Salmonellosis: what you need to know about insidious salmonella
Salmonellosis is an acute zooanthroponous intestinal infection characterized by damage to the digestive organs in the form of gastritis, gastroenteritis, enterocolitis with the development of intoxication syndrome and water - electrolyte disorders, in rare cases the development of generalized forms (typhoid, septicemic and septicopiemic).
Etiology:
The causative agent of this disease is gram-negative mobile rods of the genus Salmonella. It should be noted that salmonella not only persists in the external environment for a long time: 17 days on eggshells, up to 5 months in food and water, and up to 18 months in soil, but also multiply.
At 70 °, they die within 5-10 minutes, during the cooking of eggs they remain viable for 4 minutes. Salting and smoking have a very weak effect on them, and freezing, on the contrary, increases the survival time of microorganisms. There are also known resident (hospital) strains of salmonella, characterized by multiple resistance to antibiotics and disinfectants.
Epidemiology:
Numerous domestic and wild animals, birds (waterfowl) are the reservoir and source of infection for humans. People with salmonellosis and bacterial carriers play an important role as a source of infection.
The greatest danger among them are employees of food enterprises and persons working in children's groups, including medical personnel of maternity hospitals and children's departments.
The main mechanism of transmission of the pathogen is fecal-oral, implemented mainly by food. The factors of transmission of the pathogen are food products: meat and meat products, eggs and cream products, mayonnaise and dry egg powder.
The contact-household transmission path is realized through infected household items.
The epidemic process in salmonellosis is manifested by an outbreak and sporadic morbidity.
According to the results of 4 months of 2022 in the Lipetsk region, the epidemiological situation for intestinal infections is unstable, prone to complications, the registration of cases of salmonellosis remains (1.8 per 100 thousand population). Analysis of outbreaks of salmonellosis registered in the region in 2018-2021, group morbidity for 4 months of 2022 showed that gross violations of sanitary legislation in the production, storage and sale of products lead to the spread of infection.
Also, violations of sanitary legislation in the sale of vegetables and fruits, the organization of sanitary cleaning of territories, the operation of open reservoirs used for bathing contribute to the spread of intestinal infections.
Clinic:
The incubation period ranges from 2-6 hours to 2-3 calendar days. With a household transmission path, it can increase to 4-7 calendar days.
There are four forms of salmonellosis: gastrointestinal, generalized (septic, typhoid), subclinical, bacterial.
The main symptoms of salmonellosis include: fever (fever), headache, nausea, vomiting, pain in the epigastric and umbilical region, sometimes pain in the course of the large intestine (with a common process) — colitis syndrome joins. Appetite decreases sharply, diarrhea appears increasing in severity, with the development of dehydration, convulsions may appear, which is typical for the period of the height of the disease. In typical cases, within 5-7 days, the symptoms become less pronounced and the recovery period begins.
Bacteriocarriage
After undergoing salmonellosis, some patients become bacterial carriers. This form is characterized by the absence of clinical symptoms, but detection occurs during laboratory tests during the passage of mandatory periodic medical examination of decreed groups of the population (workers of food production and catering enterprises, employees of pre-school, medical workers).
From an epidemiological point of view, the most dangerous for the spread of salmonella infection is bacterial transmission.
Complications: dehydration of the body; development of acute renal failure; DIC syndrome; severe effects of salmonella toxins on the nervous system; intestinal bleeding; intestinal perforation, intestinal inversion (intussusception), prolapse of the mucous membrane of the rectum.
When making a diagnosis of salmonellosis, the following are taken into account: epidemiological data; characteristic clinical symptoms; results of laboratory diagnostics.
Laboratory diagnostics
Bacteriological method – isolation and identification of the pathogen (Salmonella spp.) from feces, blood, vomit, urine, bile, blood by culture method using nutrient media and biochemical tests
Molecular genetic diagnostics (PCR) with detection of Salmonella spp. DNA in biomaterial samples.
Serological examination: determination of the level of antibodies (IgM, IgG) in ELISA or anti-salmonella antibodies in the indirect hemagglutination reaction (RNGA).
Prevention:
The basis for the prevention of salmonellosis among humans is veterinary and sanitary measures aimed at ensuring proper conditions during the slaughter of livestock and poultry, carcass processing technologies, as well as compliance with the sanitary regime at food industry and catering enterprises.
Persons entering for the first time to work in preschool institutions, medical and preventive institutions, food industry enterprises and institutions equated to them are subject to mandatory bacteriological examination. Bacterial separators are not allowed to work in food and equivalent enterprises.
In public catering and personal home practice, the sanitary and hygienic rules of cooking should be strictly observed:
- It is recommended to separate cutting boards, knives, shelves in the refrigerator for raw products requiring heat treatment from kitchen utensils intended for finished products that are not subject to heat treatment.
- It is necessary to pay close attention to the quality of children's food and the cleanliness of children's dishes, especially bottles and nipples.
- It is necessary to carry out heat treatment of meat and poultry until the product is fully ready. It is not recommended to use unboiled fresh milk.
There is no vaccine against salmonellosis, but there is a bacteriophage (a microorganism that destroys a bacterium), with the help of it, according to a doctor's prescription, the disease is prevented in contact persons.
Take care of yourself and your loved ones!
Chief Freelance Specialist
on infectious diseases
health departments
Lipetsk region,
Sirotinkina Lilia Viktorovna
Preventive theses for cards:
- It is necessary to observe the rules of personal hygiene (wash your hands thoroughly before eating);
- At home, it is recommended to separate cutting boards, knives, shelves in the refrigerator for raw products requiring heat treatment from kitchen utensils intended for finished products that are not subject to heat treatment;
- When purchasing products at the market or in a store, you should monitor compliance with the commodity neighborhood of products. Raw and finished products must be on separate showcases;
- Wash the refrigerator regularly, thoroughly cleaning the egg storage cells.
- Pay close attention to the quality of children's food and the cleanliness of children's dishes, especially bottles and teats;
- It is necessary to carry out heat treatment of meat and poultry until the product is fully ready;
- Do not purchase meat, meat products, poultry, eggs, cottage cheese, milk, butter, cheese in places of unauthorized trade.
- When purchasing eggs, strictly monitor the sorting date (it is indicated both on the package and directly on the eggs);
- Boil eggs for at least 10 minutes from the moment of boiling, poultry for 40 minutes, meat for at least 2 hours.
- Thoroughly wash and scald kitchen utensils with boiling water.
- Never remove the sample from raw minced meat.
- Eat only boiled milk.
- Rinse fruits, herbs and vegetables well under running and then boiled water. Optimally - scalding with boiling water.
- There is no vaccine against salmonellosis, but there is a bacteriophage (an antibacterial agent that destroys the bacterium), with the help of it, according to the doctor's prescription, the disease is prevented in contact persons.
