Summary about Disease
Nontyphoidal Salmonella (NTS) infection is a common bacterial illness that affects the intestinal tract. It's caused by Salmonella bacteria other than Salmonella Typhi and *Paratyphi* (which cause typhoid fever). NTS infections are usually less severe than typhoid fever, causing gastroenteritis symptoms.
Symptoms
Common symptoms include:
Diarrhea (often bloody)
Fever
Abdominal cramps
Nausea
Vomiting
Headache
Causes
NTS infection is typically caused by consuming food or water contaminated with Salmonella bacteria. Common sources include:
Raw or undercooked poultry, meat, and eggs
Unpasteurized milk or dairy products
Raw fruits and vegetables
Pet reptiles (turtles, lizards) and amphibians
Medicine Used
Treatment primarily focuses on managing dehydration through oral or intravenous fluids and electrolyte replacement. Antibiotics are generally not recommended for uncomplicated cases as they don't significantly shorten the duration of illness and may contribute to antibiotic resistance. However, antibiotics may be necessary for:
Severe infections
Infections that have spread beyond the intestines (e.g., bloodstream)
Infants
Elderly individuals
Immunocompromised individuals Common antibiotics used, when necessary, include:
Fluoroquinolones (e.g., ciprofloxacin, levofloxacin) - Use with caution due to resistance concerns, especially in children.
Azithromycin
Ceftriaxone
Is Communicable
Yes, NTS infection is communicable. It can spread through:
Fecal-oral route: Contaminated hands transferring bacteria to food or surfaces.
Person-to-person contact: Especially if proper handwashing is not practiced after using the toilet or changing diapers.
Animal contact: Touching animals, especially reptiles and amphibians, and then touching your mouth or food.
Precautions
Wash hands thoroughly and frequently: Especially after using the toilet, changing diapers, handling raw food, and contact with animals.
Cook food thoroughly: Ensure poultry, meat, and eggs are cooked to safe internal temperatures.
Avoid raw or undercooked foods: Especially poultry, meat, eggs, and seafood.
Pasteurize milk and juice: Drink only pasteurized dairy and juice products.
Wash fruits and vegetables: Rinse thoroughly under running water.
Prevent cross-contamination: Use separate cutting boards and utensils for raw meats and other foods.
Keep reptiles and amphibians away from food preparation areas: Wash hands thoroughly after handling these animals.
Stay home if you are sick: Avoid preparing food for others if you have diarrhea or vomiting.
Clean and disinfect surfaces: Regularly clean and disinfect kitchen counters, cutting boards, and other surfaces.
How long does an outbreak last?
The duration of a NTS outbreak can vary significantly, depending on the source of contamination and the effectiveness of control measures. It can range from a few days to several weeks or even months. The outbreak will last until the source of the infection is identified and eliminated, and control measures are implemented to prevent further spread. Public health intervention is critical in ending outbreaks.
How is it diagnosed?
Diagnosis typically involves:
Stool culture: A stool sample is sent to a laboratory to identify the presence of Salmonella bacteria.
Blood culture: In severe cases, a blood culture may be performed to check for bloodstream infection (bacteremia).
Fecal PCR test: More rapid and specific for detection of Salmonella.
Timeline of Symptoms
Incubation period: Typically 6 hours to 6 days after exposure.
Symptom duration: Symptoms usually last 4 to 7 days.
Recovery: Most people recover without treatment. However, some may experience lingering bowel problems for several months.
Important Considerations
Antibiotic resistance: NTS strains are increasingly resistant to some antibiotics, making treatment more challenging.
Infants and elderly: These groups are more vulnerable to severe complications from NTS infection.
Immunocompromised individuals: People with weakened immune systems are at higher risk for bloodstream infections and other complications.
Dehydration: Diarrhea and vomiting can lead to dehydration, which can be serious, especially in young children and older adults.
Reactive arthritis: In rare cases, NTS infection can trigger reactive arthritis (Reiter's syndrome), characterized by joint pain, eye inflammation, and urinary problems.