been prepared, and cooking chicken to an internal temperature of at least 160 degreesF will reduce the risk of salmonellosis. Contamination of vegetables from incorrectly prepared manure may lead to epidemics of disease such as those noted above.
Reptiles are another source of salmonellosis in the home. Pet turtles, lizards, and snakes may all harbor salmonella. Infections from these sources are severe in children less than five years of age and particularly among children less than six months of age. Children under the age of 5 have higher rates of salmonella infection than any other age group, according to the CDC. The American Academy of Pediatrics recommends that households with children less than five years of age not contain reptilian pets.
In summary, proper preparation food and the elimination of reptilian pets will reduce the risk of household acquired salmonella. Recent laws have provided increased responsibility to the Food and Drug Administration to oversee the safety of the food chain. Time will tell if these new laws are adequate for protection.
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