Diagnosis and Treatment
How Can Salmonella Infections Be Diagnosed?
Many different kinds of illnesses can cause diarrhea, fever, or abdominal cramps. Determining that Salmonella is the cause of the illness depends on laboratory tests that identify Salmonella in the stool of an infected person. Once Salmonella has been identified, further testing can determine its specific type.
How Can Salmonella Infections Be Treated?
Salmonella gastrointestinal infections usually resolve in 5-7 days and most do not require treatment other than oral fluids. Persons with severe diarrhea may require rehydration with intravenous fluids. Antibiotic therapy can prolong the duration of excretion of non-typhoidal Salmonella and is recommended only for patients with severe illness (e.g., those with severe diarrhea, high fever, bloodstream infection, or who need hospitalization) or those at risk of severe disease or complications, including young infants, older adults (over 65 years old) and immunocompromised persons. Antibiotic resistance is increasing among some Salmonella bacteria; therefore, susceptibility testing can help guide appropriate therapy. Choices for antibiotic therapy for severe infections include fluoroquinolones, third-generation cephalosporins, and ampicillin (for susceptible infections).
How Do People Get Salmonella?
Salmonella live in the intestinal tracts of humans and other animals, including birds. Salmonella are usually transmitted to humans by eating foods contaminated with animal feces. Contaminated foods usually look and smell normal. Contaminated foods are often of animal origin, such as beef, poultry, milk, or eggs, but any food, including vegetables, may become contaminated. Thorough cooking kills Salmonella. Food may also become contaminated by the hands of an infected food handler who did not wash hands with soap after using the bathroom.
Salmonella may also be found in the feces of some pets, especially those with diarrhea, and people can become infected if they do not wash their hands after contact with pets or pet feces. Reptiles, such as turtles, lizards, and snakes, are particularly likely to harbor Salmonella. Many chicks and young birds carry Salmonella in their feces. People should always wash their hands immediately after handling a reptile or bird, even if the animal is healthy. Adults should also assure that children wash their hands after handling a reptile or bird, or after touching its environment.