Salmonellosis

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Salmonellosis
Electron micrograph showing Salmonella typhimurium (red) invading cultured human cells
SpecialtyInfectious disease
SymptomsDiarrhea, fever, abdominal cramps, vomiting[1]
ComplicationsReactive arthritis, irritable bowel syndrome[2]
Usual onset0.5–3 days post exposure[1]
Duration4–7 days[1]
TypesTyphoidal, nontyphoidal[1]
CausesSalmonella[1]
Risk factorsOld, young, weak immune system, bottle feeding, proton pump inhibitors[1]
Diagnostic methodStool test, blood tests[3][1]
Differential diagnosisOther types of gastroenteritis[2]
PreventionProper preparation and cooking of food, supervising contact between young children and pets[4]
TreatmentFluids by mouth, intravenous fluids, antibiotics[1]
Frequency1.2 million non–typhoidal cases per year (US)[1]
Deaths268,000 (2015)[5]

Salmonellosis is a symptomatic infection caused by bacteria of the Salmonella type.[1] The most common symptoms are diarrhea, fever, abdominal cramps, and vomiting.[1] Symptoms typically occur between 12 hours and 36 hours after exposure, and last from two to seven days.[4] Occasionally more significant disease can result in dehydration.[4] The old, young, and others with a weakened immune system are more likely to develop severe disease.[1] Specific types of Salmonella can result in typhoid fever or paratyphoid fever.[1][3]

There are two species of Salmonella: Salmonella bongori and Salmonella enterica with many subspecies.[4] Infection is usually spread by eating contaminated meat, eggs, or milk.[6] Other foods may spread the disease if they have come into contact with manure.[4] A number of pets including cats, dogs, and reptiles can also carry and spread the infection.[4] Diagnosis is by a stool test or blood tests.[1][3]

Efforts to prevent the disease include the proper washing, preparation, and cooking of food.[4] Mild disease typically does not require specific treatment.[4] More significant cases may require treatment of electrolyte problems and intravenous fluid replacement.[1][4] In those at high risk or in whom the disease has spread outside the intestines, antibiotics are recommended.[4]

Salmonellosis is one of the most common causes of diarrhea globally.[2] In 2015, 90,300 deaths occurred from nontyphoidal salmonellosis, and 178,000 deaths from typhoidal salmonellosis.[5] In the United States, about 1.2 million cases and 450 deaths occur from nontyphoidal salmonellosis a year.[1] In Europe, it is the second most common foodborne disease after campylobacteriosis.[2]

Signs and symptoms

Enteritis

See also: Enteritis § Infectious enteritis

After a short incubation period of a few hours to one day, the bacteria multiply in the small intestine, causing an intestinal inflammation (enteritis). Most people with salmonellosis develop diarrhea, fever, vomiting, and abdominal cramps 12 to 72 hours after infection.[7] Diarrhea is often watery and non-bloody but may be mucoid and bloody.[8] In most cases, the illness lasts a few days, and does not require treatment. In some cases, though, the diarrhea may be so severe that the person becomes dangerously dehydrated and must be hospitalized, the person may receive fluids intravenously to treat the dehydration, and may be given medications to provide symptomatic relief, such as fever reduction. In severe cases, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites, and can cause death.[9][10][11]

In healthy adults, the symptoms can be mild, normally, no sepsis occurs, but it can occur exceptionally as a complication in the immunocompromised. However, in people at risk such as infants, and small children, Salmonella infections can become very serious, leading to complications. In infants, dehydration can cause a state of severe toxicity. Extraintestinal localizations are possible, especially Salmonella meningitis in children. Children with sickle-cell anemia who are infected with Salmonella may develop osteomyelitis.[11][9][10]

Those whose only symptom is diarrhea usually completely recover, but their bowel habits may not return to normal for several months.[12]

Typhoid fever

Rose spots on chest of a person with typhoid fever
See also: Typhoid fever and Paratyphoid fever

Typhoid fever occurs when Salmonella bacteria enter the lymphatic system and cause a systemic form of salmonellosis. Endotoxins first act on the vascular and nervous apparatus, resulting in increased permeability and decreased tone of the vessels, upset thermal regulation, vomiting, and diarrhea. In severe forms of the disease, enough liquid and electrolytes are lost to upset the fluid balance, cause an electrolyte imbalance, decrease the circulating blood volume and arterial pressure, and cause hypovolemic shock. Septic shock may also develop. Shock of mixed character (with signs of both hypovolemic and septic shock) are more common in severe salmonellosis. Oliguria and azotemia develop in severe cases as a result of renal involvement due to hypoxia and toxemia.[7]

Long-term

Salmonellosis is associated with later irritable bowel syndrome[13] and inflammatory bowel disease.[14] Evidence however does not support it being a direct cause of the latter.[14]

A small number of people afflicted with salmonellosis experience reactive arthritis, which can last months or years and can lead to chronic arthritis.[15] In sickle-cell anemia, osteomyelitis due to Salmonella infection is much more common than in the general population. Though Salmonella infection is frequently the cause of osteomyelitis in people with sickle-cell, it is not the most common cause, which is Staphylococcus infection.[16]Those infected may become asymptomatic carriers, but this is relatively uncommon, with shedding observed in only 0.2 to 0.6% of cases after a year.[17]

Causes

Rate of reptile-associated Salmonella serotypes isolated from humans – United States, 1963-1998. Note how the rate of isolated Salmonella serotypes had increased over that 35-year period.

Among the causes for Salmonellosis are:

  • Contaminated food, often having no unusual look or smell[18]
  • Poor kitchen hygiene, especially problematic in institutional kitchens and restaurants [19]
  • Excretions from either sick or infected people and animals[19][20]
  • (Polluted) surface water and standing water, such as in shower hoses [19]
  • An association with reptiles (pet tortoises, snakes, iguanas,[21][22] and aquatic turtles) is well described.[23]

Salmonella bacteria can survive for some time without a host; they are frequently found in polluted water, with contamination from the excrement of carrier animals being particularly important.[24]

The European Food Safety Authority highly recommends that when handling raw turkey meat, consumers and people involved in the food supply chain should pay attention to personal and food hygiene.[25]

An estimated 142,000 Americans are infected each year with Salmonella Enteritidis from chicken eggs,[26] and about 30 die.[27] The shell of the egg may be contaminated with Salmonella by feces or environment, or its interior (yolk) may be contaminated by penetration of the bacteria through the porous shell or from a hen whose infected ovaries contaminate the egg during egg formation.[28][29]

Nevertheless, such interior egg yolk contamination is theoretically unlikely.[30][31][32][33] Even under natural conditions, the rate of infection was very small (0.6% in a study of naturally contaminated eggs[34] and 3.0% among artificially and heavily infected hens[35]).

Diagnosis

The diagnosis of Salmonella (salmonellosis) is done via a lab test on :[36]

  • Stool
  • Body tissue
  • Body fluids

Prevention

See also: Critical control point
How Salmonella bacteria spread from the farm

The US Food and Drug Administration (FDA) has published guidelines to help reduce the chance of food-borne salmonellosis.[37] Food must be cooked to 145–165 °F (63–74 °C), and liquids such as soups or gravies should be boiled when reheating. Freezing kills some Salmonella, but it is not sufficient to reliably reduce them below infectious levels. While Salmonella is usually heat-sensitive, it acquires heat-resistance in high-fat environments such as peanut butter.[38]

In terms of prevention , always wash your hands if you have touched pets and other animals.Don’t allow children five years of age (or younger) or older adults touch turtles, frogs, ducks or chickens which are higher-risk animals. [39]

Vaccine

Antibodies against nontyphoidal Salmonella were first found in Malawi children in research published in 2008. The Malawian researchers identified an antibody that protects children against bacterial infections of the blood caused by nontyphoidal Salmonella. A study at Queen Elizabeth Hospital in Blantyre found that children up to two years old develop antibodies that aid in killing the bacteria. This could lead to a possible Salmonella vaccine for humans.[40]

A 2014 study tested a vaccine on chickens which offered efficient protection against salmonellosis.[41]Vaccination of chickens against Salmonella essentially wiped out the disease in the United Kingdom. A similar approach was considered in the United States, but the Food and Drug Administration decided not to mandate vaccination of hens.[42]

Industrial hygiene

Since 2011, Denmark has had zero cases of human salmonella poisoning.[43] The country eradicated salmonella without vaccines and antibiotics by focusing on eliminating the infection from "breeder stocks", implementing various measures to prevent infection, and taking a zero-tolerance policy towards salmonella in chickens.[43]

Treatment

Ceftriaxone

Electrolytes may be replenished with oral rehydration supplements (typically containing salts sodium chloride and potassium chloride).[11]

Appropriate antibiotics, such as ceftriaxone, may be given to kill the bacteria, but are not necessary in most cases.[17]

Azithromycin has been suggested to be better at treating typhoid in resistant populations than both fluoroquinolone drugs and ceftriaxone[44].

There are recommendations on choice of antibiotic to avoid promoting antibiotic resistance.[45]

There is no evidence of benefit of treating healthy people with diarrhea due to non-typhoidal salmonellosis. However, the evidence for the very young, very old or people with severe diseases are uncertain.[46]

Epidemiology

United States

Main article: Salmonellosis in the United States
Map of cases per million residents during 2008 outbreak

About 142,000 people in the United States are infected each year with Salmonella Enteritidis from chicken eggs, and about 30 die.[27]

In 2010, an analysis of death certificates in the United States identified a total of 1,316 Salmonella-related deaths from 1990 to 2006. These were predominantly among older adults and those who were immunocompromised.[47] The U.S. government reported as many as 20% of all chickens were contaminated with Salmonella in the late 1990s, and 16.3% were contaminated in 2005.[48]

The United States has struggled to control salmonella infections, with the rate of infection rising from 2001 to 2011. In 1998, the USDA moved to close plants if salmonella was found in excess of 20 percent, which was the industry's average at the time, for three consecutive tests.[49] Texas-based Supreme Beef Processors, Inc. sued on the argument that Salmonella is naturally occurring and ultimately prevailed when a federal appeals court affirmed a lower court.[49] These issues were highlighted in a proposed Kevin's Law (formally proposed as the Meat and Poultry Pathogen Reduction and Enforcement Act of 2003), of which components were included the Food Safety Modernization Act passed in 2011, but that law applies only to the FDA and not the USDA.[49] The USDA proposed a regulatory initiative in 2011 to Office of Management and Budget.[50]

In May 2022, a Salmonella outbreak was reported by the CDC. The outbreak occurred over 12 states, with several individuals hospitalized.[51][52] By the end of the same month the total affected individuals were sixteen, with more products from the same company being recalled.[53]

Europe

An outbreak of salmonellosis started in Northern Europe in July 2012, caused by Salmonella thompson. The infections were linked to smoked salmon from the manufacturer Foppen, where the contamination had occurred. Most infections were reported in the Netherlands; over 1060 infections with this subspecies and four fatalities were confirmed.[54][55]

A case of widespread infection was detected mid-2012 in seven EU countries. Over 400 people had been infected with Salmonella enterica serovar Stanley (S. Stanley) that usually appears in the regions of Southeast Asia. After several DNA analyses seemed to point to a specific Belgian strain, the "Joint ECDC/E FSA Rapid Risk Assessment" report detected turkey production as the source of infection.[56]In Germany, food poisoning infections must be reported.[57]

Asia

About 150 people were sickened by Salmonella-tainted chocolate cake produced by a major bakery chain in Singapore in December 2007.[58]

History

Daniel E. Salmon, c. 1903–1905

Both salmonellosis and the microorganism genus Salmonella derive their names from a modern Latin coining after Daniel E. Salmon (1850–1914), an American veterinary surgeon. He had help from Theobald Smith, and together they found the bacterium in pigs.[59][60]

Salmonella enterica was possibly the cause of the 1576 cocliztli epidemic in New Spain.[61]

Four-inch regulation

The "Four-inch regulation" or "Four-inch law" is a colloquial name for a regulation issued by the U.S. FDA in 1975, restricting the sale of turtles with a carapace length less than four inches (10 cm).[62]

The regulation was introduced, according to the FDA, "because of the public health impact of turtle-associated salmonellosis". Cases had been reported of young children placing small turtles in their mouths, which led to the size-based restriction.[63]

Society and culture

On May of 2022, a U.S. recall of peanut butter from a major brand occurred after an outbreak of Salmonella was confirmed.[64]

See also

References

  1. ↑ 1.00 1.01 1.02 1.03 1.04 1.05 1.06 1.07 1.08 1.09 1.10 1.11 1.12 1.13 1.14 1.15 "Salmonella". CDC. 9 March 2015. Archived from the original on 25 May 2017. Retrieved 7 May 2017.
  2. ↑ 2.0 2.1 2.2 2.3 Hald, T. (2013). Advances in microbial food safety: 2. Pathogen update: Salmonella. Elsevier Inc. Chapters. p. 2.2. ISBN 9780128089606. Archived from the original on 2017-09-10.
  3. ↑ 3.0 3.1 3.2 "Salmonella Infections". MedlinePlus. Archived from the original on 30 April 2017. Retrieved 7 May 2017.
  4. ↑ 4.0 4.1 4.2 4.3 4.4 4.5 4.6 4.7 4.8 4.9 "Salmonella (non-typhoidal)". World Health Organization. December 2016. Archived from the original on 20 April 2017. Retrieved 7 May 2017.
  5. ↑ 5.0 5.1 Wang, Haidong; et al. (8 October 2016). "Global, regional, and national life expectancy, all-cause mortality, and cause-specific mortality for 249 causes of death, 1980-2015: a systematic analysis for the Global Burden of Disease Study 2015". Lancet. 388 (10053): 1459–1544. doi:10.1016/s0140-6736(16)31012-1. PMC 5388903. PMID 27733281.
  6. ↑ "Salmonella". World Health Organization. Archived from the original on 17 April 2017. Retrieved 7 May 2017.
  7. ↑ 7.0 7.1 Santos, Renato L.; Shuping Zhang; Renee M. Tsolis; Robert A. Kingsley; L. Gary Adams; Andreas J. Baumler (2001). "Animal models od Salmonella infections: enteritis versus typhoid fever". Microbes and Infection. 3 (14–15): 1335–1344. doi:10.1016/s1286-4579(01)01495-2. PMID 11755423.
  8. ↑ "Nontyphoidal Salmonella Infections - Infectious Diseases - Merck Manuals Professional Edition". Merck Manuals Professional Edition. Archived from the original on 2018-09-12. Retrieved 2018-09-15.
  9. ↑ 9.0 9.1 "Enteritis: MedlinePlus Medical Encyclopedia". medlineplus.gov. Archived from the original on 5 July 2016. Retrieved 23 May 2022.
  10. ↑ 10.0 10.1 Giannella, Ralph A. (1996). "Salmonella". Medical Microbiology (4th ed.). University of Texas Medical Branch at Galveston. ISBN 978-0-9631172-1-2. Archived from the original on 2022-04-11. Retrieved 25 May 2022.
  11. ↑ 11.0 11.1 11.2 Ajmera, Arun; Shabbir, Nadeem (2022). "Salmonella". StatPearls. StatPearls Publishing. Archived from the original on 8 February 2022. Retrieved 25 May 2022.
  12. ↑ "What is Salmonellosis?". US Center of Disease Control and Prevention. 2019-02-08. Archived from the original on 2014-03-31.
  13. ↑ Smith, JL; Bayles, D (July 2007). "Postinfectious irritable bowel syndrome: a long-term consequence of bacterial gastroenteritis". Journal of Food Protection. 70 (7): 1762–9. doi:10.4315/0362-028X-70.7.1762. PMID 17685356. S2CID 42240663. Archived from the original on 2021-08-29. Retrieved 2020-01-29.
  14. ↑ 14.0 14.1 Mann, EA; Saeed, SA (January 2012). "Gastrointestinal infection as a trigger for inflammatory bowel disease". Current Opinion in Gastroenterology. 28 (1): 24–9. doi:10.1097/mog.0b013e32834c453e. PMID 22080823. S2CID 800248.
  15. ↑ Schmitt, SK (November 2017). "Reactive Arthritis". Infectious Disease Clinics of North America (Review). 31 (2): 265–77. doi:10.1016/j.idc.2017.01.002. PMID 28292540.
  16. ↑ Cook, Bruce A.; Md, James W. Bass; Burnett, Mark W. (1998-02-01). "Etiology of Osteomyelitis Complicating Sickle Cell Disease". Pediatrics. 101 (2): 296–297. doi:10.1542/peds.101.2.296. ISSN 0031-4005. PMID 9445507. Archived from the original on 2018-10-18. Retrieved 2019-02-08.
  17. ↑ 17.0 17.1 "Nontyphoidal Salmonella Infections". Merck Manual. Archived from the original on 2016-09-19. Retrieved 2016-09-19.
  18. ↑ Jeanne Goldberg (24 February 2012). "Are the bacteria that make food smell and taste bad the same ones that make you sick?". Tufts.edu. Archived from the original on 25 May 2018. Retrieved 28 May 2018.
  19. ↑ 19.0 19.1 19.2 Canada, Public Health Agency of (7 September 2016). "Causes of salmonellosis (Salmonella)". www.canada.ca. Archived from the original on 3 December 2021. Retrieved 24 May 2022.
  20. ↑ Wiedemann, Agnès; Virlogeux-Payant, Isabelle; Chaussé, Anne-Marie; Schikora, Adam; Velge, Philippe (2015). "Interactions of Salmonella with animals and plants". Frontiers in Microbiology. 5. doi:10.3389/fmicb.2014.00791/full. ISSN 1664-302X. Archived from the original on 9 June 2022. Retrieved 3 June 2022.
  21. ↑ "Reptile-Associated Salmonellosis—Selected States, 1998–2002". Centers for Disease Control and Prevention. 12 December 2003. Archived from the original on 6 October 2011. Retrieved 9 October 2011.
  22. ↑ Mermin J, Hoar B, Angulo FJ (March 1997). "Iguanas and Salmonella marina infection in children: a reflection of the increasing incidence of reptile-associated salmonellosis in the United States". Pediatrics. 99 (3): 399–402. doi:10.1542/peds.99.3.399. PMID 9041295.
  23. ↑ "Ongoing investigation into reptile associated salmonella infections". Health Protection Report. 3 (14). 9 April 2009. Archived from the original on 29 April 2009. Retrieved 12 April 2009.
  24. ↑ Andino, A.; Hanning, I. (13 January 2015). "Salmonella enterica: Survival, Colonization, and Virulence Differences among Serovars". The Scientific World Journal. 2015: e520179. doi:10.1155/2015/520179. Archived from the original on 12 February 2021. Retrieved 31 May 2022.
  25. ↑ "Multi-country outbreak of Salmonella Stanley infections Update". EFSA Journal. 10 (9): 2893. 21 September 2012. doi:10.2903/j.efsa.2012.2893.
  26. ↑ "Playing It Safe With Eggs". FDA Food Facts. 2013-02-28. Archived from the original on 2013-03-01. Retrieved 2013-03-02. The U.S. Food and Drug Administration (FDA) estimates that 142,000 illnesses each year are caused by consuming eggs contaminated with Salmonella.
  27. ↑ 27.0 27.1 Black, Jane; O'Keefe, Ed (2009-07-08). "Administration Urged to Boost Food Safety Efforts". Washington Post. Archived from the original on 2011-06-04. Retrieved 2009-07-07. Among them is a final rule, issued by the FDA, to reduce the contamination in eggs. About 142,000 Americans are infected each year with Salmonella enteritidis from eggs, the result of an infected hen passing along the bacterium. About 30 die.
  28. ↑ Gantois, Inne; Richard Ducatelle; Frank Pasmans; Freddy Haesebrouck; Richard Gast; Tom J. Humphrey; Filip Van Immerseel (July 2009). "Mechanisms of egg contamination by Salmonella Enteritidis". FEMS Microbiology Reviews. 33 (4): 718–738. doi:10.1111/j.1574-6976.2008.00161.x. PMID 19207743. Eggs can be contaminated on the outer shell surface and internally. Internal contamination can be the result of penetration through the eggshell or by direct contamination of egg contents before oviposition, originating from infection of the reproductive organs. Once inside the egg, the bacteria need to cope with antimicrobial factors in the albumen and vitelline membrane before migration to the yolk can occur
  29. ↑ Humphrey, T. J. (January 1994). "Contamination of egg shell and contents with Salmonella enteritidis: a review". International Journal of Food Microbiology. 21 (1–2): 31–40. doi:10.1016/0168-1605(94)90197-X. PMID 8155476. Salmonella enteritidis can contaminate the contents of clean, intact shell eggs as a result of infections of the reproductive tissue of laying hens. The principal site of infection appears to be the upper oviduct. In egg contents, the most important contamination sites are the outside of the vitelline membrane or the albumen surrounding it. In fresh eggs, only a few salmonellae are present. As albumen is an iron-restricted environment, growth only occurs with storage-related changes to vitelline membrane permeability, which allows salmonellae to invade yolk contents.
  30. ↑ Stokes, J.L.; W.W. Osborne; H.G. Bayne (September 1956). "Penetration and Growth of Salmonella in Shell Eggs". Journal of Food Science. 21 (5): 510–518. doi:10.1111/j.1365-2621.1956.tb16950.x. Normally, the oviduct of the hen is sterile and therefore the shell and internal contents of the egg are also free of microorganisms (10,16). In some instances, however, the ovaries and oviduct may be infected with Salmonella and these may be deposited inside the egg (12). More frequently, however, the egg becomes contaminated after it is laid.
  31. ↑ Okamura, Masashi; Yuka Kamijima; Tadashi Miyamoto; Hiroyuki Tani; Kazumi Sasai; Eiichiroh Baba (2001). "Differences Among Six Salmonella Serovars in Abilities to Colonize Reproductive Organs and to Contaminate Egges in Laying Hens". Avian Diseases. 45 (1): 61–69. doi:10.2307/1593012. JSTOR 1593012. PMID 11332500. when hens were artificially infected to test for transmission rate to yolks: "Mature laying hens were inoculated intravenously with 106 colony-forming units of Salmonella enteritidis, Salmonella typhimurium, Salmonella infantis, Salmonella hadar, Salmonella heidelberg, or Salmonella montevideo to cause the systemic infection. Salmonella Enteritidis was recovered from three yolks of the laid eggs (7.0%), suggesting egg contamination from the transovarian transmission of S. enteritidis."
  32. ↑ Gast, RK; D.R. Jones; K.E. Anderson; R. Guraya; J. Guard; P.S. Holt (August 2010). "In vitro penetration of Salmonella enteritidis through yolk membranes of eggs from 6 genetically distinct commercial lines of laying hens". Poultry Science. 89 (8): 1732–1736. doi:10.3382/ps.2009-00440. PMID 20634530. Archived from the original on 2011-07-24. Retrieved 2010-08-20. In this study, egg yolks were infected at the surface of the yolk (vitelline membrane) to determine the percentage of yolk contamination (a measure used to determine egg contamination resistance, with numbers lower than 95% indicating increasing resistance): Overall, the frequency of penetration of Salmonella Enteritidis into the yolk contents of eggs from individual lines of hens ranged from 30 to 58% and the mean concentration of Salmonella Enteritidis in yolk contents after incubation ranged from 0.8 to 2.0 log10 cfu/mL.
  33. ↑ Jaeger, Gerald (Jul–Aug 2009). "Contamination of eggs of laying hens with S. Enteritidis". Veterinary Survey (Tierärztliche Umschau). 64 (7–8): 344–348. Retrieved 2010-08-20. The migration of the bacterium into the nutritionally rich yolk is constrained by the lysozyme loaded vitelline membrane, and would need warm enough storage conditions within days and weeks. The high concentration on of antibodies of the yolk does not inhibit the Salmonella multiplication. Only seldom does transovarian contamination of the developing eggs with S. enteritidis make this bacterium occur in laid eggs, because of the bactericidal efficacy of the antimicrobial peptides
  34. ↑ Humphrey, T.J.; A. Whitehead; A. H. L. Gawler; A. Henley; B. Rowe (1991). "Numbers of Salmonella enteritidis in the contents of naturally contaminated hens' eggs". Epidemiology and Infection. 106 (3): 489–496. doi:10.1017/S0950268800067546. PMC 2271858. PMID 2050203. Over 5700 hens eggs from 15 flocks naturally infected with Salmonella enteritidis were examined individually for the presence of the organism in either egg contents or on shells. Thirty-two eggs (0·6%) were positive in the contents. In the majority, levels of contamination were low.
  35. ↑ Gast, Richard; Rupa Guraya; Jean Guard; Peter Holt; Randle Moore (March 2007). "Colonization of specific regions of the reproductive tract and deposition at different locations inside eggs laid by hens infected with Salmonella Enteritidis or Salmonella Heidelberg". Avian Diseases. 51 (1): 40–44. doi:10.1637/0005-2086(2007)051[0040:cosrot]2.0.co;2. PMID 17461265. Archived from the original on 2010-03-10. Retrieved 2010-08-20. when hens are artificially infected with unrealistically large doses (according to the author): In the present study, groups of laying hens were experimentally infected with large oral doses of Salmonella Heidelberg, Salmonella Enteritidis phage type 13a, or Salmonella Enteritidis phage type 14b. For all of these isolates, the overall frequency of ovarian colonization (34.0%) was significantly higher than the frequency of recovery from either the upper (22.9%) or lower (18.1%) regions of the oviduct. No significant differences were observed between the frequencies of Salmonella isolation from egg yolk and albumen (4.0% and 3.3%, respectively).
  36. ↑ "Diagnosis and Treatment | Salmonella | CDC". www.cdc.gov. 15 April 2019. Archived from the original on 17 May 2022. Retrieved 22 May 2022.
  37. ↑ "Salmonella Questions and Answers". USDA Food Safety and Inspection Service. 2006-09-20. Archived from the original on 2009-01-15. Retrieved 2009-01-21.
  38. ↑ "FDA issues peanut safety guidelines for foodmakers". Reuters. 2009-03-10. Archived from the original on 2009-03-12.
  39. ↑ "Prevention | General Information | Salmonella | CDC". www.cdc.gov. 2 March 2021. Archived from the original on 6 October 2014. Retrieved 27 May 2022.
  40. ↑ MacLennan CA, Gondwe EN, Msefula CL, et al. (April 2008). "The neglected role of antibody in protection against bacteremia caused by nontyphoidal strains of Salmonella in African children". J. Clin. Invest. 118 (4): 1553–62. doi:10.1172/JCI33998. PMC 2268878. PMID 18357343.
  41. ↑ Nandre, Rahul M.; Lee, John Hwa (Jan 2014). "Construction of a recombinant-attenuated Salmonella Enteritidis strain secreting Escherichia coli heat-labile enterotoxin B subunit protein and its immunogenicity and protection efficacy against salmonellosis in chickens". Vaccine. 32 (2): 425–431. doi:10.1016/j.vaccine.2013.10.054. PMID 24176491.
  42. ↑ Neuman, William (2010-08-24). "U.S. Forgoes Salmonella Vaccine for Egg Safety". The New York Times. ISSN 0362-4331. Archived from the original on 2016-04-17. Retrieved 2016-03-12.
  43. ↑ 43.0 43.1 "Contaminated chicken: After illnesses soar, Denmark attacks salmonella at its source". 2014-03-18. Archived from the original on 2015-06-09. Retrieved 2016-09-18.
  44. ↑ Effa, Emmanuel E; Bukirwa, Hasifa (5 October 2011). "Azithromycin for treating uncomplicated typhoid and paratyphoid fever (enteric fever)". Cochrane Database of Systematic Reviews. doi:10.1002/14651858.CD006083.pub3. Archived from the original on 24 May 2022. Retrieved 24 May 2022.
  45. ↑ "Salmonella-Questions and answers". CDC. Archived from the original on 9 June 2022. Retrieved 29 May 2022.
  46. ↑ Onwuezobe, IA; Oshun, PO; Odigwe, CC (2012-11-14). "Antimicrobials for Treating Symptomatic Non-Typhoidal Salmonella Infection". The Cochrane Database of Systematic Reviews. 11: CD001167. doi:10.1002/14651858.CD001167.pub2. PMC 6532567. PMID 23152205. Archived from the original on 2021-08-29. Retrieved 2020-05-31.
  47. ↑ Cummings, PL; Sorvillo F; Kuo T (November 2010). "Salmonellosis-related mortality in the United States, 1990–2006". Foodborne Pathogens and Disease. 7 (11): 1393–9. doi:10.1089/fpd.2010.0588. PMID 20617938.
  48. ↑ Burros, Marian (March 8, 2006). "More Salmonella Is Reported in Chickens". The New York Times. Archived from the original on January 9, 2016. Retrieved 2007-05-13.
  49. ↑ 49.0 49.1 49.2 "Salmonella Lurks From Farm to Fork « News21 2011 National Project". foodsafety.news21.com. Archived from the original on 2016-06-02. Retrieved 2016-09-18.
  50. ↑ "Ground Turkey Recall Shows We Still Need Kevin's Law | Food Safety News". 2011-08-12. Archived from the original on 2016-10-09. Retrieved 2016-09-18.
  51. ↑ "CDC: Salmonella Outbreak Linked to Peanut Butter". Centers for Disease Control and Prevention. 21 May 2022. Archived from the original on 21 May 2022. Retrieved 23 May 2022.
  52. ↑ Nutrition, Center for Food Safety and Applied (21 May 2022). "The J. M. Smucker Co. Issues Voluntary Recall of Select Jif® Products Sold in the U.S. for Potential Salmonella Contamination". U.S. Food and Drug Administration. Archived from the original on 22 May 2022. Retrieved 23 May 2022.
  53. ↑ "How Does Peanut Butter Get Contaminated With Salmonella, Anyway?". MSN. Archived from the original on 9 June 2022. Retrieved 28 May 2022.
  54. ↑ Veelgestelde vragen Salmonella Thompson 15 oktober 2012, Rijksinstituut voor Volksgezondheid en Milieu [Frequently asked questions Salmonella Thompson 15 October 2012, Netherlands Institute for Public Health and the Environment].
  55. ↑ "Salmonella besmetting neemt verder af, 2 november 2012, Rijksinstituut voor Volksgezondheid en Milieu" [Salmonella infections continue to decline 2 November 2012, Netherlands Institute for Public Healthand the Environment].
  56. ↑ Multi-country outbreak of Salmonella Stanley infections Update Archived 2014-04-13 at the Wayback Machine EFSA Journal 2012;10(9):2893 [16 pp.]. Retrieved 04/23/2013
  57. ↑ § 6 and § 7 of the German law on infectious disease prevention, Infektionsschutzgesetz
  58. ↑ Hong, Lynda (7 December 2007). "PrimaDeli food poisoning cases increase to 153". Channel NewsAsia. Archived from the original on 8 December 2007.
  59. ↑ "Daniel E. Salmon". www.nal.usda.gov. Archived from the original on 6 February 2022. Retrieved 25 May 2022.
  60. ↑ Nuttall, George Henry Falkiner (1 December 1935). "Theobald Smith, 1859-1934". Obituary Notices of Fellows of the Royal Society. 1 (4): 514–521. doi:10.1098/rsbm.1935.0014. Archived from the original on 9 June 2022. Retrieved 2 June 2022.
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  62. ↑ "Human Health Hazards Associated with Turtles". U.S. Food and Drug Administration. Archived from the original on 2007-06-09. Retrieved 2007-06-29.
  63. ↑ Bosch, Stacey; Tauxe, Robert V.; Behravesh, Casey Barton (July 2016). "Turtle-Associated Salmonellosis, United States, 2006-2014". Emerging Infectious Diseases. 22 (7): 1149–1155. doi:10.3201/eid2207.150685. ISSN 1080-6059. Archived from the original on 9 June 2022. Retrieved 31 May 2022.
  64. ↑ "Jif peanut butter salmonella concerns prompt more recalls". www.cbsnews.com. Archived from the original on 26 May 2022. Retrieved 1 June 2022.

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External resources
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