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Salmonellosis Causes, Symptoms and Treatment

The Salmonellosis is an infection with bacteria called Salmonella or Salmonella. It is one of the leading causes of food poisoning in Canada.

Most infected people suffer from stomach crampsdiarrhea and fever. These symptoms occur 12 to 72 hours after ingestion of the contaminated food. Salmonella is found mostly in raw or undercooked foods: poultry, meat, seafood and eggs. It can also contaminate vegetables or food left without refrigeration for several hours.

The animal’s domestic (especially birds and reptiles) can also transmit salmonella infection.

Usually, recovery occurs in 4 to 7 days, without the need for treatment. However, the infection can be serious and even fatal for the elderly or sick as well as for infants.

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Who is affected?

According to Health Canada, an estimated 2 million Canadians are victims of food poisoning each year. From 6,000 to 12,000 cases of salmonellosis are reported each year. However, the number of actual cases would be much higher because many have only mild symptoms that sometimes go unnoticed. The children are more at risk of salmonellosis: those under 5 years old are five times more affected than the general population.

Hard for the intestines …

The majority of germs are destroyed by the acidity of the stomach. Salmonella is particularly sensitive. But when a sufficient number of bacteria survive, they eventually reach the intestines and multiply. They release irritating toxins (enterotoxins), which causes acute inflammation of the intestinal wall and diarrhea .

Sources of contamination

People who live in areas of the world with poor sanitation are at higher risk for salmonellosis.

List of pathogens responsible for food recalls
1. Listeria monocytogenes
2. Salmonella
3. E. coli
4. E. coli 0157: H7
5. Staphylococcus aureus

Food. In more than 90% of cases, it is the consumption of a food contaminated with animal excrement that is involved. Food contaminated with Salmonella does not necessarily have visible discolouration or a suspicious odor. It is mainly eggs (and products containing them), meat and poultry eaten raw or undercooked.
However, any food – including fruits and vegetables – is likely to carry Salmonella, especially if it is washed with contaminated water or comes in contact with contaminated raw meat.
Even if meat has been properly frozen, it can be risky. In fact, as soon as the cold chain is broken, there is a risk of contamination. This is why summer is more conducive to salmonella contamination.
Only cooking can be right for the bacteria. Perfect hygiene during meal preparation is therefore essential to guard against contamination (see the Prevention section).

Pets. Salmonella is naturally present in the intestines of animals. Many cases of salmonellosis in children have been associated with birds or reptiles (especially turtles and iguanas but also lizards and snakes) that were used as pets. Contamination can occur simply by touching the animal (the skin of reptiles is often contaminated) or its excrement but this is not always the case. The mere touching of an object in contact with the animal may suffice.

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Transmission from one person to another. The risk is higher when the infected person prepares a meal for other people. In general, Salmonella can be found everywhere in a house because it is a resistant bacterium that can survive for a while outside of a living host.

Possible complications

Usually, salmonellosis has no serious consequences. However, the elderly, infants and the debilitated can suffer more seriously.

The most common complication is dehydration. Therefore, it is advisable to be well hydrated as long as the symptoms persist. It may take a few weeks before bowel function returns to normal.

On rare occasions, the infection crosses the intestinal barrier and spreads to various parts of the body through the bloodstream. It is then necessary to treat the infection with antibiotics without delay.

Some people with salmonella may develop a form of reactive arthritis 3 to 4 weeks after infection: Reiter’s syndrome. It is exceptional, however.

People who have already been infected with salmonella often become asymptomatic carriers of the bacteria for some time. This means they have no symptoms but excrete bacteria in their stool. For adults and older people, this state lasts on average up to 12 weeks after infection and up to 1 year for children 5 and under. Less than 1% of people become chronic carriers. Asymptomatic carriers may still be contagious but the risk is relatively low and the duration of the contagion period is unknown.

Another strain of salmonella, Salmonella typhi, causes a high fever called typhoid fever, rather than digestive disorders, but this will not be the case here.

Symptoms of Salmonellosis

The symptoms of salmonellosis can be confused with those of many other diseases.

  • High fever;
  • Stomach cramps;
  • Diarrhea;
  • Nausea;
  • vomiting;
  • Headache.
  • Dryness of the mouth and skin;
  • Fewer urinating and darker urine than usual;
  • Weakness;
  • Hollow eyes.

People at risk for Salmonellosis

Some people are more likely to be victims of food poisoning. They struggle harder against infections. Particular vigilance is required when preparing food.

  • People with   chronic inflammatory bowel disease or a condition that reduces the   body’s natural immune defenses against Salmonella: Crohn’s disease, ulcerative colitis, HIV infection, diabetes, cancer, etc.;
  • The elderly, pregnant women and young children;
  • People who have just received an antibiotic treatment   because these drugs affect the intestinal flora. Those taking   oral corticosteroids are also at higher risk;
  • Possibly, people whose stomach secretes less hydrochloric acid. The acidity of the stomach helps to destroy salmonella. Here are some possible reasons:
  • the use of antacids of the proton pump inhibitor type (for example, Losec, Nexium, Pantoloc, Pariet, Prevacid);
  • lack of acid secretion by the stomach (achlorydrie), caused by chronic gastritis or other problem;
  • stomach surgery to correct hyperacidity;
  • Pernicious anemia.

Risk factors

  • Stay in a developing country
  • Have a pet, especially if it is a bird or a reptile;
  • Season: Salmonella cases are more common in summer.

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The prevention of salmonellosis

Basic preventive measures
There is no vaccine to protect against food poisoning caused by salmonellosis. They are therefore adequate hygiene measures that will prevent contamination with food and animal excrement. From producer to consumer, all are concerned.

People with weaker health should make sure to follow good hygiene advice. Health Canada has produced guides for them. For more information,

Hand hygiene

  • Wash your hands frequently.
  • When preparing a meal, wash your hands before switching from a raw food to a cooked food.
For food

  • All foods of animal origin can transmit salmonella. Avoid eating raw the eggs (and products that contain it), the poultry and meat ;
  • Make cook these foods until they reach the internal temperature recommended (refer to table cooking temperatures provided by the Canadian Food Inspection Agency, in the interests Sites section);
  • When preparing food:
  • The utensils used for the preparation of uncooked food must also be thoroughly washed before using it for other foods;
  • Surfaces and countertops must be cleaned: the ideal is to prepare meat on a separate surface;
  • Uncooked meats should not be placed in contact with cooked or ready-to-eat foods.
  • The refrigerator should have a temperature of 4.4 ° C (40 ° F) or less, and the freezer , -17.8 ° C (0 ° F) or less;
  • Fresh fruits and vegetables should always be washed under running water before eating;
  • The milk and dairy products Unpasteurized (like raw milk cheese) can also transmit salmonella. It is advisable to avoid them if one is at risk (pregnant women, young children, sick or elderly people).

Remarks

  • It is allowed to use raw milk for cheese production in accordance with sanitary standards because raw milk retains its natural flora and allows the manufacture of various high-end products;
  • Since 1991, the sale of raw milk has been strictly prohibited in Canada under the Food and Drug Regulations.
  • Ideally, you should not prepare food for others if you have salmonellosis until the diarrhea is gone;
  • Reusable bags used to carry food should be frequently washed.
For pets

  • Always wash your hands after changing an animal’s litter or in contact with excreta, even if it is healthy (be extra careful with birds and reptiles);
  • Better not to buy a bird or a reptile from a child. People with weak immune defenses due to illness should also refrain from possessing them;
  • At the farm or at the zoo  : wash the children’s hands immediately if they have touched animals (especially for birds and reptiles);
  • People who have a reptile should follow the appropriate precautions:
  • Wash hands after handling reptiles or cages;
  • Do not let reptiles roam freely in the house;
  • Keep reptiles out of the kitchen or any other place where food is prepared.

Other tips:

  • Do not have a reptile in the house if there are young children;
  • Eliminate reptiles if you are expecting a baby;
  • Do not keep reptile in a child care center.

 

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Medical treatments of Salmonellosis

Rehydration

Most people recover on average after 4 to 7 days. The usual treatment consists of a simple rehydration: drink plenty of water, soups, broths, etc. If necessary, prepare a rehydration solution (see box below).

Rehydration solutions

Recipe from the World Health Organization

  • Mix 1 liter of sterile water, 6 tbsp. sugar and 1 tsp. salt.

Another recipe

  • Mix 360 ml unsweetened orange juice with 600 ml cooled boiled water, 1/2 tsp. table salt.
Mode of conservation. The solutions are stored for 12 hours at room temperature and 24 hours in the refrigerator.

See a doctor as needed

When diarrhea or fever is severe, dehydration sets in, or the person is weakened, seek medical attention. A stool test can detect the presence of salmonella and also know the precise strain of bacteria (there are several types of salmonella). Sometimes it is necessary to be hospitalized and rehydrated intravenously.

Tips on feeding

Take lighter but more frequent meals, avoiding excess fat, dietary fiber and spices. Also avoid drinking alcohol, which dehydrates.

As long as the discomfort persists, it is better to avoid eating the following foods, which aggravate cramps and diarrhea.

  • Dairy products;
  • Citrus juices;
  • The meat;
  • Spicy dishes;
  • The sweets;
  • Foods high in fat (including fried foods);
  • Foods that contain wheat flour (bread, pasta, pizza, etc.);
  • Corn and bran, which are high in fiber;
  • Fruits, with the exception of bananas, which would be rather beneficial, even in young children from 5 months to 12 months;
  • Raw vegetables.

Once the nausea has disappeared, we gradually reintroduce a solid diet by focusing on certain foods that are easier to digest. Starchy foods like white rice, sugar-free cereals, white bread and crackers are usually well tolerated. Stop eating if the discomfort returns. Then gradually add fruits and vegetables (potatoes, cucumbers, and squash), yoghurt and protein foods (lean meat, fish, eggs, cheese, etc.).

Pharmaceuticals

Of antibiotics are administered if the infection through the intestinal barrier and wins the bloodstream (a bacteremia). This is the case for about 8% of salmonella infections. Children are treated with ceftriaxone or azithromycin and adults with levofloxacin or azithromycin. The treatment normally lasts 5 to 7 days. Its duration is extended for people whose immune system is weakened. Some strains of salmonella have developed resistance to antibiotics. It may happen that a second treatment is required.

Attention. The drugs against diarrhea, such as lope amide (Imodium) and bismuth subsalicylate (Pepto-Bismol) are not recommended because they prolong the duration of infection.

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