* Your assessment is very important for improving the workof artificial intelligence, which forms the content of this project
Download File - Kevin Crawford
Toxocariasis wikipedia , lookup
Brucellosis wikipedia , lookup
Hepatitis C wikipedia , lookup
Ebola virus disease wikipedia , lookup
Bovine spongiform encephalopathy wikipedia , lookup
Hepatitis B wikipedia , lookup
Sexually transmitted infection wikipedia , lookup
Chagas disease wikipedia , lookup
Onchocerciasis wikipedia , lookup
Neglected tropical diseases wikipedia , lookup
Rocky Mountain spotted fever wikipedia , lookup
Marburg virus disease wikipedia , lookup
Sarcocystis wikipedia , lookup
African trypanosomiasis wikipedia , lookup
Eradication of infectious diseases wikipedia , lookup
Middle East respiratory syndrome wikipedia , lookup
Hospital-acquired infection wikipedia , lookup
Trichinosis wikipedia , lookup
Coccidioidomycosis wikipedia , lookup
Oesophagostomum wikipedia , lookup
Traveler's diarrhea wikipedia , lookup
Gastroenteritis wikipedia , lookup
Schistosomiasis wikipedia , lookup
Fasciolosis wikipedia , lookup
Leptospirosis wikipedia , lookup
Foodborne illness wikipedia , lookup
1984 Rajneeshee bioterror attack wikipedia , lookup
SALMENOSIS Author: Kevin Crawford Dr. Phalen HSCI 530 1|Page Table of Contents INTRODUCTION ............................................................3 IDENTIFICATION ..........................................................4 Description of the Agent .................................................4 Antigenic Structure .........................................................4 Laboratory Identification ................................................5 Testing ............................................................................5 Symptoms .......................................................................5 Natural Sources in the Environment ...............................6 Associated Foods ............................................................6 Occurrence in the United States......................................6 Reservoirs .......................................................................7 Modes of Transmission...................................................7 Infective Dose .................................................................8 Incubation Period ............................................................8 Methods of Control and Prevention ..................................8 Major Food-Borne Outbreaks .........................................10 2|Page INTRODUCTION Salmonellosis is an infection of the bacteria called Salmonella. It is known to be associated with living in the intestinal tracts of warm and cold blooded animals. It is transmitted and derived from infected animals and or contaminated feces. It is part of the family enterobacteriaceae and has numerous known serotypes ranging up to 2500 different subspecies (Knechtges, 2012). The two most concerned serotypes for humans are S. Typhimurium and S. Enteritidus. The species itself has been around for hundreds of years. In the 1880’s the typhoid bacillus was first observed by Eberth in sections of the spleen and mesenteric lymph nodes from a patient who died from typhoid. He successfully cultivated this bacterium in 1881 which further lead to the serodiagnosis of typhoid by 1896 (Todar, 2013). Common symptoms include headache, abdominal pain, diarrhea, nausea, and vomiting. Some serotypes can lead to more serious illness such as typhoid fever. Due to the range of mild to severe cases of salmonella, and the fact that non industrialized countries do not have proper reporting systems, the actual number of cases cannot be identified but it is estimated that 42,000 laboratory-confirmed cases happen in the U.S yearly (CDC, 2012). Contamination and ingestion are the two most common ways for the disease to spread. Unsanitary practices in food production ranging from the slaughtering of animals to commercially preparing food can be used as a mode of transmission if any fecal matter were to be involved (Todar, 2013). This helps backup the idea that we must set preventive measures and control to ensure that large and widespread occurrences do not happen. Establishing regulations on sanitary practices and 3|Page ensuring the quality of products from livestock all the way to the consumer will help save lives and prevent further occurrences (Heymann, 2004). IDENTIFICATION Description of the Agent Salmonella is a motile bacterium, gram negative, facultative rod shaped bacterium in the family enterobacteriaceae. It is non-spore forming and non-motile variants of the species do exist such as S. Gallinarum and S. Pullorum (Hammack, 1998). It is commonly manifested by acute enteroclotius which is an infection of the intestinal tract. 2500 Different serotypes are known today between the two species S. Enterica and S. Bangori. S. Enterica consists of six subspecies and includes most serotypes involving animal and human infection. These numerous serotypes were named after the type of animal or carrier it was found in (Knechtges, 2012) .The two most commonly reported types include S. Typhimurium and S. Enteritidus. Antigenic Structure Its DNA base composition is 50-50 mol% G+C, similar to that of Escherichia, shigella, and citrobacter. Somatic antigens within salmonella are heat stable and alcohol resistant. Flagella antigens are heat-labile proteins while surface antigens in salmonella may mask O antigens, and the bacteria will not be angulated with O antisera (Todar, 2013). Most strains are prototrophic meaning they do not require any growth factors. Auxotrophic strains do occur, meaning they can synthesize their own organic compounds to help reproduce and thrive. These strains are found especially in host adapted serovars so as Typhi and Paratyphi A.(Todar, 2013). 4|Page Laboratory Identification The most commonly used media selective for salmonella includes and not limited too; SS Agar, bismuth sulfite agar, hektoen enteric (HE), brilliant green agar, and xylose-lisine-deoxycholate (XLD) agar (Todar, 2013). Most salmonella strains are motile with peritrichous flagella while non-motile variants may occur occasionally. Most strains grow on nutrient agar as smooth colonies, 2 – 4 mm in diameter (Todar,2013). Testing Determining cause for salmonella requires laboratory testing which can be identified with a stool sample, 3-10 grams of fecal matter should be inoculated (Heymann, 2004). Symptoms Symptoms for salmonellosis ranges due to type of infections that my happen. Depending on serotype, more serious illnesses can occur such as typhoid and paratyphoid fevers from respective strains S. Typhimurium and S. Paratyhphimurium (Hammack, 1998). Onset of headache, abdominal pain, diarrhea, nausea and vomiting are all common with salmonella infections and enteric disease. Typhoid fever can include high fevers from 103-104 degrees, lethargy, gastrointestinal symptoms including abdominal pain, diarrhea or constipation, headache, loss of appetite. Rash of flat, rose-colored spots sometimes occur. Paratyphi fever has been known to be much more subtle and milder compared to typhoid (Hammack, 1998). Post infectious irritable bowel syndrome, which is prevalent in an average of 15% among those who have recovered from an intestinal infection, may occur. Symptoms include and sometimes result in abdominal abscesses (Knechtges, 2012). Reiter’s syndrome; a condition which results when the body’s immune system attacks its own tissues includes symptoms such as arthritis, eye irritation and urinary tract problems (Knechtges, 2012). 5|Page Natural Sources in the Environment Salmonellae are disseminated in the natural environment through human or animal excretion. These environments include water, soil, and even sometimes plants used as food and feed (Todar, 2013). Infected farm animals by feeds and fertilizers have been pointed out as a source of contamination which results in infected products such as meats and poultry. Associated Foods The salmonellae family has a large number of associated foods due to its ease of transmission through fecal contamination. Animal products such as meats, poultry, eggs, fish and shrimp are all susceptible (Hammack, 1998). Milk and dairy products if they have not been through a pasteurization process, which brings the product to a specific temperature for a predefined length and time to remove harmful pathogens, can be a probable source (Heymann, 2004). Raw veggies such as alfalfa sprouts, tomatoes, peppers, cantaloupes, lettuce due to contaminated water supply can result in salmonella. (Knechtges, 2012). Occurrence in the United States Extensive reporting has been done on salmonella in the United States and Europe due to better reporting systems. In some industrialized countries, as few as 1% of cases actually get reported. Incident rates are most common in children and elderly as they are the most susceptible (Heymann, 2004). The incidence of foodborne Salmonella infection/toxication remains relatively high in developed countries because of commercially prepared food or ingredients for food. Any contamination of commercially prepared food will result in a large-scale infection (Todar, 2013). According to the CDC, an estimated 1.2 million cases occur annually in the United States; of these, approximately 42,000 are laboratory-confirmed cases which are reported (CDC, 2013). Of these 1.2 million cases, an estimated 1,027,561 cases of domestically acquired nontyphodial 6|Page salmonellosis occur while the CDC recently estimated that a mean of 1,821 cases occur annually in the U.S. (Hammack, 1998) Reservoirs As mentioned earlier, salmonellae live in the intestinal tracts of warm and cold blooded animals. Salmonella serovars can be found predominantly in one particular host, can be ubiquitous, or can have an unknown habitat (Todar, 2013). Salmonellosis in these cases is transmitted through fecal contamination of water and food, it must be noted that Typhi and Paratyphi A are strictly human serovars (Todar, 2013). Beef includes most individual outbreaks, while poultry and eggs consist of most of the salmonellosis pandemics. Much wild game such as birds, hoofed animals can be transmitters while even house hold pets such as cats, dogs, and reptiles (Knechtges, 2012). Municipal water supplies can also carry salmonella strains if not properly treated with a recommended dose of chlorine. Modes of Transmission The most commonly and frequently seen mode of transmission for salmonella is to be taken a dose orally, that is ingesting of contaminated food, fecal particles or contaminated water (Hammack, 1998). Surface contamination of meats during cooking usually has little to no consequence if the person is properly cooking it, although handling of contaminated meat may result in contamination of hands, tables, kitchenware, towels, and other foods (Todar, 2013). Outbreaks have sourced from raw fruits and veggies as they do not go through any cooking processes. Infected farm animals may have been a result of contaminated feed and fertilizers and this infection can spread from the rearing and slaughter process (Heymann, 2004). Person to 7|Page person transmission is possible while animal to human transmission is more likely. Typhi and Paratyphi are strictly human serovars and are usually associated with cross contamination, particularly in areas of poor sanitation (Knechtges, 2012). Infective Dose The infective dose, also known as virulence, varies greatly with the serotype and host resistance. Its range is known to be as wide as 10 to 1,000,000,000 colony-forming units (Knechtges, 2012). Susceptibility is increased by anchlorhydria, antacid treatment, and gastrointestinal surgery. Severity is related to serotype; number of organisms ingested and host factors. Septicemia is increased in those with sickle cell disease (Heymann, 2004). Incubation Period The incubation period of salmonellosis occurs relatively rapidly, after ingestion, the bacilli colonize sites on the epithelium of the intestine, and within a manner of minutes, they invade cells of the intestinal mucosa (Knechtges, 2012). Once infection occurs, onset of symptoms can happen as soon as 6 to 72 hours, but this timeframe is most active around 12-36 hours. The period of communicability includes through the course of the infection which can be from several days to several weeks. Those infected can be temporary convalescent carriers for months. 1% of adults and 5% of children excrete the organism for more than a year, usually from typhoid cases (Heymann, 2004). Methods of Control and Prevention Methods of control to help stop the spread of the disease as reported in the communicable diseases manual, states that reporting your illness to a local health authority is the first step in gauging the problem. Next, isolation and immunization of those in contact with disease may be 8|Page needed to help prevent any further spreading. Next, quarantine and investigation of contacts and source will help identify the issue. Finally, specific treatment and concurrent disinfection will be needed to ward off the disease (Heymann, 2004). Preventive measures were further outlined in the disease manual which stated we must educate food handlers and public handlers of proper sanitary practices. Use pasteurized or irradiated egg products to prepare dishes. Exclude individuals with diarrhea from food handling. Indoctrinate known carriers on washing hands after using the restroom. Recognize that household pets can be carriers of salmonella and must be handled carefully. Establish facilities and encourage irradiation of meat and eggs. Inspect and supervise sanitation methods while also establishing salmonella control programs. Finally, all foods should be adequately cooked or heat treated to ensure integrity of such foods from foreign invaders (Heymann, 2004). National surveillance is conducted through the public health laboratories for culture-confirmed cases and through the National Notifiable Diseases Surveillance System (NNDSS). Active laboratory- and population-based surveillance is conducted in FoodNet sites (CDC, 2013). Challenges outlined on the Centers for Disease Control and Prevention website believes that identifying unrecognized major sources of salmonella infections; determining the sources of infections in infants; preventing contamination of vegetables with manure from concentrated animal feeding operations and preventing further emergence of highly resistant strains through improved detection from collaborative efforts from laboratories and trained state health department personnel are effective opportunities to help reduce the spread of salmonellosis (CDC, 2013). 9|Page Major Food-Borne Outbreaks The CDC website has listed on their salmonella homepage all reported outbreaks from 2006 to 2013. 1. Multistate Outbreak of Human Salmonella Typhimurium Infections Linked to Live Poultry June 6, 2013 A total of 224 persons infected with the outbreak strain of Salmonella Typhimurium have been reported from 34 states. Epidemiologic, laboratory, and traceback findings have linked this outbreak of human Salmonella Typhimurium infections to contact with chicks, ducklings, and other live baby poultry purchased from multiple feed stores and sourced from multiple mailorder hatcheries. Mail-order hatcheries, agricultural feed stores, and others that sell or display chicks, ducklings, and other live poultry should provide health-related information to owners and potential purchasers of these birds prior to the point of purchase. This should include information about the risk of acquiring a Salmonella infection from contact with live poultry. 2. Multistate Outbreak of Salmonella Typhimurium and Salmonella Newport Infections Linked to Cantaloupe. October 5, 2012 A total of 261 persons infected with the outbreak strains of Salmonella Typhimurium (228 persons) and Salmonella Newport (33 persons) were reported from 24 states. Collaborative investigation efforts of state, local, and federal public health and regulatory agencies indicated that cantaloupe originating from Chamberlain Farms Produce, Inc. of Owensville, Indiana, was the source of this outbreak. (ALL OUTBREAKS SOURCED FROM http://www.cdc.gov/salmonella/outbreaks.html) 10 | P a g e 1. Hammack, Thomas. "Salmonella Species." Foodborne Pathogenic Microorganisms and Natural Toxins Handbook: The 'bad Bug Book' 2nd ed. [Washington, D.C.]: U.S. Food & Drug Administration, Center for Food Safety and Applied Nutrition, 1998. 12-16. Print. 1. Identification and/or description of the agent Salmonella is a motile non-sporeforming Gramnegative rod-shaped bacterium in the family Enterobacteriaceae and the tribe Salmonellae. Non-motile variants include S. Gallinarum and S. Pullorum. 2. Associated disease or illness, including the following relevant information: a. Name of disease or illness Salmonella b. Identification of the disease (e.g. signs and symptoms, medical tests) Nontyphoidal Salmonellosis Nausea, vomiting, abdominal cramps, diarrhea, fever, headache. Typhoid Fever High fever, from 103° to 104°F; lethargy; gastrointestinal symptoms, including abdominal pains and diarrhea or constipation; headache; achiness; loss of appetite. A rash of flat, rose-colored spots sometimes occurs. Serological identification of cultural isolates from stool c. Natural habitat or sources in the environment It can colonize the intestinal tracts of vertebrates, including livestock, wildlife, domestic pets, and humans. May also live in environments such as pond-water sediment. d. Associated foods fresh produce associated with animal products meats, poultry, eggs, milk and dairy products, fish, shrimp, spices, yeast, coconut sauces, unpasteurized salad dressings, cake mixes, cream-filled desserts and toppings that contain raw egg, dried gelatin, peanut butter, cocoa. e. Occurrence in the United States Nontyphoidal Salmonellosis (CDC) estimates that 1,027,561 cases of domestically acquired nontyphoidal 11 | P a g e salmonellosis occur annually in the U.S. Typhoid Fever CDC recently estimated that a mean of 1,821 cases occur annually in the U.S. f. Reservoirs S. Typhi and S. Paratyphi A are found only in human hosts. g. Modes of transmission oral (e.g., ingestion of contaminated food, fecal particles, or contaminated water) h. Virulence (e.g. infective dose) Nontyphoidal Salmonellosis i. As low as one cell, depending on age and health of host and strain differences among members of the genus. Typhoid Fever Fewer than 1,000 cells Incubation period Nontyphoidal Salmonellosis 6 to 72 hours after exposure. Typhoid Fever Generally 1 to 3 weeks, but may be as long as 2 months after exposure. 3. Major food-borne outbreaks (2-3) Outbreaks also have been linked to the handling of certain animals sometimes kept as pets, such as turtles, frogs, and chicks. Notes from the Field: Multistate Outbreak of Salmonella Infantis, Newport, and Lille Infections Linked to Live Poultry from a Single Mail-Order Hatchery in Ohio — March–September, 2012 Notes from the Field: Salmonella Bredeney Infections Linked to a Brand of Peanut Butter — United States, 2012 Outbreaks of Acute Gastroenteritis Transmitted by Person-to-Person Contact — United States, 2009–2010 12 | P a g e 2. Heymann, David L. “SALMONELLOSIS” ICD-9003. Control of communicable diseases manual. 18th Ed. Washing, D.C: American Public Health Association, 2004. 469-73. Print. 1. Identification Bacterial disease commonly manifested by acute enterocloitus. Symptoms; onset of headache, abdominal pain, diarrhea, nausea, vomiting. Dehydration in elderly & infants Enterocolitus, fecal excretion persists after few days of acute effects. 3-10 grams of fecal matter should be inoculated 2. Infectious Agents Numerous serotypes have been found pathogenic to both animals and people Much variation & prevalence of serotypes from country to country S. Typhimurium + S. Enteritidus most commonly reported 3. Occurrence Extensively reported in US and EU due to better reporting systems Foodborne disease mainly of animal origin, which is dominant mode of transmission. In industrialized countries, few as 1% of clinical cases are reported Incidence rate are highest in infants and young children 60 – 80% of all cases occur sporadically Large outbreaks in hospitals, child institutions, restaurants are not uncommon arising from a contaminated food source. USA epidemic involving 25,000 cases resulted from non-chlorinated municipal water supply. Largest single epidemic; improper pasteurized milk affected 285,000 persons 4. Reservoir Domestic wild animals; poultry, swine, cattle, rodents Pets such as dogs, cats, iguanas, tortoises, turtles, terrapins Humans; ie. Patients and convalescent carriers. 5. Mode of Transmission Ingestion of the organisms in food derived from infected animals or contaminated feces. Contaminated raw and undercooked eggs, milk, water, meat/meat products, poultry/poultry products 13 | P a g e Outbreaks have sourced from raw fruits and veggies Infected farm animals by feeds and fertilizers Infection spreads from rearing/slaughter process Cross-contamination during food handling Person-person transmission 6. Incubation Period From 6 to 72 hours, usually about 12-36 hours Through course of infection Several days to several weeks Temporary carrier continues for months 1% of adults, 5% of children excrete the organism for more than a year 8. Susceptibility Increased by anchlorhydria, antacid treatment, gastrointestinal surgery Severity is related to serotype; number of organisms ingested and host factors. Septicemia is increased in those with sickle cell disease. 9. Methods of Control PREVENTIVE MEASURES a) b) c) d) e) f) g) h) i) j) educated food handlers of sanitary practices Educate public handlers of sanitary practices Use pasteurized or irradiated egg products to prepare dishes. Exclude individuals with diarrhea from food handling Indoctrinate known carriers on washing hands after using restroom recognition of salmonella in pets Establish facilities and encourage irradiation of meat and eggs Inspect and supervise sanitation methods. Establish salmonella control programs Adequately cook or heat-treat foods 10. CONTROL OF PATIENT a) b) c) d) e) f) g) Report to local health authority Isolation Concurrent disinfection Quarantine Immunization of Contacts Investigation of contacts and source Specific treatment 14 | P a g e 3. Knechtges, Paul L. "Chapter 2 Foodborne Infectious and Microbial Agents; Salmonella Species and Serotypes." Food Safety: Theory and Practice. Sudbury, MA: Jones & Bartlett Learning, 2012. 66-73. Print. 4. Associated disease or illness, including the following relevant information: a. Name of disease or illness 2500 Different Serotypes Two species; S. Enterica and S. Bangori S. Enterica consists of six subspecies and includes most serotypes involving animal and human infection. Group by O antigen similarities first, then further classified by H antigens. Species or serotype is named after the type of animal it was found in S. Typhi and S. Paratyphi are responsible for the serious diseases of typhoid and paratyphoid fever. b. Identification of the disease (e.g. signs and symptoms, medical tests) Typhoid Fever; Fever, headache, constipation Paratyphoid fever is generally milder compared to typhoid fever Enteric Disease; diarrhea, fever, vomiting, and abdominal cramps Post infectious irritable bowel syndrome, which is prevalent an average 15% among those who have recovered from an intestinal infection; Symptoms include abdominal pain, diarrhea, fever, and sometimes resulting abdominal abscesses. Reiters syndrome; condition results when the bodys immune system attacks its own tissues; symptoms include arthritis, eye irritation, urinary tract problems. c. Natural habitat or sources in the environment d. Associated foods Red meats, poultry, eggs, unpasteurized milk, fruits, vegetables, and processed products, alfalfa sprouts, tomatoes, peppers, cantaloupes, and lettuce. e. Occurrence in the United States Typhoid Fever; before antibiotics, case fatality rate was 10-20%, but with proper treatment it is now less than 1%. Considered endemic in regions of Asia, Africa, and Latin America. f. Reservoirs Convalescent carrier times can be quite prolonged, lasting months and possibly a year in some cases. Warm and cold blooded animals Wild birds, hoofed animals, cats, dogs, rodents, reptiles, insects Food contact surfaces Beef includes most individual outbreaks, while poultry and eggs consists of most of the salmonellosis pandemics 15 | P a g e g. Modes of transmission Typhoid; Control of disease transmission is very difficult due to unwary human carriers. Human typhoid fever is associated exclusively with human carriers and usually with contaminated food or water, particularly in areas with poor sanitation. Animal-to-human contact h. Virulence (e.g. infective dose) Varies greatly with the serotype and host resistance Ranges wide as 10 to 1,000,000,000 CFU’s i. Incubation period Occurs relatively rapidly, after ingestion, the bacilli colonize sites on the epithelium of the intestine, and within a manner of minutes, they invade cells of the intestinal mucosa. 5. Methods of control and prevention Treatment involves supportive care, rehydration, electrolyte replacement and antibiotic therapy Medical clearance and good personal hygiene among food workers who have recently recovered 6. Major food-borne outbreaks (2-3) Eggs implicated in 80% of the reported outbreaks in the united states by salmonella from 1985 through 1999. Year 2000 was estimated to be between 81,535 and 276,500 cases Two largest outbreaks caused by dairy products; 1985, cross contamination of pasteurized and non-pasteurized milk led to 16000 culture confirmed salmonellosis cases and a total number of cases estimated to be nearly 200,000 people(Illinois). 1994; contaminated ice cream estimated in 224,000 persons were infected with s. enteritidis from ice cream premix. 16 | P a g e 4. Todar, Kenneth, PhD. "Salmonella and Salmonellosis." Salmonella and Salmonellosis. Madison, Wisconsin, n.d. Web. 29 May 2013. <http://textbookofbacteriology.net/salmonella.html>. 7. Identification and/or description of the agent Salmonella Gram-negative 8. facultative rod-shaped bacterium same proteobacterial family as Escherichia coli the family Enterobacteriaceae DNA base composition is 50-52 mol% G+C, similar to that of Escherichia, Shigella, and Citrobacter. Antigenic Structure Somatic antigens are heat stable and alcohol resistant. Flagellar antigens are heat-labile proteins. Surface antigens in Salmonella may mask O antigens, and the bacteria will not be agglutinated with O antisera. 9. Associated disease or illness, including the following relevant information: a. Identification of the disease (e.g. signs and symptoms, medical tests) The most commonly used media selective for Salmonella are SS agar bismuth sulfite agar Hektoen enteric (HE) medium brilliant green agar and xylose-lisine-deoxycholate (XLD) agar Most Salmonella strains are motile with peritrichous flagella however, nonmotile variants may occur occasionally. Most strains grow on nutrient agar as smooth colonies, 2-4 mm in diameter. Most strains are prototrophs, not requiring any growth factors. auxotrophic strains do occur, especially in host-adapted serovars such as Typhi and Paratyphi A. symptoms appear (diarrhea, vomiting, fever) and last 2-5 days. Salmonella strains may produce a thermolabile enterotoxin antibiotic resistance and multiresistance of Salmonellaspp. have increased a great deal. o cause appears to be the increased and indiscriminate use of antibiotics in the treatment of humans and animals o Until 1972, Typhi strains had remained susceptible to antibiotics b. Natural habitat or sources in the environment Salmonellae are disseminated in the natural environment (water, soil, sometimes plants used as food) through human or animal excretion c. Associated foods Contamination of meat (cattle, pigs, goats, chicken, etc.) most often it results from contamination of muscles with the intestinal contents during evisceration of animals, washing, and transportation of carcasses. Surface contamination of meat is usually of little consequence as proper cooking will sterilize it (although handling of contaminated meat may result in contamination of hands, tables, kitchenware, towels, other foods, etc.). Infection may follow ingestion of any food that supports multiplication of Salmonella such as eggs, cream, mayonnaise, creamed foods, etc. 17 | P a g e d. Occurrence in the United States The incidence of foodborne Salmonella infection/toxication remains relatively high in developed countries because of commercially prepared food or ingredients for food. Any contamination of commercially prepared food will result in a large-scale infection. e. Reservoirs Salmonellae live in the intestinal tracts of warm and cold blooded animals Salmonella serovars can be found predominantly in one particular host, can be ubiquitous, or can have an unknown habitat. f. Salmonellosis in these cases is transmitted through fecal contamination of water or food. Typhi and Paratyphi A are strictly human serovars Virulence (e.g. infective dose) a large number of ingested salmonellae are needed to give symptoms. g. Incubation period About 12-24 hours following ingestion of contaminated food Salmonella excretion by human patients may continue long after clinical cure. About 5% of patients clinically cured from typhoid remain carriers for months or even years. Salmonellae survive sewage treatments if suitable germicides are not used in sewage Processing. h. Discovery 1880s, the typhoid bacillus was first observed by Eberth in spleen sections and mesenteric lymph nodes from a patient who died from typhoid. succeeded in cultivating the bacterium in 1881 Serodiagnosis of typhoid was thus made possible by 1896. 18 | P a g e 5. Centers for Disease Control and Prevention, National Center for Emerging and Zoonotic Infectious Diseases (NCEZID), Division of Foodborne, Waterborne, and Environmental Diseases (DFWED) Page last reviewed: May 14, 2013 Page last updated: May 14, 2013 http://www.cdc.gov/salmonella/index.html 6. FoodSaftey.gov, Salmonella, U.S. Department of Health & Human Services - 200 Independence Avenue, S.W. - Washington, D.C. 20201 Date Modified: June 10, 2013 http://www.foodsafety.gov/poisoning/causes/bacteriaviruses/salmonella/#.UbXtePmsh8E 7. Salmonella Infections, U.S. National Library of Medicine 8600 Rockville Pike, Bethesda, MD 20894 U.S. Department of Health and Human Services National Institutes of Health Page last updated on 19 April 2013 Topic last reviewed 30 August 2012 http://www.nlm.nih.gov/medlineplus/salmonellainfections.html 19 | P a g e