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Salmonella Infections in Children

young girl with tummy ache young girl with tummy ache

By: Robert W. Frenck, Jr., MD, FAAP

Salmonella bacteria cause more than a million infections each year in the United States. Most often, people get sick after eating food contaminated with Salmonella. Their symptoms usually include diarrhea, fever and stomach cramps. Salmonella illness can sometimes be severe enough to require a hospital stay.

Here's what families need to know about Salmonella, how to recognize symptoms of infection and how to prevent it.

Who is most at risk from salmonella?

Infections occur most often in infants and children younger than 4 years because their immune systems are still developing. Babies who are not breastfed are also more likely to get sick from Salmonella. Infants may be exposed to Salmonella if they eat contaminated food or come into contact with contaminated surfaces or sick family members.

Elderly people and those whose immune systems are weakened from certain medical conditions (such as diabetes, liver or kidney disease and cancer) or treatments also are at increased risk.

How does salmonella spread?

Salmonella bacteria usually spread to humans by animal products such as poultry, beef, fish, eggs and dairy products. At times, though, other foods such as fruits, vegetables and bakery products have caused outbreaks. Most often, this happens when these foods were 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, which is also caused by Salmonella, is only spread through contact with an infected person or an item contaminated by an infected person.

Recent salmonella outbreaks

All-purpose flour

As of May 1, 2023, more than a dozen people have been infected in a multistate outbreak of Salmonella illnesses linked to bleached and unbleached all-purpose flour. (More information here.) Be sure to get rid of any recalled flour. If you stored recalled flour in another container, wash the container thoroughly with warm water and soap before using again. Always bake or cook food made with any brand of raw flour, like cookie dough or cake batter before eating it.

Backyard chickens

In 2022, public health experts investigated outbreaks of Salmonella infections linked to contact with backyard poultry. (More information here.) More than 1,200 illnesses were reported across the U.S., 21% of which were in children under 5 years old. Two people died. Backyard poultry can carry Salmonella germs even if they look healthy and clean. The bacteria can spread in areas where the poultry live and roam, and are found on the egg shell.

Signs & symptoms of salmonella infection

Salmonella bacteria are best known for being a cause of diarrhea. This type of illness, called gastroenteritis, typically happens after eating food that has been contaminated with Salmonella.

When your child has a salmonella infection that causes gastroenteritis, they may have symptoms such as:

  • Diarrhea

  • Abdominal cramps and tenderness

  • Fever

While the overwhelming number of people with Salmonella infection have gastroenteritis, the bacteria also can cause a variety of other disorders, including:

  • Bacteria in the blood (bacteremia)

  • Inflammation of the membranes of the brain or spinal cord (meningitis)

  • Inflammation of the bone (osteomyelitis)

Any recent travel?

Although very rare in the United States, travelers to India, Latin American, Africa and parts of the Asia may become infected with a strain of Salmonella called typhoid. This is a long lasting febrile illness which if untreated can be fatal in up to 30% of cases. So, if you return from travel and have an unexplained fever, it is important to let your doctor know about your recent travels.

What to know about typhoid fever

Typhoid fever develops gradually. It's signs and symptoms 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 they have blood in their stools or shows signs of dehydration (such as an absence of tears when crying, a decline in urination).

How is Salmonella diagnosed?

Your pediatrician can test for Salmonella organisms from cultures of stool, blood, or urine that are examined in the laboratory.

Treatment for Salmonella infections

If your child only has Salmonella-associated diarrhea, the treatment is supportive (fluids and rest). Antibiotics are not prescribed as they do not make your child get better faster and actually may increase the length of time your child has Salmonella in the stool. An exception is infants under 3 months of age, because they have an increased risk of the infection spreading from the intestine to the blood and other organs in the body. However, when the infection is found in the blood, brain, bone or other organs, antibiotics are needed.

A child with severe diarrhea may get very dehydrated and need intravenous (IV) fluids or extra fluids given by mouth.

How long does a Salmonella infection last?

Most salmonella gastrointestinal infections last for 4 to 7 days and clear up on their own without treatment.

How to prevent Salmonella infection

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 their immune system: Avoid reptiles used as pets, such as lizards and snakes. Children with sickle cell anemia are at risk for Salmonella infection of the bones. Families of these children should avoid having reptiles and amphibians as pets.

  • If you plan travel to an area where typhoid exists: Make an appointment with your doctor (preferably 1-2 months before travel) to discuss vaccination against the infection. See Precautions for International Travel: Information for Parents.

More information

About Dr. Frenck

Robert W. Frenck, Jr, MD, FAAP Robert W. Frenck, Jr, MD, FAAP, is board-certified in general pediatrics and pediatric infectious diseases. He practices at Cincinnati Children's Hospital Medical Center and is a Professor in the Department of Pediatrics at the University of Cincinnati School of Medicine in Cincinnati, Ohio. Within the American Academy of Pediatrics, Dr. Frenck is a member of both the Section on Uniformed Services (SOUS) and the Section on Infectious Diseases (SOID).

Last Updated
American Academy of Pediatrics Section on Infectious Diseases (Copyright © 2023)
The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.
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