Salmonellosis has been in the news due to contamination of some of the U.S. food supply, with the most recent outbreaks connected to peanut butter and products containing peanut butter. The Centers for Disease Control and Prevention and the Food and Drug Administration are collaborating with public health officials in many states to investigate the continuing outbreaks.

The investigation has led to King Nut Companies, a distributor of peanut butter manufactured by the Peanut Corporation of America, and the company has voluntarily recalled 2,850 items. The recall list is published at the FDA Web site (www.fda.gov).

Salmonellosis occurs when the gastrointestinal tract becomes infected with Salmonella bacteria. The disease has been more common over the past 25 years, with an estimated 2–4 million cases occurring in the United States annually. Emergence of the disease worldwide is attributed to changes in international travel and trade, as well as changes in food production systems, demographics and behavior.

Salmonella typically lives in the intestinal tract of animals, including birds and humans, and is shed through feces. Humans generally become infected through contaminated food, such as poultry, meat and eggs. Your risk for infection is higher if you travel to countries with poor sanitation.

Symptoms start with nausea and vomiting and progress to abdominal pains and diarrhea. Additional signs include fever, chills and muscle pains lasting from several days to two weeks. Most healthy individuals recover without specific treatment. In some cases, diarrhea leads to dehydration, requiring medical attention or hospitalization. Life-threatening complications may develop if the infection spreads into the bloodstream. If you have a healthy immune system, you may not feel ill at all; however, you may continue to shed the Salmonella bacteria in your feces and remain contagious for up to a year.

There are more than 2,000 types of Salmonella bacteria, although fewer than a dozen are responsible for most illness in humans. Each strain causes its own typical symptoms.

Gastroenteritis is caused by the S. enteritidis bacterium, which is most often ingested through raw or undercooked meat, poultry, eggs or egg products. This infection also causes blood to appear in the stool.

Enteric fever (typhoid fever) is caused by the S. typhi bacterium and is most commonly contracted through contaminated drinking water. Additional symptoms include constipation, sore throat, cough, headache and mental confusion.

Bacteremia results when Salmonella enters the bloodstream. Infants, the elderly and those with compromised immune systems are at risk. Other complications include sepsis and meningitis (infection of the tissues surrounding the brain and spinal cord).

Humans usually become infected with Salmonella when they eat foods contaminated with animal feces. Salmonella present on raw meat and poultry can survive if the food is not cooked to a minimum safe internal temperature. Foods may also become contaminated when raw meat or poultry comes in contact with other food, or when a food handler’s hands are not washed after using the bathroom. Foods contaminated with Salmonella look, smell and taste normal.

Salmonellosis is contagious, so take precautions to avoid spreading it to others. Prevention is especially important when preparing foods or providing care for infants, older adults and people with compromised immune systems.

If you think you have salmonellosis, seek medical attention. Your doctor will request a stool sample and a blood specimen for analysis. Call your doctor if you have blood in your stool, if there is no improvement after two to five days or if you experience severe vomiting, abdominal pain or dehydration.

In order to reduce salmonellosis, a comprehensive farm-to-table approach to food safety is needed. Farmers, food importers, inspectors, retailers, food service workers, consumers and travelers — all are critical links in the food safety chain. The CDC leads federal efforts to gather data and investigates food-borne illnesses and outbreaks, and monitors the effectiveness of prevention and control while working with food safety regulatory agencies. Visit www.cdc.gov.

Salmonella Safeguards

• Keep eggs refrigerated below 41 degrees. Eggs should not be unrefrigerated for more than two hours.
• Check egg cartons for expiration date. Discard cracked or dirty eggs.
• Cook eggs at least 15 seconds at 145 degrees and eat promptly after cooking.
• Avoid eating raw eggs, as in homemade ice cream or mayonnaise, cookie dough or eggnog.
• Only consume pasteurized eggs and dairy products.
• Send back eggs, meat or poultry in a restaurant if they are not adequately cooked.
• Separate raw meats from other foods in the shopping cart and in the refrigerator.
• Wash your hands before and after handling uncooked foods.
• Thoroughly clean cutting boards, knives and cooking utensils.
• Use paper towels to clean kitchen surfaces.
• Thaw foods in the refrigerator, in cool water or in the microwave — never at room temperature.
• Wash your hands after contact with all animals and birds, including pets.
• Wash your hands before and after bathroom use.
• Wash your hands after handling human or animal feces, including diapers.