Salmonella Egg Recall: Current Health Crisis

Hundreds of people have been sickened in a salmonella outbreak linked to eggs in four states and possibly more, health officials said Wednesday as an egg distribution company dramatically expanded a recall to more than 380 million eggs.

The Centers for Disease Control and Prevention is working with state health departments to investigate the illnesses. No deaths have been reported, said Dr. Christopher Braden, a CDC epidemiologist involved in the investigation.

Initially, 228 million eggs, or the equivalent of 19 million dozen-egg cartons, were recalled by the company Wright County Egg of Galt, Iowa. But that number was increased to nearly 32 million dozen-egg cartons.

Minnesotaofficials have linked seven salmonella illnesses to the eggs.

Other states have seen a jump in reports of the type of salmonella. For example, California has reported 266 illnesses since June and believes many are related to the eggs. Colorado saw 28 cases in June and July, about four times the usual number. Spikes or clusters of suspicious cases have also been reported in Arizona, Illinois, Nevada, North Carolina, Texas and Wisconsin.

[Source for data: Associated Press, reported on msnbc.com, 8/18/10]

Salmonella is the most common bacterial form of food poisoning. And the strain involved in the outbreak is the most common strain of salmonella, accounting for roughly 20 percent of all salmonella food poisonings.

Overview of Salmonella

Salmonella is the name given to a group of closely related Gram-negative bacteria: they are most commonly discussed (clinically) as a cause of food poisoning, although Salmonella is also responsible for causing typhoid fever.   

Salmonella infections cause diseases in humans (for example, salmonellosis, gastroenteritis, and typhoid fever), birds, and a few other animal species. They are one of the major causes of gastroenteritis (food poisoning) in the world. Salmonella were first isolated from infected pigs in 1885 by T. Smith and were named after his lab director, D. E. Salmon.

What Are the Symptoms of Salmonella

These are the common symptoms of Salmonella:

  • Nausea
  • Vomiting
  • Diarrhea
  • Abdominal cramps or pain
  • Fever, as high as 104 (especially with typhoid fever)
  • Bloody stools (with severe gastroenteritis or with typhoid)

Salmonella gastroenteritis is usually self-limited, and fully heals in three to eight days, except for the severest of cases.  [Source:  Merck Manual of Diagnosis and Therapy 18th Edition, Merck Publishing, 2006]

When to Seek a Doctor’s Care for Salmonella

Although 80-90% of cases of salmonella heal without any medical intervention, here are some ‘danger signs’ that should prompt a medical visit:

  • Any bloody diarrhea or stool
  • Fever lasting longer than three days, or higher than 102.5
  • Severe weakness, dizziness, or fainting  (signs of dehydration)
  • Immunocompromised patients (e.g. AIDS, cancer, seniors, or babies)
  • Excruciating abdominal pain

How to Test for or Diagnose Salmonella

An astute clinician will have a high index of suspicion for salmonella based on a thorough history and physical examination, especially if there is a known epidemic occurring in that region. 

Salmonella infection can be detected by testing a sample of your stool. This is called a ‘Stool Culture’ test for salmonella.  If your doctor suspects that you may have a salmonella infection in your bloodstream (called sepsis), he or she may suggest testing a sample of your blood for the bacteria.

How Should Salmonella be Treated

Treatment for Salmonella gastroenteritis or food poisoning is debated among physicians. Some doctors recommend no antibiotics (just adequate hydration) since the disease is self-resolving, while other clinicians suggest using antibiotics such as Cipro for 10-14 days. Patients identified as being immunosuppressed (see above) should certainly receive antibiotics. In any case—adequate hydration (either orally or by IV fluids) should be a mainstay of treatment.

How Can I Prevent Getting Salmonella

Cleanliness is the most important advice for prevention of salmonella.  This means frequent handwashing with antibacterial soap and hot water, especially just before and after eating, or after visiting the bathroom.

Other prevention methods:

  • Minimize handling of raw eggs, poultry, and raw meats
  • Avoid eating meats that are improperly cooked
  • Minimize direct contact with animals that are common carriers of salmonella (pigs, snakes, and turtles, for example)
  • Dine at reputable establishments that are clean (take a peek into the restroom or the kitchen)
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