| Salmonellosis is an infection caused by the bacteria Salmonella enterica. The most common form of the disease produces gastrointestinal upset or "food poisoning." The course of the disease depends on the subspecies of Salmonella enterica ingested.
All types of salmonellosis can be transmitted through eating contaminated foods, particularly meat, poultry, eggs, and raw milk. Infection can also occur if organisms in feces directly or indirectly contaminate food. This can happen if vegetable or fruit crops are sprayed with sewage, flies settle on feces and then on food, or food is handled by an individual who did not wash his or her hands. Contaminated food left out in warm conditions for any length of time can rapidly develop a large colony of bacteria without signs of food spoilage. Touching infected animals such as baby chicks, ducks, turtles, and pet reptiles can also transmit salmonellosis. It is rare for medical products derived from animals such as thyroid extracts, bile salts, or pancreatin to be contaminated with the bacteria.
Prevention of salmonellosis includes thorough cooking of all meats, poultry, and eggs. Milk, dairy products, and drinking water should also be protected from contamination. Countertops and utensils should be thoroughly cleaned, especially when used in the preparation of raw meat or poultry. Proper handwashing should be done during food preparation, before eating, after using the restroom, and after touching animals especially reptiles. Carriers (individuals who harbor the bacteria but have no noticeable symptoms) should not be permitted to work as food handlers. Appropriate food storage is also important.
Appropriate waste disposal is important even after an infection resolves because individuals continue to pass Salmonella bacteria in their stools for several weeks.Risk: Individuals under age 5 and over age 60 are at higher risk for this disease and are likely to develop more severe cases if they are infected. There is some risk of transmission from an infected mother or family member to newborns and infants. Individuals with depressed immune systems, such as those with multiple sclerosis or HIV/AIDS, are at increased risk of contracting salmonellosis. Individuals in institutions (jails, nursing homes) are also at higher risk. Incidence and Prevalence: Salmonellosis is almost certainly underreported, because the disease is usually self-limiting and has symptoms similar to many other illnesses. However, it is estimated that there are 40,000 to 45,000 reported cases in the US each year (Feldman 1880; Zapor) and over 1 million unreported cases. Worldwide salmonellosis is common, with about 12 to 23 million cases estimated to occur each year. It is especially common in developing countries and in areas where natural disasters disrupt waste and water treatment. |
Source: Medical Disability Advisor
| History: When caused by Salmonella, symptoms of acute gastroenteritis usually occur within 8 to 48 hours after eating contaminated food or liquid. Symptoms last 3 to 7 days and may include fever, chills, nausea, vomiting, painful abdominal cramps, and diarrhea. The diarrhea may be bloody.
Infection entering the bloodstream (Salmonella bacteremia) can cause local infections. Individual may complain of aching in joints or bones. Physical exam: Physical findings in acute gastroenteritis may include fever and abdominal tenderness and distention but these may apply to any number of conditions (nonspecific). Signs of dehydration may include blood pressure that changes with body position changes (orthostatic blood pressure), dry mucous membranes, sunken eyes, and decreased skin tension (turgor). Tests: Stools are examined for the presence of white blood cells. If present, a stool culture is indicated to identify the organism. A complete blood count (CBC) or blood culture may also be done when infection is suspected of entering the bloodstream (Salmonella bacteremia). |
Source: Medical Disability Advisor
| Salmonella gastroenteritis infections are usually time-limited. Treatment of uncomplicated cases is primarily supportive. Dehydration is avoided by replacing fluids and electrolytes.
Treatment with antibiotics is indicated for individuals who are malnourished, severely ill, or have sickle cell disease. Depending on the individual's condition, antibiotics can be given either orally or intravenously. Since relapse is common in HIV-infected individuals, lifelong suppressive therapy may be required. |
Source: Medical Disability Advisor
| Salmonellosis gastroenteritis is usually a self-limited disease, with most cases resolving symptoms of fever within 48 to 72 hours and symptoms of diarrhea within 3 to 7 days. |
Source: Medical Disability Advisor
| Complications of Salmonella gastroenteritis include severe dehydration, shock, or collapse. |
Source: Medical Disability Advisor
| Due to initial fatigue, sedentary work responsibilities with frequent breaks may be required until strength and stamina return. |
Source: Medical Disability Advisor
| If an individual fails to recover within the expected maximum duration period, the reader may wish to consider the following questions to better understand the specifics of an individual's medical case. Regarding diagnosis:
- Has the diagnosis of salmonellosis been confirmed? What type of infection occurred? Enteric fever, Salmonella gastroenteritis, or Salmonella bacteremia?
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Could the symptoms be caused by an organism other than Salmonella?
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Has the infection spread to other organs in the body?
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Does individual have additional illnesses that are contributing to the disease, such as sickle cell disease, inflammatory bowel disease, malnourishment, or suppressed immune system?
Regarding treatment:
- Has additional treatment been required, such as rehydration therapy? Antibiotics?
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If current antibiotic therapy seems ineffective, would a change in antibiotics be warranted? Has sensitivity been done to rule out antibiotic-resistant strains of organisms?
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Was there evidence of Salmonella bacteremia? If so, did individual receive appropriate supportive care (i.e., hospitalization, intravenous fluids, etc.)?
Regarding prognosis:
- Based on the severity of symptoms and general health of individual, what was the expected outcome? Has adequate time elapsed for recovery?
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Does individual have any underlying condition such as sickle cell disease, inflammatory bowel disease, implants and prosthetic devices, malnourished individuals, and those with weakened immune systems that may influence severity of illness or ability to recover? If so, is the underlying condition being addressed in the treatment plan?
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Has individual experienced any relapse? Is lifelong prophylactic treatment warranted?
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Has individual been evaluated to rule out the possibility of a carrier state? If so, what measures are being taken to prevent disease transmission?
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Source: Medical Disability Advisor
| Feldman, Mark, Lawrence S. Friedman, and Marvin H. Sleisenger, eds. Gastrointestinal and Liver Disease. 7th ed. 2 vols. Philadelphia: W.B. Saunders, 2002.Zapor, Michael, and David P. Dooles. "Salmonellosis." eMedicine. Eds. Mary Nettleman, et al. 5 Jun. 2002. Medscape. 16 Oct. 2004 <http://emedicine.com/med/topic2058.htm>. |
Source: Medical Disability Advisor
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