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| Salmonellosis | |
 | |
| Illustration dating from 1939 showing the different means of pollution of water by bacteria. | |
| Information | |
| Region (s) | Global |
|---|---|
| Cause | Bacterium |
| Vector | Drinks, food |
| Contagiousness |  no |
| CIM-10 | A02.0 |
| CIM-9 | 003.0 |
| Prophylaxis: | |
| * vaccine | no (except for S. typhi and S. paratyphi) |
| * medication | no |
| Therapy: |  Yes |
| Location | |
 | |
| Geographical areas of prevalence of salmonellosis. | |
 Medical warning | |
A salmonellosis is an infectious disease caused by an enterobacterium of the genus Salmonella (Salmonella). The most severe forms are paratyphoid caused by Salmonella paratyphi and, above all, the typhoid caused by Salmonella typhi.
Understand
It is the lack of hygiene, and more particularly that brought to the food, which is the main cause of the spread of these diarrheal diseases.
Every year, cases of salmonellosis are recorded around the world. Thus, in 2012, a epidemic touched 1,060 people to Netherlands and a hundred to United States with, in question, smoked salmon packaged by the Dutch firm Foppen. Also in 2012 and in the United States, more than 1,100 cases were identified with, in question, the meat of chicken, turkey and tuna. Since 2012, the cases identified have been decreasing thanks to the efforts of public health organizations. However, for the first half of 2014, 22 cases were identified in Canada with, in question, the meat of farmed snakes.
- Public Health Agency of Canada, "Public health notice - Outbreak of salmonellosis associated with contact with snakes and rodents used to feed them », www.phac-aspc.gc.ca,
Salmonellosis is usually mild, causing only one gastroenteritis without sepsis and without consequence. A healthy adult must ingest 100,000 to 100,000,000 to trigger infection. Alone Salmonella typhi and Salmonella paratyphi can cause severe forms of salmonellosis, namely typhoid and the paratyphoid.
Location
Salmonella, which are able to survive for several weeks in dry conditions and several months in water, are most often found in aquatic environments polluted by animal feces. This is especially true in Africa sub-Saharan, in Central Asia, in South Asia (more particularly in Hindu countries likeIndia), in South East Asia and, to a lesser extent, in South America (especially the Bolivia) and in Balkans. However, epidemics are likely to trigger anywhere on earth as a result of poor sanitary quality of food.
Vector protection
Since the vector is animal faeces having soiled the water or food, the main protection will consist of:
- keep food preparation areas and refrigerators immaculately clean;
- peel fruits and vegetables, avoid unpasteurized milk, raw eggs, raw vegetables and undercooked meat, cook food over 65 ° C for at least five to six minutes, frozen minced meat should be cooked without prior thawing;
- do not swallow non-food water while walking or swimming in nature;
- in so-called "poor" countries, drink only drinks uncapped in front of you if not water that has been imperatively boiled or purified by adding a chlorine tablet, avoid ice cubes, do the same for brushing teeth;
- wash your hands with soap before each meal, before and after going to the toilet or changing an infant, otherwise using a hand sanitizer;
- do not handle a dead or visibly sick wild or domestic animal without gloves.
Protection against bacteria
A live attenuated strain vaccine and an inactivated vaccine exist against the two most serious forms of salmonellosis, which are typhoid and the paratyphoid. A live attenuated strain vaccine against Salmonella Enteritidis, responsible for the majority of salmonellosis exists only in poultry; however, a vaccine candidate for humans has been in the testing phase since 2013.
The human body has gastric juices within it, the acidity of which is capable of destroying a large number of pathogenic germs ingested. The immune system will also secrete antibody directed against antigens bacteria.
Diagnostic
Symptoms
After the incubation period which varies from 12 to 48 h for most salmonella, the main common symptoms are:
- diarrhea with dehydration;
- fever and headache;
- abdominal cramps, nausea, vomiting;
- blood in stool ;
- blurred vision and brief loss of consciousness.
Clinical signs
The clinical examination will show a gastroenteritis and more particularly a enterocolitis. A blood culture venous blood and, better, a coproculture stools will often reveal the presence of the bacteria. A serology, called Widal's test, is used to determine the presence of antibody directed against antigens bacteria without, however, distinguishing a current infection from an old and cured disease or excluding false positive reactions due, for example, to the malaria, a sepsis or an immunological disorder. Finally, a test called TSI shows a black precipitate in the middle of the test tube showing the production of hydrogen sulfide specific to bacteria of the genus Salmonella and a test called XLD also shows this presence of hydrogen sulfide.
Therapy
After the incubation period, the invasion period and that ofstate together last about four to seven days and a healthy adult will recover most often, except for severe forms, with no other therapeutic treatment than antipyretic to fight against fever. In infants and young children, more sensitive from a smaller infectious dose received, a rehydration solution, intravenously if necessary, to compensate for the loss of fluid due to diarrhea will also be administered.
However, since there is no clinical test that can determine with certainty which salmonella is responsible for the infection, the doctor will prescribe an antibiotic to be taken for 10 to 15 days. In first intention, in adults, a fluoroquinolone or ceftriaxone will be most often used while in children under fifteen years, the combination co-trimoxazole or ampicillin will often be preferred.
Possible consequences
After recovery, a small percentage of individuals continue to harbor salmonella, mainly in the gallbladder, especially if they are affected by gallstones or from cholecystitis. These are excreted episodically in the stool and can therefore be the cause of secondary cases.
Remarks
- Salmonellosis is on the list of Infectious diseases mandatory in Belgium, in France, to Quebec, in Swiss.
- Pregnant women, infants and young children, people over the age of sixty, and people with diseases causing immune deficiency, such as AIDS or leukemia, are more susceptible to bacteria of the genus Salmonella.
- People with sickle cell anemia are also more sensitive to it.
Further information
- Health topics, Food safety – The food safety page on the WHO website.
- Salmonellosis – The page devoted to salmonellosis on the Institut Pasteur website.
