What is salmonellosis?

Salmonellosis is an infection with bacteria called Salmonella, which generally affects the intestines and occasionally the bloodstream. It is one of the more common causes of diarrheal illness with an estimated several thousand cases occurring in New York State each year. Most cases occur in the summer months and can be seen as single cases, clusters or outbreaks.

Who gets salmonellosis?

Any person can get salmonellosis, but it is diagnosed more often in infants and children. Young children, the elderly, and the immunocompromised are the most likely to have severe infections.

How are Salmonella bacteria spread?

Salmonella are spread by eating or drinking contaminated food or water or by contact with infected people or animals.

What are the symptoms of salmonellosis?

People infected with Salmonella may experience mild or severe diarrhea, abdominal cramps, fever and occasionally vomiting. Bloodstream infections can be quite serious, particularly in the very young or elderly.

How soon after exposure do symptoms appear?

The symptoms generally appear one to three days after contact with Salmonella bacteria.

Where are Salmonella found?

Salmonella can be found in raw or undercooked meats and eggs, unpasteurized milk and cheese products . Foods can also be contaminated by Salmonella bacteria during preparation or processing. Other exposures may include contact with infected animals, especially poultry, swine, cattle, rodents and pets, such as reptiles (iguanas, snakes, lizards and turtles), chicks, ducklings, birds, dogs and cats. Previous outbreaks of Salmonella in New York State have been associated with peanut butter, frozen pot pies, eggs, pet foods and turtles.

How long can an infected person carry Salmonella?

An infected person can carry the bacteria for a few days or several months. People who have been treated with oral antibiotics and younger people tend to carry the bacteria longer than others.

Do infected people need to be isolated or excluded from work or school?

Most infected people may return to work or school when their diarrhea has stopped. Food workers, health care personnel and children in daycare must obtain the approval from the local or state health department before returning to their normal work activities.

What is the treatment for salmonellosis?

Salmonella infections usually resolve in five to seven days and often do not require treatment unless the patient becomes severely dehydrated or the infection spreads from the intestines. Those with severe diarrhea may require rehydration, often with intravenous fluids. Antibiotics are usually not necessary unless the infection spreads from the intestines.

How can salmonellosis be prevented?

1. Always handle raw poultry, beef and pork accordingly:
   • Wrap fresh meats in plastic bags at the market to prevent blood from dripping on other foods. Refrigerate foods promptly; minimize holding at room temperature.
   • Never place cooked food on an unwashed plate that previously held raw beef, poultry, pork, fish or seafood.
   • Cutting boards and counters used for beef, poultry, pork, fish or seafood preparation should be washed immediately after use to prevent cross contamination with other foods.
   • Avoid eating raw or undercooked meats. While the juice color will usually change from red to gray when the meat is fully cooked, it is not a reliable test to assure it is safe to eat.

   • Always check the temperature with a meat thermometer. Foods that reach the temperatures listed below or higher are fully cooked.

     Food	Temperature
     Chicken	165° F
     Hamburger	160° F
     Pork	150° F
     Hot dogs	140° F
     Leftovers	165° F
     Eggs	145° F
     Other foods	140° F

   • To check the temperature of the meat, insert the thermometer into the center of the meat, which is the least cooked part. For checking hot dogs, go from the end of the hot dog to the center. Be careful not to pass through the meat and touch the cooking surface or you will get a false high temperature reading.
   • Further advice on food preparation and disease prevention is available at http://www.nyhealth.gov/environmental/indoors/food_safety/barbecue.htm
2. Avoid eating raw eggs or undercooking foods containing raw eggs. Raw eggs may be unrecognized in some foods such as homemade hollandaise sauce, Caesar and other homemade salad dressings, tiramisu, homemade ice cream, homemade mayonnaise, homemade eggnog, cookie dough and frosting.
3. Avoid drinking unpasteurized milk.
4. Wash fruits and vegetables before eating.
5. Encourage careful hand washing before and after food preparation.
6. Wash hands (especially children) immediately after handling reptiles, having contact with pet feces or handling pet food or treats.
7. Do not keep reptiles as pets in homes with immunocompromised persons or young children.

What Is E. Coli?

E. coli is a common type of bacteria that can get into food, like beef and vegetables. E. coli is short for the medical term Escherichia coli. The strange thing about these bacteria — and lots of other bacteria — is that they're not always harmful to you.
E. coli normally lives inside your intestines, where it helps your body break down and digest the food you eat. Unfortunately, certain types (called strains) of E. coli can get from the intestines into the blood. This is a rare illness, but it can cause a very serious infection.

Someone who has E. coli infection may have these symptoms:

• bad stomach cramps and belly pain
• vomiting
• diarreha sometimes with blood in it

One very bad strain of E. coli was found in fresh spinach in 2006 and some fast-food hamburgers in 1993. Beef can contain E. coli because the bacteria often infect cattle. It can be in meat that comes from cattle and it's also in their poop, called manure. Cow poop in your food? How does that happen? Not on purpose, of course, but it can happen if the manure is used for fertilizer (a common practice to help crops grow) or if water contaminated with E. coli is used to irrigate the crops.

Foods to Watch

E. coli can be passed from person to person, but serious E. coli infection is more often linked to food containing the bacteria. The person eats the contaminated food and gets sick.

Here are some foods that can cause E. coli poisoning:

• undercooked ground beef (used for hamburgers)
• vegetables grown in cow manure or washed in contaminated water
• fruit juice that isn't pasteurized (pasteurization is a process that uses heat to kill germs)

Heat can kill E. coli, so experts recommend that people cook beef (especially ground beef) until it is cooked through and no longer pink. Choosing pasteurized juice is another way to avoid possible infection.

Lastly, some experts recommend washing and scrubbing vegetables before eating them. But others say E. coli is hard to remove once it has contaminated produce, such as spinach, lettuce, or onions. The solution, they say, is to take more steps so that E. coli doesn't come in contact with crops.

What Will the Doctor Do?

If someone has symptoms of E. coli poisoning, the doctor will run some blood tests and take a sample of the person's stool (poop). The blood and stool can be checked to see if a harmful strain of E. coli is present. Even though diarrhea is one of the main symptoms, the person shouldn't take anti-diarrhea medicines because they can slow down recovery time.

Some people recover at home, while others need to be in the hospital. In some cases, E. coli poisoning can cause life-threatening kidney problems.

What Can Kids Do?

Adults are the main people in charge of preventing E. coli infection by serving well-cooked meat, cleaning countertops when preparing meats, and being aware of any recalls affecting contaminated vegetables or other products.

But kids can help, too. Here are three ways:

1. When you're at a restaurant, order your burger well done. Eat it only if it's brown, not pink, on the inside.
2. Don't swallow lake, ocean, or pool water. If the water contains any human waste, it can carry the E. coli bacteria.
3. Always wash your hands after you use the bathroom and before you eat. There are plenty of bacteria in your poop. Gross! You don't want to accidentally eat some of those bad bacteria!