By: Robert W. Frenck, Jr., MD, FAAP
Salmonella bacteria cause more than a million infections each year in the United States. Most often, people get sick after eating food contaminated with
Salmonella. Their symptoms usually include diarrhea, fever and stomach cramps.
Salmonella illness can sometimes be severe enough to require a hospital stay.
Here's what families need to know about
Salmonella, how to recognize symptoms of infection and how to prevent it.
Who is most at risk from
Salmonella?
Infections occur most often in infants and children younger than 4 years because their immune systems are still developing. Babies who are not breastfed are also more likely to get sick from
Salmonella. Infants may be exposed to
Salmonella if they eat contaminated food or come into contact with contaminated surfaces or sick family members.
Elderly people and those whose immune systems are weakened from certain medical conditions (such as diabetes, liver or kidney disease and cancer) or treatments also are at increased risk.
How does
Salmonella spread?
Salmonella bacteria usually spread to humans by animal products such as poultry, beef, fish, eggs and
dairy products. At times, though, other foods such as fruits, vegetables and bakery products have caused outbreaks. Most often, this happens when these foods were contaminated by contact with an animal product.
The bacteria can also be spread by drinking
contaminated water. Salmonella outbreaks have been linked to infected
pets such as
backyard poultry, snakes,
small turtles, lizards and other reptiles. And, it can spread by contact with contaminated pet food. Typhoid fever, which is also caused by
Salmonella, is only spread through contact with an infected person or an item contaminated by an infected person.
Salmonella outbreaks
Cucumbers
As of July 1, 2024, at least 449 people in 31 states and Washington, D.C., reported
Salmonella illness from whole cucumbers. The CDC and FDA have determined that cucumbers from Bedner Growers, Inc., of Boynton Beach, Fla., are a likely source of illness. The recalled cucumbers are beyond shelf life and should no longer be available for sale in stores. The CDC and FDA advise people to throw away recalled cucumbers and wash surfaces and containers that have touched them using hot soapy water or a dishwasher.
(More information here.)
Backyard poultry
As of June 27, 2024, 195 people in 38 states have been infected with
Salmonella linked to contact with backyard poultry. Backyard poultry can carry
Salmonella germs even if they look healthy and clean. Always wash hands after touching backyard poultry, their eggs or anything where they live or roam.
(More information here.)
Bearded dragons
As of June 14, 2024, 15 people—including 9 children under age 5 years—have been infected with Salmonella linked to bearded dragons. Bearded dragons are not recommended as pets for children younger than age 5 years. They can carry Salmonella germs in their droppings even if they look healthy and clean. People can get sick from touching the reptile or anything in its environment and then touching their mouth or food. (More information here.)
Signs & symptoms of
Salmonella infection
Salmonella bacteria are best known for being a cause of
diarrhea. This type of illness, called gastroenteritis, typically happens after eating food that has been contaminated with
Salmonella.
When your child has a
Salmonella infection that causes gastroenteritis, they may have symptoms such as:
While the overwhelming number of people with
Salmonella infection have gastroenteritis, the bacteria also can cause a variety of other disorders, including:
Bacteria in the blood (bacteremia)
Inflammation of the membranes of the brain or spinal cord (meningitis)
Inflammation of the bone (osteomyelitis)
Any recent travel?
Although very rare in the United States, travelers to India, Latin American, Africa and parts of the Asia may become infected with a strain of
Salmonella called typhoid. This is a long-lasting febrile illness which if untreated can be fatal in up to 30% of cases. So, if you return from travel and have an unexplained fever, it is important to let your doctor know about your recent travels.
What to know about typhoid fever
Typhoid fever develops gradually. Its signs and symptoms may include fever, headache, loss of appetite, lethargy, abdominal pain, changes in mental status, an enlarged spleen and constipation or diarrhea.
The incubation period for gastroenteritis ranges from 6 to 48 hours, while typhoid fever has a longer incubation period of 3 to 60 days.
When to call your pediatrician
Contact your pediatrician if your child shows no improvement within 2 to 3 days of symptoms appearing or if they have blood in their stools or shows signs of dehydration (such as an absence of tears when crying, a decline in urination).
How is
Salmonella diagnosed?
Your pediatrician can test for
Salmonella organisms from cultures of stool, blood, or urine that are examined in the laboratory.
Treatment for
Salmonella infections
If your child only has
Salmonella-associated diarrhea, the treatment is supportive (fluids and rest). Antibiotics are not prescribed as they do not make your child get better faster and actually may increase the length of time your child has
Salmonella in the stool. An exception is infants under 3 months of age, because they have an increased risk of the infection spreading from the intestine to the blood and other organs in the body. However, when the infection is found in the blood, brain, bone or other organs, antibiotics are needed.
A child with severe diarrhea may get very dehydrated and need intravenous (IV) fluids or extra fluids given by mouth.
How long does a
Salmonella infection last?
Most
Salmonella gastrointestinal infections last for 4 to 7 days and clear up on their own without treatment.
How to prevent
Salmonella infection
Salmonella infections can often be prevented by practicing good hygiene techniques during food preparation, as well as regular
hand washing. Be sure to thoroughly cook eggs, poultry and ground beef. Hands should always be washed after playing with pets, especially lizards and pet turtles.
If your child has a problem with their immune system: Avoid reptiles used as pets, such as lizards and snakes. Children with
sickle cell anemia are at risk for
Salmonella infection of the bones. Families of these children should avoid having reptiles and amphibians as pets.
If you plan travel to an area where typhoid exists: Make an appointment with your doctor (preferably 1-2 months before travel) to discuss vaccination against the infection.
See
Precautions for International Travel: Information for Parents.
More information
About Dr. Frenck
Robert W. Frenck, Jr, MD, FAAP, is board-certified in general pediatrics and pediatric infectious diseases. He practices at Cincinnati Children's Hospital Medical Center and is a Professor in the Department of Pediatrics at the University of Cincinnati School of Medicine in Cincinnati, Ohio. Within the American Academy of Pediatrics, Dr. Frenck is a member of both the Section on Uniformed Services (SOUS) and the Section on Infectious Diseases (SOID).
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