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Salmonella Infection Outbreak

Posted Aug 24 2010 12:39am

What is Salmonella?

Salmonellosis is an infection caused by the bacteria Salmonella. Those infected with Salmonella develop diarrhea, fever, and abdominal cramps 12 to 72 hours after infection. The illness usually lasts 4 to 7 days.   Most recover without treatment. However, in some the diarrhea may be so severe that hospitalization is required. Sometimes fatal infections occur in young children, frail or elderly people, and others with weakened immune systems. In these patients, the Salmonella infection may spread from the intestines to the blood stream, and then to other body sites and can cause death unless the person is treated promptly with antibiotics. The elderly, infants, and those with impaired immune systems are more likely to have a severe illness.

Salmonella is actually a group of bacteria that can cause diarrheal illness in humans. They are microscopic living creatures that pass from the feces of people or animals to other people or other animals. There are many different kinds of Salmonella bacteria. Salmonella serotype Typhimurium (typhoid fever) and Salmonella serotype Enteritidis are the most common in the United States. Salmonella germs have been known to cause illness for over 100 years. They were discovered by an American scientist named Salmon, for whom they are named.

Healthy persons infected with Salmonella often experience fever, diarrhea, nausea, vomiting and abdominal pain. In rare circumstances, infection with Salmonella can result in the organism getting into the bloodstream and producing more severe illnesses such as arterial infections, endocarditis, or arthritis.

What Eggs Are Affected?

Eggs affected by this recall were distributed to grocery distribution centers, retail grocery stores and food service companies which service or are located in fourteen states, including the following: Arkansas, California, Iowa, Illinois, Indiana, Kansas, Minnesota, Missouri, Nebraska, North Dakota, Ohio, South Dakota, Texas, and Wisconsin. Eggs are distributed under the following brand names: Hillandale Farms, Sunny Farms, and Sunny Meadow in 6-egg cartons, dozen-egg cartons, 18-egg cartons, 30-egg package, and 5-dozen cases. Loose eggs are packaged under the following brand names: Wholesome Farms and West Creek in 15 and 30-dozen tray packs. The loose eggs may also be repackaged by customers.

The only eggs effected by this recall have plant numbers P1860 or P1663 and Julian dates as follows:

    * P1860 – Julian dates ranging from 099 to 230

    * P1663 – Julian dates ranging from 137 to 230

Only eggs with these plant numbers are effected - even though the brand name may be the same

How Do Eggs Become Infected?

Unlike eggborne salmonellosis of past decades, the current epidemic is due to intact and disinfected grade A eggs. Salmonella enteritidis silently infects the ovaries of healthy appearing hens and contaminates the eggs before the shells are formed.

Most types of Salmonella live in the intestinal tracts of animals and birds and are transmitted to humans by contaminated foods of animal origin. Stringent procedures for cleaning and inspecting eggs were implemented in the 1970s and have made salmonellosis caused by external fecal contamination of egg shells extremely rare. However, unlike egg-borne salmonellosis of past decades, the current epidemic is due to intact and disinfected grade A eggs. The reason for this is that Salmonella enteritidis silently infects the ovaries of healthy appearing hens and contaminates the eggs before the shells are formed.

Although most infected hens have been found in the northeastern United States, the infection also occurs in hens in other areas of the country. In the Northeast, approximately one in 10,000 eggs may be internally contaminated. In other parts of the United States, contaminated eggs appear less common. Only a small number of hens seem to be infected at any given time, and an infected hen can lay many normal eggs while only occasionally laying an egg contaminated with the Salmonella bacterium.

How Does One Reduce Risk?

Eggs, like meat, poultry, milk, and other foods, are safe when handled properly. Shell eggs are safest when stored in the refrigerator, individually and thoroughly cooked, and promptly consumed. The larger the number of Salmonella present in the egg, the more likely it is to cause illness. Keeping eggs adequately refrigerated prevents any Salmonella present in the eggs from growing to higher numbers, so eggs should be held refrigerated until they are needed. Cooking reduces the number of bacteria present in an egg; however, an egg with a runny yolk still poses a greater risk than a completely cooked egg. Undercooked egg whites and yolks have been associated with outbreaks of Salmonella enteritidis infections. Both should be consumed promptly and not be held in the temperature range of 40 to 140 for more than 2 hours.

Is There Treatment If Infected?

Nontyphoid Salmonella infection is generally self-limited. Treatment for enteritis or food poisoning is controversial. Some doctors recommend no antibiotics since the disease is self-limited, while others suggest using antibiotics such as ciprofloxacin for 10-14 days. A review of 12 clinical trials showed no significant change in the overall length of the illness or the related symptoms in otherwise healthy children and adults treated with a course of antibiotics for nontyphoid Salmonella disease. Antibiotics tend to increase adverse effects and prolong Salmonella detection in stools. Patients identified as immunosuppressed (for example, patients with AIDS or undergoing cancer chemotherapy) should receive antibiotics. Some investigators believe antibiotics prolong the carrier state.   Antibiotics usually chosen to treat Salmonella infections are fluoroquinolones and third-generation cephalosporins (used in children because fluoroquinolones are not indicated for use in children). Resistance to these drugs is a potential problem for those individuals that become infected with Salmonella as drug treatment options become limited.

Clearly, common sense, attention to cleanliness, thorough cooking of eggs and general public health measures are the best protection from infection.   Once infection occurs, prompt treatment with supportive measures and medications as medically indicated is essential.   Careful attention to hand washing and personal hygiene is critical to reduce the risk of spreading infection to care givers and other family members.

Salmonella Contamination of Eggs Shipped to Many States -

Salmonella Infection Outbreak -

No evidence that tainted eggs go beyond 2 farms -

FDA: No evidence yet that millions of eggs tainted by salmonella extend beyond 2 Iowa farms -

Investigation Update: Multistate Outbreak of Human Salmonella Enteritidis Infections Associated with Shell Eggs -

CDC Investigation Announcement: Multistate Outbreaks of Human Salmonella Hartford and Salmonella Baildon Infections -

Hillandale Farms of Iowa Conducts Nationwide Voluntary Recall of Shell Eggs Because of Possible Health Risk -

Investigation Update: Multistate Outbreak of Human Typhoid Fever Infections Associated with Frozen Mamey Fruit Pulp -

How can I tell if my eggs have been recalled? -

How are Salmonella infections treated?

Antibiotics for treating salmonella gut infections - (Sirinavin S, Garner P. Antibiotics for treating salmonella gut infections. Cochrane Database Syst Rev. 2000;CD001167)

Salmonellosis -

Salmonella enteritidis -


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