Salmonella Infections

Salmonellosis is a foodborne illness caused by infection with Salmonella bacteria. Most infections are spread to people through consumption of contaminated food (usually meat, poultry, eggs, or milk).

Salmonella infections affect the intestines and cause vomiting, fever, and cramping, which usually clear up without medical treatment.

You can help prevent Salmonella infections by not serving any raw meat or eggs, and by not keeping reptiles as pets, particularly if you have very young children.

Hand washing is a powerful way to guard against Salmonella infections. So teach kids to wash their hands, particularly after trips to the bathroom and before handling food in any way.

Salmonella Basics

Not everyone who ingests Salmonella bacteria will become ill. Children, especially infants, are most likely to get sick from it. About 50,000 cases of salmonellosis are reported in the United States each year and about a third of those are in kids 4 years old or younger.

There are many different types of Salmonella bacteria. The type responsible for most infections in humans is carried by chickens, cows, pigs, and reptiles (such as turtles, lizards, and iguanas). Another, rarer form — called Salmonella Typhi (S.Typhi) — causes typhoid fever. People usually get typhoid fever by drinking beverages or eating food that has been handled by someone who has typhoid fever or is a carrier of the illness. Most cases are in developing countries where clean water and other sanitation measures are hard to come by.

Signs and Symptoms

A Salmonella infection generally causes nausea, vomiting, abdominal cramps, diarrhea (sometimes bloody), fever, and headache. Because many different kinds of illnesses can cause these symptoms, most doctors will take a stool sample to make an accurate diagnosis.

Symptoms of most infections start within 3 days of contamination and usually go away without medical treatment.

At first, typhoid fever caused by Salmonella bacteria looks similar to infections by non-typhoid Salmonella. But in the second week, the liver and spleen can become enlarged, and a distinctive “rose spotted” skin rash may appear. From there, the infection can cause other health problems, like meningitis and pneumonia.

People at risk for more serious complications from a Salmonella infection include those who:

• have problems with their immune systems (such as people with HIV)
• take cancer-fighting drugs
• have sickle cell disease or an absent or nonfunctioning spleen
• take chronic stomach acid suppression medication

In these higher-risk groups, most doctors will treat an infection with antibiotics to prevent it from spreading to other parts of the body.

Prevention

Here are some ways to help prevent Salmonella bacteria from making your family sick:

• Cook food thoroughly. Salmonella bacteria are most commonly found in animal products and can be killed by the heat of cooking. Don’t serve raw or undercooked eggs, poultry, or meat. Microwaving is not a reliable way to kill the bacteria. If you’re pregnant, be especially careful to avoid undercooked foods.
• Take care with eggs. Because Salmonella bacteria can contaminate even intact and disinfected grade A eggs, cook them well and avoid serving poached or sunny-side up eggs (with runny yolks).
• Clean cooking surfaces regularly. Salmonellosis also can spread through cross-contamination, so when you’re preparing meals, keep uncooked meats away from cooked and ready-to-eat foods. Thoroughly wash your hands, cutting boards, counters, and knives after handling uncooked foods.
• Avoid foods that might contain raw-food products. Caesar salad dressing, the Italian dessert tiramisu, homemade ice cream, chocolate mousse, eggnog, cookie dough, and frostings can contain raw eggs. Unpasteurized milk and juices also can be contaminated with Salmonella.
• Wash hands often. Fecal matter (poop) is often the source of Salmonella contamination, so hand washing is extremely important, especially after using the toilet and before preparing food.
• Take care with pets. Avoid contact with the feces of family pets — especially reptiles. Wash your hands thoroughly after handling an animal and make sure that no reptiles are permitted to come into contact with a baby. Even healthy reptiles (especially turtles and iguanas) are not safe pets for small children and should not be in the same house as an infant.
• Don’t cook food for others if you are sick, especially if you have vomiting or diarrhea.
• Keep food chilled. Don’t leave cooked food out for more than 2 hours after serving (1 hour on a hot day) and store it promptly. Also, keep your refrigerator set to under 40°F (4.4°C).

Treatment

If your child has salmonellosis and a healthy immune system, your doctor may let the infection pass without giving any medicines. But any time a child develops a fever, headache, or bloody diarrhea, call the doctor to rule out any other problems.

If your child is infected and has a fever, you may want to give acetaminophen to reduce his or her temperature and relieve cramping. As with any infection that causes diarrhea, it’s important to give your child plenty of liquids to avoid dehydration.