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Regina D. Knight, PhD Student: Public Health/Epidemiology
Walden University
PUBH-8165-10: Environmental Health
Instructor: Dr. Robert Marino
Spring Quarter, 2010
Dinner with Salmonella
• History of Salmonella
• Sources of Salmonella
• Types of Salmonellosis
• Incidence and Prevalence
• Prevention
• Research
• Identify the Types of Salmonella and
Accompanying Symptoms
• Name the Causes of Salmonellosis
• Determine Appropriate Prevention
Measures
• Government Entities Involved in
Salmonella Control
• Become Aware of the Incidence and
Prevalence in the US
• Discovered
by Daniel E. Salmon in 1884
• Salmonella choleraesuis – hog cholera
• Gram-negative, motile bacterium
•Invades the intestines or bloodstream of the host
•Leading cause of food poisoning
(US NLM, 2005)
(Helath.google.com, 2010)
(US NLM,2005)
US National Library of Medicine. (2005). Daniel E. Salmon. National Institutes of Health. Retrieved from:
http://www.nlm.nih.gov/hmd/medtour/vetcol.html
Health.google.com. (2010). Salmonella enterocolitis. A.D.A.M. Retrieved from:
https://health.google.com/health/ref/Salmonella+enterocolitis
(Health.google.com, 2010)
(FDA, 2009; NIAID, 2010; Klotchko & Wallace, 2008)
• Food
• Raw poultry, eggs, raw seafood, beef, unwashed fruit
• Cross contamination
• Environmental Sources
• Water –untreated , stagnant
• Soil – feces of infected animals
• Surfaces – Kitchen and factory
• Animals
• Handling various reptiles, kittens, chicks, ducklings
• Food Preparers
• Cross-contamination
Failure to wash hands
US Food and Drug Administration. (2009). BBB – Salmonella spp. Retrieved from:
http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm069966.htm
National Institute of Allergy and Infectious Diseases. (2010). Salmonellosis. US Department of Health and Human Services: National Institutes of
Health. Retrieved from: http://www.niaid.nih.gov/topics/salmonellosis/pages/default.aspx
Klotchko, A. & Wallace, M. R. (2009, March 31). Salmonellosis. Medscape: Emedicine. Retrieved from
http://emedicine.medscape.com/article/228174-overview
(Todar, 2008; FDA, 2009)
S. typhi
S. enterica
• Enteric fever or Typhoid
• Symptoms:
• Infection in the
bloodstream
• Pain
• Stiffening in Joints
• Arthritis
• Overall Systemic
Septicemia
• Gastroenteritis or food
poisoning
• Symptoms:
• Abdominal cramping
• Headache
• Nausea
• Vomiting
• Diarrhea
Courtesy of CDC/Armed
Forces Institute of
Pathology, Charles N.
Farmer at
Health.google.com, 2010
(Health.google.com,
2010)
US Food and Drug Administration. (2009). BBB – Salmonella spp. Retrieved from:
http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm069966.htm
Health.google.com. (2010). Salmonella enterocolitis. A.D.A.M. Retrieved from: https://health.google.com/health/ref/Salmonella+enterocolitis
(Klotchko & Wallace, 2009; CDC, 2009)
•Sufficient amount of bacteria ingested
•Bacteria becomes attached to epithelial cells in small
intestine
•Internalized by endocytosis
•Transported to the lamina propria
•Response is usually immediate
•Lasts about a week
•Treatment
•Hydration
Center for Disease Control and Prevention. (2009). Salmonellosis. National Center for Zoonotic, Vector-Borne, and Enteric Disease. Retrieved
from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/salmonellosis/
Klotchko, A. & Wallace, M. R. (2009, March 31). Salmonellosis. Medscape: Emedicine. Retrieved from
http://emedicine.medscape.com/article/228174-overview
(Answers.com)
Layers of Stomach Wall:
1. Serosa
2. Tela subserosa
3. Muscularis
4. Oblique fibers of muscle wall
5. Circular muscle layer
6. Longitudinal muscle layer
7. Submucosa
8. Lamina muscularis mucosae
9. Mucosa
10. Lamina propria
11. Epithelium
12. Gastric glands
13. Gastric pits
14. Villous folds
15. Gastric areas (gastric surface
Answers.com. (2010). Lamina propria. Retrieved from: http://www.answers.com/topic/lamina-propria
(Answers.com, 2010)
(CDC, 2009; Todar, 2008; Klotchko & Wallace, 2009)
• Major immune response
•Travels through the lymphatic and circulatory systems
•Invades deeper tissues
•Delayed response
•Treatment
•Antibiotics
Center for Disease Control and Prevention. (2009). Salmonellosis. National Center for Zoonotic, Vector-Borne, and Enteric Disease. Retrieved
from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/salmonellosis/
Todar, K. (2008). Salmonella and Salmonellosis. Todar’s online textbook of bacteriology. Retrieved from:
http://www.textbookofbacteriology.net/salmonella.html
Klotchko, A. & Wallace, M. R. (2009, March 31). Salmonellosis. Medscape: Emedicine. Retrieved from
http://emedicine.medscape.com/article/228174-overview
(Circulatory, Answers.com 2010;
Lymphatic, answers.com, 20101)
Circulatory System
Lymphatic system
Answers.com. (2010). Circulatory system. Retrieved from: http://www.answers.com/topic/circulatory-system
Answers.com. (2010). Lymphatic system. Retrieved from: http://www.answers.com/topic/lymphatic-system
(CDC, 2009; FDA, 2009)
• 40,000 cases reported annually in the US
• Many go unreported and untreated
• FDA estimates 2 to 4 million cases of
Salmonellosis annually
• 74,000 cases attributed to amphibians and
reptiles
• Estimated 400 people die each year with acute
cases
Center for Disease Control and Prevention. (2009). Salmonellosis. National Center for Zoonotic, Vector-Borne, and Enteric Disease. Retrieved
from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/salmonellosis/
US Food and Drug Administration. (2009). BBB – Salmonella spp. Retrieved from:
http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm069966.htm
(CDC, 2009; Klotchko & Wallace, 2009)
• All people are susceptible
• Greatest numbers and most severe cases are
among the very young and elderly
• Under the age of 5
• Over 60 years of age
Center for Disease Control and Prevention. (2009). Salmonellosis. National Center for Zoonotic, Vector-Borne, and Enteric Disease. Retrieved
from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/salmonellosis/
Klotchko, A. & Wallace, M. R. (2009, March 31). Salmonellosis. Medscape: Emedicine. Retrieved from
http://emedicine.medscape.com/article/228174-overview
(CDC, 2009)
• Cook food thoroughly
• Wash hands
• Wear gloves
• Clean preparation surfaces
• Wash food prior to preparation
• Use non-toxic cleaners to wash fruits and vegetables
• Avoid direct contact with reptiles
• Wash hands before handling an infant or the
immunocompromised
• Breast-feeding
Center for Disease Control and Prevention. (2009). Salmonellosis. National Center for Zoonotic, Vector-Borne, and Enteric Disease. Retrieved
from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/salmonellosis/
(FDA, 2009)
• Improve hygiene practices
• Clean livestock and habitats
• Insect control
• Clean and functional meat packing facilities
• Better education of food industry workers in food safety
and restaurant inspections
• Increase usage of pasteurized egg products
• Irradiation of raw meat
US Food and Drug Administration. (2009). BBB – Salmonella spp. Retrieved from:
http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm069966.htm
• Center of Disease Control and Prevention (2009)
• Keeps track of reported cases, strain types, and frequency
• Food and Drug Administration (2009)
• Inspects imported foods and pasteurization plants
• Issues guidelines for better food preparation in restaurants and
food processing plants
• Regulates the use of antibiotics in livestock
• Regulates the sales of turtles
• US Department of Agriculture (CDC, 2009)
• Monitors livestock
• Inspects egg pasteurization plants
• Responsible for the quality of slaughtered and processed meat
• Environmental Protection Agency (CDC, 2009)
• Regulates and monitors water quality and supplies
Center for Disease Control and Prevention. (2009). Salmonellosis. National Center for Zoonotic, Vector-Borne, and Enteric Disease. Retrieved
from: http://www.cdc.gov/nczved/divisions/dfbmd/diseases/salmonellosis/
US Food and Drug Administration. (2009). BBB – Salmonella spp. Retrieved from:
http://www.fda.gov/Food/FoodSafety/FoodborneIllness/FoodborneIllnessFoodbornePathogensNaturalToxins/BadBugBook/ucm069966.htm
(Attig, 2009)
• 1984 Incident in The Dalles, Oregon
• Rajneeshee cult , followers of Bhagwan Shree Rajneesh
•Contaminated salad bars with S. typhicurium
• Sickened 750 people
• Wanted to Incapacitate voters
Attig, R. (2009,October 5). The poisoning of an Oregon town. OregonLive.com Retrieved from:
http://www.oregonlive.com/opinion/index.ssf/2009/10/the_poisoning_of_an_oregon_tow.html
(Moon & McSorley, 2009; Wigley et al., 2006).
• Studies have been conducted on mouse and chicken models
• Mouse model did not develop diarrhea, but contracted the
typhoid form when infected with Salmonella
• Discovered rapid intracellular metastasis
• Spread throughout the liver and spleen
• Presence of macrophages deposited Salmonella T-cells and Bcells
• Body of host manufactured antibodies against the pathogen and
exhibited immunity when exposed to Salmonella again
• Immunity = antibodies + TH-1 cell of pathogen
• Attenuated cells could possibly be used as a vaccine
Moon, J. J. & McSorley, S. J. (2009). Tracking the dynamics of Salmonella specific T-cell responses. Current Topics in Microbiology and Immunology.
334: pp. 179–198. doi:10.1007/978-3-540-93864-4_8. Retrieved from:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732114/pdf/nihms121430.pdf/?tool=pmcentre
Wigley, P., Hulme, S., Rothwell, L., Bumstead, N., Kaiser, P., & Barrow, P. (2006, February). Macrophages isolated from chickens genetically
resistant or susceptible to systemic salmonellosis show magnitudinal and temporal differential expression of cytokine and chemokines following
Salmonella enterica challenge. Infection Immunity, 74(2), pp. 1425-1430. Retrieved from:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360331/pdf/1265%2D05.pdf/?tool=pmcentrez
• Caused by Salmonella - Gram-negative, motile
• Two types: Gastroenteritis - S. enterica – ; Typhoid Fever - S. typhi
• Affects 2 to 4 million people annually; 400 die each year
• Anyone can get Salmonellosis but the very young and the elderly are
more susceptible to the pathogen
• Prevention - good hygiene, reduction of cross contamination via
washing hands, cleaning utensils, cleaning surfaces, cooking food
thoroughly, etc.
• Government Agencies – CDC, FDA, USDA, and EPA
• Salmonella is a bioterrorism concern because it can incapacitate large
groups of people
• Research shows that previous infection with Salmonellosis can create
immunity in the host from future outbreaks and possibly use antibodies
for vaccine production
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2.
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4.
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6.
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8.
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Attig, R. (2009,October 5). The poisoning of an Oregon town. OregonLive.com Retrieved from:
http://www.oregonlive.com/opinion/index.ssf/2009/10/the_poisoning_of_an_oregon_tow.html
Center for Disease Control and Prevention. (2009). Salmonellosis. National Center for Zoonotic, VectorBorne, and Enteric Disease. Retrieved from:
http://www.cdc.gov/nczved/divisions/dfbmd/diseases/salmonellosis/
Health.google.com. (2010). Salmonella enterocolitis. Retrieved from:
https://health.google.com/health/ref/Salmonella+enterocolitis
Klotchko, A. & Wallace, M. R. (2009, March 31). Salmonellosis. Medscape: Emedicine. Retrieved from
http://emedicine.medscape.com/article/228174-overview
Moon, J. J. & McSorley, S. J. (2009). Tracking the dynamics of Salmonella specific T-cell responses.
Current Topics in Microbiology and Immunology. 334: pp. 179–198. doi:10.1007/978-3-540-93864-4_8.
Retrieved from:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2732114/pdf/nihms121430.pdf/?tool=pmcentrez
National Institute of Allergy and Infectious Diseases. (2010). Salmonellosis. US Department of Health
and Human Services: National Institutes of Health. Retrieved from:
http://www.niaid.nih.gov/topics/salmonellosis/pages/default.aspx
Todar, K. (2008). Salmonella and Salmonellosis. Todar’s online textbook of bacteriology. Retrieved from:
http://www.textbookofbacteriology.net/salmonella.html
US National Library of Medicine. (2005). Daniel E. Salmon. National Institutes of Health. Retrieved
from: http://www.nlm.nih.gov/hmd/medtour/vetcol.html
Wigley, P., Hulme, S., Rothwell, L., Bumstead, N., Kaiser, P., & Barrow, P. (2006, February). Macrophages
isolated from chickens genetically resistant or susceptible to systemic salmonellosis show
magnitudinal and temporal differential expression of cytokine and chemokines following
Salmonella enterica challenge. Infection Immunity ,74(2), pp. 1425-1430. Retrieved from:
http://www.ncbi.nlm.nih.gov/pmc/articles/PMC1360331/pdf/1265%2D05.pdf/?tool=pmcentrez
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2.
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Heithoff, D. M., Shimp, W. R., Lau, P. W., Badie, G., Enioutina, E. Y., Daynes, R. A., Byrne, B. A.,
House, J. K., & Mahan, M. J. (2008, March). Human salmonella clinical isolates distinct from
those of animal origin. Applied and Environmental Microbiology, 74(6), pp. 1757-1766. doi:
10.1128/AEM.02740-07
Wrongdiagnosis.com. (2010). Prevalence and incidence of Salmonella poisoning. Retrieved from:
http://www.wrongdiagnosis.com/s/salmonella_food_poisoning/prevalence.html
Davis, B. (2010). Salmonellosis. YahooHealth.com. Retrieved from:
http://health.yahoo.com/infectiousdisease-overview/salmonellosis/healthwise-te6320spec.html
Environmental Protection Agency. (2006, July). Method 1682: Salmonella in sewage sludge (biosolids)
by modified semisolid Rappaport-Vassiliadis (MSRV) medium. Washington DC: Office of
Water. Retrieved from:
http://www.epa.gov/waterscience/methods/method/biological/1682.pdf