By: Robert W. Frenck, Jr, MD, FAAP
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.
While the overwhelming number of patients 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)
Salmonella outbreak from backyard chickens
Public health experts in several states are investigating outbreaks
of salmonella infections linked to contact with backyard poultry. Over 200 illnesses have been reported across at least 38 states, including many children under age 5 years. Several people have been hospitalized.
Backyard poultry can carry salmonella germs even if they look healthy and clean. These germs can easily spread in areas where the poultry live and roam. The germs that can make us sick are found on the egg shell. That is why health experts advise us to avoid eating raw eggs and avoid licking the bowl when we make cake or cookie batter. The salmonella outbreaks are not related to recent cases of H5N1 bird flu
viruses detected in U.S. wild birds and poultry.
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, though, 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 & symptoms of salmonella infection
When your child has a salmonella infection that causes gastroenteritis, they may have symptoms such as:
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 (e.g., the 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.
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. Thus, if you return from travel and have an unexplained fever, it is important to let your doctor know about your recent travels.
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 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. Parents 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.
About Dr. Frenck
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).