salmonella gastroenteritis 04.21.2010

8/9/2019 Salmonella Gastroenteritis 04.21.2010

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Salmonella GastroenteritisMary Steinmann, MD

AM Report4/26/10


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Salmonella entericaSalmonella enterica

Motile, nonencapsulatedGNR

Facultative anaerobicgrowth

O (somatic, heat stable)and H (flagellar, heatlabile) antigens

Viable at ambient tempsfor days, water for weeks,soil for years


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S. Enterica nomenclatureS. Enterica nomenclature

More than 2500 different serotypes

Most common causing disease in humans:serovar Enteritidis and serovar Typhimurium

Other interesting serovars:

Choleraesuis in pigs

Dublin in cattle

Typhi cause typhoid fever


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EpidemiologyEpidemiology

1.4 million infections annually in US

15,000 hospitalizations

400 deaths

Incidence proportional to environmental factors

Clean water access

Hygiene and sanitation standards Food preparation practices


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Epidemiology (2)Epidemiology (2)

Infection rates on the rise

Mass food production

Animal husbandry practices

Bacterial resistance factors

Accounts for half of gastroenteritis cases

S. enterica serovar Enteritidis

S. enterica serovar typhimurium increasing

Peaks in infants and elderly


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SourcesSources Pets (dogs, cats, rodents,

amphibians, lizards)

Contaminated/raw poultryor eggs or transport 1:20,000 eggs

Animal feeds with fishmeal or bone meal

Prior antibiotic use

Contaminated hospitalequipment

Daycare


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SymptomsSymptoms

Occur 12-72 hrs after infection

Fever, abdominal pain, diarrhea, nausea, vomiting

Usually resolves after 4-7 days

Bacteremia (1-5% of cases) more common in very

young, very old, and immunocompromised

Fever, chills, septic shock need to consider Abx treatment

Focal seeding meningitis, brain abscess,

osteomyelitis (especially in sickle cell)


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SequellaeSequellae Can continue to be excreted x1-2 months

Antibiotics increase risk of prolonged carrier state

Carrier state also prolonged by:

Biliary tract disease

Cholelithiasis

Chronic hemolysis

Underlying immune deficiency


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Salmonella in the NewsSalmonella in the News Peanut butter 2008-09 529 persons from 43

states traced back to a Georgia plant

Dog Food 2006 70 cases in 19 states

Banquet Pot Pies 2007 35 states

African Dwarf Water Frogs 4/09-1/10 31 states,traced back to breeder in CA

Jalapeno peppers 2009 1442 people in 43 states,traced back to packing in Mexico

Veggie Booty suspected in some 2007 cases

For updates/trackers: www.cdc.gov


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Frogs may not be a safeFrogs may not be a safe

alternative petalternative pet 53% of affected people knew Salmonella could be

passed from reptiles and turtles

31% knew Salmonella could be acquired from

amphibians

Water from the aquarium can spread Salmonella

30% cleaned aquariums in the kitchen sink,

increasing risk of food contamination


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PreventionPrevention Washing hands thoroughly after contact with

animals

No reptiles or amphibians in child care centers

Dont eat raw eggs

Poultry cooked at least 10 minutes to internal temp

167 F

Dont wash your aquariums in the kitchen sink

salmonella gastroenteritis 04.21.2010

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