Salmonella enteritis

Causes and Risks:
Salmonella enterocolitis can range from mild to severe diarrheal illness. The infection is acquired through ingestion of contaminated food or water. Any food can become contaminated during preparation if conditions and equipment for food preparation are unsanitary. The incubation period is 8 to 48 hours after exposure, and the acute illness lasts for 1 to 2 weeks. The bacteria is shed in the feces for months in some treated patients. A carrier state exists in some people who shed the bacteria for 1 year or more following the initial infection.

The risk factors include:
  • ingestion of improperly prepared or stored food (especially undercooked turkey or chicken, unrefrigerated turkey dressing, undercooked eggs)
  • family members with recent salmonella infection
  • recent family illness with gastroenteritis
  • institutionalization
  • recent poultry ingestion
  • owning a pet iguana, turtles, lizards and snakes (reptiles are carriers of salmonella)

The incidence is 1 out of 1,000 people. Two thirds of patients are less than 20 years of age. Infants and children under the age of 9 years are most commonly affected. The highest incidence occurs from July through October.

Prevention:
Proper food handling and storage are preventive measures. Good hand washing is important especially when handling eggs and poultry. If you own a reptile, wear gloves when handling the animal or its feces because salmonella is easily passed from the animal.

Symptoms:



Signs and Tests:



Treatment:
The objective of treatment is to replace fluids and electrolytes (salt and minerals) lost by diarrhea . (Antidiarrheal medications are generally not given, because they may prolong the infectious process.) Self care measures to avoid dehydration include drinking electrolyte solutions to replace fluids lost by diarrhea - these are available without a prescription. Antibiotic therapy may be indicated for those who are severely symptomatic .

People with diarrhea who are unable to take oral (by mouth) fluids due to nausea may need medical attention and intravenous fluids, especially small children. Fever and aches can be treated with acetaminophen or ibuprofen.

People taking diuretics need to be cautious with diarrhea, and may need to stop taking the diuretic during the acute episode as directed by the health care provider. Dietary modifications during diarrhea may be helpful: restrict milk products, give bananas, rice, apples, toast (BRAT diet). Infants should continue to breast feed and receive electrolyte replacement solutions as directed by your health care provider.

Prognosis:
The probable outcome is usually good. Symptoms subside in normal individuals in 2-5 days.

Complications:
A complication is dehydration from diarrhea especially in young children and infants. May also result in life threatening meningitis and septicemia .

Call Your Healthcare Provider:
Call your health care provider if blood is noted in the stools or if your child shows no improvement after 2-3 days. Also if any of the following occurs:




The causative agent of typhoid fever is the bacterium Salmonella typhi. (Courtesy of the Centers for Disease Control.)



This illustration shows the major organs of the digestive system. Their relative sizes and positioning in the body are also demonstrated.