Salmonellosis

Salmonellosis is an infection caused by the Salmonella bacterium, which can develop anaerobically (without oxygen) or aerobically (with oxygen), allowing it to affect different parts of the body. It is one of the leading causes of gastrointestinal infections worldwide and, according to the World Health Organization, one of the four most common causes of diarrheal diseases.

Salmonella belongs to the Enterobacteriaceae family and has flagella for movement, which enables it to travel through liquids. The most common way it infects humans is through contaminated water or food.

Salmonellosis is usually a mild condition. However, depending on the type of Salmonella and the patient's overall health, it can pose a serious risk and even be fatal. This bacterium is divided into two main groups:

• Salmonella bongori: Not pathogenic to humans.
• Salmonella enterica: Causes disease in humans, with over 2,500 defined serotypes classified into various subgroups. Some of these include:
• Salmonella enterica Dublin: Mainly affects cattle, but when transmitted to humans, it is highly invasive.
• Salmonella enterica Choleraesuis: Typically infects pigs, but in humans, it can be fatal.
• Salmonella enterica serotype Enteritidis and serotype Typhimurium: Commonly transmitted from animals to humans. Usually not dangerous, causing gastroenteritis-like symptoms.

Young children, the elderly, and immunocompromised individuals should take special precautions, as their condition increases the risk of complications.

Symptoms

Symptoms appear between 6 and 72 hours after incubation and typically last between 2 and 7 days. The most notable symptoms include:

• Diarrhea
• Abdominal pain
• Nausea and vomiting
• Fever
• Occasionally, headaches

Causes

The food and water we consume may contain Salmonella bacteria due to contamination from fertilizer used in agriculture or the water used for irrigation and animal hydration. However, improper food handling is the primary cause, as seen with eggs, which can become contaminated if the shell comes into contact with the interior when cracked.

High-risk foods include:

• Eggs and egg-based products
• Ground meat
• Pork products
• Vegetables
• Juices

Risk Factors

The risk of contracting salmonellosis increases in the following situations:

• Consumption of raw or undercooked foods, especially meat, fish, or eggs
• Ingestion of unpasteurized dairy products
• Poor hygiene when handling food
• Traveling to areas with inadequate sanitation systems
• Eating vegetables from countries with poor sanitation
• Contact with animals
• Weakened immune system
• Gastrointestinal disorders

Complications

Infants, young children, the elderly, and individuals with weakened immune systems are at greater risk of severe symptoms and complications from salmonellosis. The most common complications include:

• Dehydration: Causes dry mouth, reduced tear and sweat production, sunken eyes, and in severe cases, kidney failure.
• Blood infection: Can be identified by the presence of blood in the stool.
• Bacteremia: Infection spreading to other organs, such as bones, meninges (membranes covering the brain and spinal cord), endocardium (heart lining), or urinary system components.
• Reiter’s syndrome or reactive arthritis: A type of arthritis causing conjunctivitis and urethritis, in addition to joint inflammation.

Prevention

Key recommendations for preventing salmonellosis include:

• Enhancing hygiene during primary production and processing by taking measures such as:
• Separating live animals from slaughter and processing areas.
• Taking special care when eviscerating gastrointestinal contents.
• Avoiding the use of fecal-contaminated water for irrigation or animal hydration.
• Maintaining the cold chain.
• Washing hands before handling food and after using the restroom.
• Storing eggs in the refrigerator after washing and ensuring the shell is undamaged.
• Consuming pasteurized dairy products and fully cooking eggs unless they are pasteurized.
• Preventing cross-contamination by cleaning utensils used for handling raw food before reusing them.

Which doctor treats salmonellosis?

Specialists involved in diagnosing and treating salmonellosis include infectious disease specialists, pediatricians, geriatricians, and family medicine physicians.