Salmonella bacteria are best known for the gastrointestinal problems they can cause. This type of illness, called gastroenteritis, usually affects the small intestine and is a common reason for diarrhea in children.
However, Salmonella (specifically, so-called non-typhoidal Salmonella organisms) can cause a variety of other disorders as well, including bacteria in the blood (bacteremia), inflammation of the membranes of the brain or spinal cord (meningitis), and inflammation of the bone (osteomyelitis). Other types of Salmonella can cause other illnesses, such as an especially long-lasting bacterial illness known as typhoid (or enteric) fever. Typhoid fever is rare in the United States, but is a problem for travelers to areas of the world where typhoid fever is common (eg, India, Latin American, Africa, parts of the Far East).
Salmonella infections occur most often in children younger than 4 years. They are usually spread to humans by animal products such as poultry, beef, fish, eggs, and dairy products. At times, however, other foods such as fruits, vegetables, and bakery products have caused outbreaks, most often when contaminated by contact with an animal product. The bacteria can also be spread by drinking contaminated water, as well as through contact with infected pets such as chicks, snakes, turtles, lizards, and other reptiles. Typhoid fever is only spread through contact with an infected person or an item contaminated by an infected person.
Signs and Symptoms
When your child has a Salmonella infection that causes gastroenteritis, she may have symptoms such as
- Abdominal cramps and tenderness
Typhoid fever develops gradually, with signs and symptoms that may include fever, headache, loss of appetite, lethargy, abdominal pain, changes in mental status, an enlarged spleen, and constipation or diarrhea.
The incubation period for gastroenteritis ranges from 6 to 48 hours, while typhoid fever has a longer incubation period of 3 to 60 days.
When to Call Your Pediatrician
Contact your pediatrician if your child shows no improvement within 2 to 3 days of symptoms appearing or if she has blood in her stools or shows signs of dehydration (eg, the absence of tears when crying, a decline in urination).
How Is the Diagnosis Made?
Your pediatrician can test for Salmonella organisms from cultures of stool, blood, or urine that are examined in the laboratory.
Antibacterials do not help treat Salmonella-caused gastroenteritis because they will not shorten how long the disease lasts. However, antibacterials are needed when the infection is found in the blood, brain, bone, or other organs. Antibiotics may be given to infants younger than 3 months because of the risk of the infection spreading into the blood and other organs in the body.
A child with severe diarrhea may get very dehydrated and need intravenous fluids or extra fluids given by mouth.
What Is the Prognosis?
Most Salmonella gastrointestinal infections last for 4 to 7 days and clear up on their own without treatment.
Salmonella infections can often be prevented by practicing good hygiene techniques during food preparation, as well as regular hand washing. Be sure to thoroughly cook eggs, poultry, and ground beef. Hands should always be washed after playing with pets, especially lizards and pet turtles. If your child has a problem with her immune system, you should avoid reptiles used as pets, such as lizards and snakes. Children with sickle cell anemia are at risk for Salmonella infection of the bones. Parents of these children should avoid having reptiles and amphibians as pets.
Two typhoid vaccines are approved for use in the United States, although they may provide only limited protection and are only recommended before traveling to areas where the risk of typhoid fever is high. Talk with your pediatrician before traveling to other countries.