What Is Salmonella? Symptoms, Causes, Diagnosis, Treatment, and Prevention

Salmonella is a group of bacteria that commonly cause foodborne illness. An infection by the bacteria is called salmonellosis (or salmonella for short), and you can get it by consuming contaminated food products, including raw poultry, eggs, raw or unpasteurized dairy, beef, and in some cases fruits and vegetables. Processed foods may also cause salmonellosis. You can also get it by handling pets — particularly some birds and reptiles.

Most people who get a salmonella infection fully recover without treatment, but in some cases, the illness can be severe enough to require hospitalization.

Salmonella often causes mild to severe gastroenteritis, which is inflammation of the stomach and/or intestines. Such symptoms can be very similar to those caused by the viral infection commonly known as the stomach flu. Symptoms typically begin sometime between six hours to six days after exposure to the bacteria (though it can take several weeks for some people to develop symptoms). Common symptoms include:

• Diarrhea
• Abdominal cramps
• Fever
• Headache
• Nausea and vomiting
• Loss of appetite

• Nausea and vomiting
• Persistent diarrhea that lasts for longer than three days
• Blood in your stools
• Fever higher than 102 degrees Fahrenheit
• Continuous vomiting and inability to keep liquids down
• Reduced urine output and dry mouth and throat (which are signs of dehydration)
• Dizziness, especially when standing up
• Severe abdominal pain

Salmonella lives in the intestinal tract of humans and other animals, and can pass out of the body through feces. The bacteria can infect someone when they touch or eat something that’s been contaminated with salmonella. Some common ways in which a person can become infected include:

1. Eating food, drinking water, or making contact with water that has been contaminated with the intestinal content of an animal or a person or with their feces, such as:

• Undercooked beef, poultry, or fish (cooking destroys salmonella)
• Raw eggs or products containing uncooked eggs, such as cookie dough
• Raw or unpasteurized dairy or dairy products, such as milk
• Raw vegetables or fruit

2. Eating food that has been handled by a food worker who hasn’t properly washed their hands.

3. Petting an animal or handling the waste of an animal, particularly when it’s an animal that is known to carry salmonella, such as lizards, turtles, or baby birds.

• Children under age 5
• Infants who are not breastfed
• Adults 65 and older
• Individuals with a weakened immune system (such as people with HIV or sickle cell disease, cancer patients, patients undergoing chemotherapy, and those taking corticosteroids)
• People taking antacids (stomach acid can kill many types of salmonella bacteria; antacids lower your stomach’s acidity, which allows more bacteria to survive)
• People taking antibiotics (these can lower the amount of “good” bacteria and leave you vulnerable to the infection)
• People with inflammatory bowel disease, such as Crohn’s disease or ulcerative colitis, which damages your intestinal lining and makes it easier for salmonella to flourish
• Pet owners (especially those who own birds and reptiles)

Since symptoms of salmonella are similar to those of many illnesses, doctors rely on lab tests to diagnose the infection. The test that’s commonly used first is one that examines a person’s stool sample to look for the presence of the bacteria. Samples of a person’s blood may also be taken.

Prognosis of Salmonella

Most people with salmonella start to feel better within a week or so and recover completely, although it may take a few weeks or months before their bowel function (how often they poop and the consistency of their stools) returns to normal.

However, some serious cases of salmonella infection can result in death, especially if proper treatment isn’t started early enough.

In most cases, salmonella is a brief illness that causes stomach cramps and diarrhea for a few days. Symptoms typically last for about four to seven days but may linger as long as several weeks.

In some cases, however, symptoms can be more severe, last longer, and may lead to hospitalization and long-term complications.

1. Drink plenty of fluids, such as:

• Water
• Diluted fruit juice
• Sports drinks (which can help replace lost electrolytes)
• Clear broths
• Pedialyte or similar electrolyte replacement drinks (but speak to your doctor before consuming or administering them)

2. If you’re having trouble keeping anything down, try sipping small amounts of water or sucking on ice chips.

3. Eat saltine crackers or pretzels to help replace electrolytes (sodium is an electrolyte).

4. Eat small meals throughout the day.

If your doctor is concerned that you may be at risk for severe dehydration, or if you have a high fever or severe abdominal pain, they may recommend you go to the hospital for treatment with intravenous fluids and monitoring.

Medication Options

If you have a weakened immune system or if your symptoms are severe and not getting better, your doctor may prescribe antibiotics to treat your salmonella infection. Antibiotics may be recommended for:

• People with severe illness (such as high fever, severe diarrhea, or bacteria that has spread to their bloodstream)
• Adults older than 50 with underlying medical conditions, such as heart disease
• Adults 65 and older
• Infants younger than 12 months old
• People with compromised or weakened immune systems (such as cancer patients who are undergoing chemotherapy or people with HIV/AIDS)

Doctors may prescribe antibiotics, such as ciprofloxacin (Cipro), azithromycin (Zithromax), and ceftriaxone, to treat patients with severe salmonella infections. But worryingly, antibiotic-resistant salmonella has become a problem in recent years. Infections from these “multi-drug-resistant strains” of salmonella can be more severe and result in higher rates of hospitalization.

Alternative and Complementary Therapies

Researchers are still studying how probiotics may help treat food poisoning such as salmonella infections, so be sure to always talk to your doctor before using probiotics or any other treatment for your gastrointestinal problem. But given the increasing problem of antibiotic-resistant salmonella strains, potential alternative treatments such as probiotics are becoming more important.

Prevention of Salmonella

Most salmonella infections are caused by contaminated food. The best way to reduce your risk for getting salmonella is to follow good food safety measures and take steps to prevent food poisoning.

• Clean Wash your hands and surfaces such as cutting boards and countertops often and rinse fruits and vegetables under running water.
• Separate Avoid cross-contamination by using a separate cutting board for raw meat, poultry, and seafood, and by keeping these items separated from other food
• Cook Make sure food is cooked to the recommended internal temperature to kill germs.
• Chill Keep your refrigerator temperature at 40 degrees F or below and never leave perishable food out of the fridge for more than two hours. Thaw frozen food in the refrigerator or in the microwave, because leaving food out on the counter to defrost can allow bacteria to multiply rapidly.

Remember, too, to always wash your hands thoroughly after using the toilet or changing diapers and to wash your hands after contact with animals.

Salmonella infections can cause complications if the bacteria spreads from the digestive system to other places in the body, including the bloodstream, bones, joints, and central nervous system (brain and spinal cord).

Dehydration People who have a salmonella infection are at risk for losing too much fluid due to vomiting and diarrhea. Symptoms of dehydration include:

• Decreased urine production
• Dry mouth
• Sunken eyes
• Dizziness
• Heart fluttering

Bacteremia Salmonella can spread from your intestines into your bloodstream. If that happens, infection can spread to other areas of your body, including:

• The tissues surrounding the brain and spinal cord (causing meningitis)
• The lining of your heart or its valves (causing endocarditis)
• Bones or bone marrow (causing osteomyelitis)

• Pain, stiffness, swelling, or redness in the joints
• Conjunctivitis
• Painful urination

• Salmonella causes an estimated 1.35 million cases of illness each year.
• An estimated 26,500 hospitalizations are attributed to salmonella infections annually.
• Each year, salmonella causes approximately 420 deaths.

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As mentioned above, salmonella infections can lead to:

• Bacteremia
• Dehydration
• Reactive arthritis
• Typhoid or paratyphoid fever

And these underlying conditions, which weaken the immune system, may make a person more susceptible to an infection:

• Cancer
• HIV/AIDS
• Diabetes
• Kidney disease