| This month, PreventInfection.org is dedicated to the topic of that nasty germ, Salmonella. Many of you have heard a lot about this bacteria lately, following news broadcasts of contaminated peanut butter making many people ill, which will be addressed later in this article.
First, however, it is important to discuss the basics of Salmonella, what it is, how common it is, how it is diagnosed, treated, and how it can be prevented.
What is Salmonella?
Salmonella is the name of a family of several bacteria that have been causing serious cases of food poisoning for more than 100 years. In fact, S. typhi was the germ that caused many deaths from the historic disease Typhoid fever – you likely remember hearing about Typhoid Mary. There isn't much Typhoid fever out there these days, but other species such as S. enteritidis are quite common. Scientists break down the family names even more when working on outbreaks - the bacteria related to the peanut butter outbreak is called S. Tennessee. These germs are commonly found in the feces of animals, fish, reptiles and birds. A frequent source of Salmonella comes as a result of children playing with water turtles, and then failing to wash their hands before eating.
The animals don't get sick but the children do.
How does it affect you?
Salmonellosis (illness from Salmonella) can be a mild or serious, and sometimes fatal disease. In most cases, a person becomes mildly ill and does not seek medical care. The infection often resolves itself within 5-7 days without treatment, according to the Centers for Disease Control and Prevention (CDC). The symptoms of this illness usually include: diarrhea, fever, and abdominal cramps 12 to 72 hours after exposure. In some cases a person afflicted with Salmonella becomes seriously ill due to dehydration from the diarrhea or from a blood infection when the bacteria have passed from the intestines into the bloodstream. The condition becomes much more critical when it strikes an elderly person or infant. Most people recover completely from Salmonella, but a small number may develop joint pains, eye irritation or painful urination. When this occurs, it is called Reiter's Syndrome. It can last for months and develop into chronic arthritis, despite treatment with antibiotics.
Where does it come from?
Sources for the bacteria have been contaminated milk, water, eggs, ice cream, meringue pies, shellfish, and undercooked pork, chicken, or fish. Any food, including vegetables and salad, can become contaminated with salmonella bacteria. This can happen in the home when someone handles raw meat or fish then handles vegetables or salad without first washing their hands. Contamination may occur when vegetables come in contact with soiled surfaces - counter tops, cutting boards, knives, or dishes used for raw meat. Even a soiled dish towel or sponge can contaminate clean hands or dishes. The bacteria can be found in raw meat, fish, or eggs, if these food items are not cooked adequately, the bacteria will not be killed. Also, because wooden cutting boards have cracks and cuts which are difficult to thoroughly clean, non-porous glass or plastic cutting boards are preferred for preventing salmonella infection. All raw meat, fish, and eggs should be considered as having salmonella and should be cooked well. Never eat raw cake batter, cookie dough, Caesar salad, eggnog or any other item if they contain raw eggs.
How common is Salmonella?
Salmonellosis is very common. Because mild cases are rarely reported to health departments, most cases are not counted. To be counted as a "case of Salmonella," the patient must see a medical care provider and have a culture done on a stool specimen. Despite this, the CDC says that over 40,000 cases of salmonellosis are reported each year in the United States. Out of these cases, there are approximately 600 deaths due to salmonella infection.
How will a doctor know you have Salmonella?
When you see a doctor because you have the symptoms of food poisoning such as diarrhea, vomiting, abdominal pain, etc., he or she will be able to diagnosis Salmonella by obtaining a culture from one of your diarrhea stools. The laboratory can test the sample and see if any specific bacteria will grow. It will help the lab if they know what your symptoms have been, such as vomiting within two hours of eating or bouts of diarrhea 12 hours after eating. Your doctor will want to know if anyone else in your family or group of friends is having the same symptoms. If they are, what did they eat and when did their symptoms start? Salmonellosis is a reportable disease and your doctor or the laboratory will report it to the local Health Department. You may receive a call from the Health Department to find out where you have purchased groceries or which restaurants you have frequented recently. This helps the Health Department determine if there is an outbreak with a common source.
How is it treated or prevented?
In many cases, Salmonellosis is not treated and the ill person gets over the diarrhea and infection within a week. But if the person becomes dehydrated (loses too much fluid), runs a high or prolonged fever, has severe abdominal pain, or the diarrhea does not stop, he/she should seek medical attention. People who are high risk for infection (such as certain chronic diseases, cancer treatment, etc.) should talk to their doctor when they become ill. The doctor will be able to monitor their infection and treat it if necessary.
Preventing Salmonellosis involves common sense. These are some of the easy precautions recommended by the CDC:
- Cook all chicken, beef and eggs before you eat them. Do not eat food items that contain raw eggs (e.g., eggnog, cake batter) or non-pasteurized milk.
- If a restaurant serves you undercooked food, send it back to the kitchen.
- Clean hands, surfaces and cooking utensils after contact with raw meat, fish, eggs, etc. (Paper towels are better than sponges in the kitchen.)
- Be very careful with food cooked for infants, elderly people and persons with low immunity.
- Prevent infants and persons with low immunity from having contact with reptiles (snakes, turtles, etc.)
- Make sure to use good hand hygiene if caring for an infant when cooking.
- Breastfeeding can prevent many health problems for infants, such as Salmonellosis.
What is the current outbreak?
In the fall of 2006, the CDC became suspicious that a common item was causing this food borne illness. After much investigation, it was determined that peanut butter made by a company in Georgia was responsible. As of February 27th, according to the CDC, 370 persons have become ill with Salmonella Tennessee in 42 states. This is the number who have had cultures done and have been confirmed to be connected to the present outbreak. There is no way of determining how many other, unreported cases have occurred. Out of the 370 cases reported thus far, 60 persons have been admitted to a hospital. No deaths have occurred.
Because there may be more jars of this peanut butter still in people's homes, the CDC and the FDA (Food and Drug Administration) are recommending that anyone with a jar of Peter Pan or Great Value peanut butter with a product code that starts with 2111 not eat this product. Throw it away to prevent anyone from eating it.
For more information, you can contact your local or state health department |