Salmonella (including Typhoid fever and Paratyphoid fever)

Salmonellosis Basics

Salmonellosis is illness caused by the bacterium Salmonella. It is one of the more common causes of gastroenteritis with more than 2300 cases occurring in Georgia each year. Most cases occur in the summer and early fall months and are seen as single cases, clusters, or outbreaks. Salmonellosis symptoms typically include diarrhea (sometimes with bloody stool), fever, nausea, abdominal pain, or vomiting. Most persons with Salmonella infection do not require medical treatment, and symptoms often resolve without medication. The elderly, infants, and those with impaired immune systems are more likely to have a severe illness

Salmonella is spread by ingestion of Salmonella bacteria in food derived from infected animals or food contaminated by feces of an infected animal or person. Common vehicles include undercooked eggs, raw milk, contaminated water, meat and poultry. Pet turtles, iguanas and chicks are common sources for infants and children. Fecal-oral transmission from person to person is important, especially when diarrhea is present. Most people infected with Salmonella develop symptoms between 12 and 72 hours after infection; the illness usually lasts 4 to 7 days.

The best way to prevent Salmonella infection is by practicing good hand hygiene. Wash your 

hands with soap and water before eating or preparing food, after changing diapers, and after using the restroom. Avoid swallowing water from ponds, lakes, or recreational water that is untreated.

Salmonellosis Information for Healthcare Professionals

Diagnosis and Treatment

Salmonella can be detected in stool by culture or culture-independent diagnostic test methods. Healthcare providers may prescribe antibiotics for some people with severe cases of salmonellosis.

Healthcare professionals with salmonellosis

It is possible for Salmonella to be transmitted in patient care. Healthcare workers should not return to work until 24 hours after symptoms have resolved. Contact your local health department for more information.

Salmonellosis Information for Childcare Settings

Children under five with salmonellosis

Salmonella spreads easily in childcare settings. It is common for infec

ted individuals to continue to shed the bacteria and remain infectious to others after symptoms resolve. Children under five should not return to childcare settings until 24 hours after symptoms resolve. Contact your local health department for more information.

Childcare workers with salmonellosis

Salmonella spreads easily in childcare settings. It is common for infected individuals to continue to shed the bacteria and remain infectious to others after symptoms resolve. Childcare workers should not return to childcare settings until 24 hours after symptoms resolve. Contact your local health department for more information.

Salmonellosis Information for Food Handlers

Salmonella is easily transmitted in food service settings. It is common for infected individuals to continue to shed the bacteria and remain infectious to others after symptoms resolve. The Georgia Food Code has specific rules and regulations requiring exclusion of food handlers with Salmonella. Food handlers must not return to work until cleared by public health with follow up stool cultures. Contact your local health department for more information.

 

 

 

 

 

Related Links

CDC Salmonellosis Fact Sheet 

FDA Bad Bug Book 

FoodNet Data and Reports

Suspecting Foodborne Illnesses in Special Populations: Quick Facts for Providers 

Typhoid fever/Paratyphoid fever Basics

Typhoid fever and paratyphoid fever are life-threatening bacterial illnesses caused by Salmonella serotype Typhi and Salmonella serotype Paratyphi, respectively. Both have similar symptoms including sustained fever, weakness, stomach pain, diarrhea, and loss of appetite. These illnesses are uncommon in Georgia, with around 20 total cases each year.

Most people in the United States with typhoid fever or paratyphoid fever become infected while traveling abroad, most often to countries where these diseases are common. If you plan to travel outside of the United States, find out if you need the typhoid fever vaccine at www.cdc.gov/travel.

Typhoid fever and paratyphoid fever are treated with antibiotics. People who do not get appropriate antibiotic treatment may have fever for weeks or months and may develop complications. People who do not get treatment can die from complications of the infection.

Even if your symptoms seem to go away, you may still be carrying Salmonella Typhi or Salmonella Paratyphi. If so, the illness could return, or you could pass the bacteria to other people. In fact, if you are a healthcare worker or work at a job where you handle food or care for small children, you may not be able to return to work until a doctor has determined you no longer carry the bacteria.

If you are being treated for typhoid fever or paratyphoid fever, it is important to do the following to lower the chance that you will pass the bacteria on to someone else.

  • Keep taking antibiotics for as long as the doctor has recommended.
  • Wash your hands carefully with soap and water after using the bathroom.
  • Do not prepare or serve food for other people.

Typhoid fever/Paratyphoid fever Information for Healthcare Professionals

Diagnosis and Treatment

Blood culture is the mainstay of diagnosis. Bone marrow cultures have sensitivity of 80% in some studies and can remain positive despite antibiotic therapy. Stool and urine cultures are positive less frequently. Multiple cultures are usually needed to identify the pathogen. Serologic tests, such as the Widal test, are not recommended because of the high rate of false positives.

Healthcare professionals with Typhoid fever and Paratyphoid fever

It is possible for Salmonella Typhi and Salmonella Paratyphi to be transmitted in patient care. Infected healthcare professionals should be excluded until symptoms resolve and there are 3 negative stool cultures taken 24 hours apart and at least 48 after antibiotic treatment has ended and at least 30 days after symptom onset. Contact your local health department for more information.

Typhoid fever/Paratyphoid fever Information for Childcare and School Settings

Children in childcare or school settings

Infected children attending daycare or school should be excluded until symptoms resolve and there are 3 negative stool cultures taken 24 hours apart and at least 48 after antibiotic treatment has ended and at least 30 days after symptom onset.

Childcare workers

Infected childcare workers should be excluded until symptoms resolve and there are 3 negative stool cultures taken 24 hours apart and at least 48 after antibiotic treatment has ended and at least 30 days after symptom onset.

Typhoid fever/Paratyphoid fever Information for Food Handlers

The Georgia Food Code has specific rules and regulations requiring exclusion of food handlers with Salmonella Typhi and Salmonella Paratyphi. Food handlers must not return to work until cleared by public health with follow up stool cultures. Contact your local health department for more information.

 

 

Related Links

CDC Typhoid and Paratyphoid Information