What a gift it is to have pure, clean water!

Not just for drinking and cooking, but to wash produce, scrub hands, brush teeth, and bathe.

Clean water is a basic human need, yet the UN’s Institute for Water, Environment and Health reports that 663 million people still lack ‘improved’ drinking water. That’s despite efforts being made each year to supply more people with better quality water.

One side of this reality is the diseases that routinely accompany contaminated water. A salmonella infection, or salmonellosis, is one common bacterial infection. It can happen anywhere, but this disease plagues developing countries with contaminated water supplies.

What are salmonella, salmonella infection, and salmonellosis?

These three terms are sometimes used interchangeably, but salmonella is the name of the bacteria, while salmonellosis and salmonella infection are the resulting illness.

This genus of bacteria is responsible for one of the most common forms of food poisoning worldwide. Globally, millions of cases of salmonellosis are reported every year. Many more go unreported.

Discovered by a doctor in the 1870’s, the bacteria became known as salmonella when a veterinary pathologist involved in the U.S. Department of Agriculture’s microorganism research program found salmonella in hogs that were dying. The genus “salmonella” was named for this researcher, Daniel Salmon.

Most salmonella infections can be classified as stomach flu or gastroenteritis. The infection strikes the intestinal tract. The bacteria typically live in human and animal intestines, including birds, and then are shed through their feces. Even someone with no symptoms can be a carrier and infect others.

The way most humans become infected is through ingesting water that’s been contaminated with the bacteria, or tainted food – in particular raw/undercooked meat, poultry, eggs or egg products. Salmonella infections are more common in the summer than winter.

Where is Salmonella bacteria found?

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The bacteria itself is found worldwide. Humans carry certain types of salmonella. It’s found in wild and domestic animals. Poultry, swine, cattle, wild birds, and rodents can carry it, but so can reptiles – iguanas, turtles, and others. Even dogs and cats may harbor the bacteria.

What are the symptoms of salmonella infection?

Sometimes people with salmonella infection have no symptoms. Others develop diarrhea, abdominal cramps, and fevers within a few hours to 3 days.

A complete list of symptoms may include:

  • Nausea
  • Vomiting
  • Abdominal cramps
  • Diarrhea
  • Fever
  • Chills
  • Headache
  • Blood in the stool

The salmonella infection generally lasts from four to ten days. It’s normally not life-threatening, and without treatment, most healthy people recover within two weeks.

Unfortunately, that’s not always the case. Infants, young children, the elderly, transplant recipients, pregnant women and unborn babies, and those with compromised immune systems are more likely to have an acute form of the illness or be in danger if complications occur.

Diarrhea linked to salmonella can be dehydrating. Dehydration occurs when you aren’t able to drink enough liquids to replace fluid lost from diarrhea. Even after abdominal pain and diarrhea subside, it may be months before bowels are back to normal.

You may be dehydrated if you’re experiencing these or other signs:

  • Dry mouth and or tongue
  • Little urine output
  • Producing few to no tears
  • Sunken eyes

How does salmonella cause diarrhea?

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It’s insidious! Here’s Science Daily’s description of this cunning invader:

Salmonella is a pathogenic bacteria which penetrates intestinal epithelium cells which form the topmost layer of the intestinal tissue. Although the pathogens are killed in these cells, they succeed in provoking inflammation that destroys the intestinal flora and nullifies their protective function. Their comrades of the same species that remained in the intestine exploit this, and proliferate, and the affected person develops violent diarrhea.

Sometimes dehydration is severe enough to require medical attention or hospitalization. In those cases, blood or stool samples help medical personnel distinguish salmonella infection from other illnesses with the same symptoms.

How is a salmonella infection treated?

As noted before, some cases clear up on their own. Severe cases may require hospitalization to receive fluids intravenously. Anti-diarrhea meds may be prescribed or medications to relieve cramping, although the latter may prolong diarrhea that comes with the infection.

Antibiotics don’t help with uncomplicated cases of salmonella. They’re usually used for treatment when it appears salmonella bacteria have entered the bloodstream, and sometimes for severe cases or patients with a compromised immune system. Antibiotics could increase a risk of relapse.

Salmonella infections become life-threatening when complications develop. especially when the infection spreads beyond the intestines to the bloodstream. Once present in the bloodstream it’s called bacteremia. Bacteremia can lead to infection of any organ, like the brain, spinal cord, heart valves, lining of the heart, or bone marrow.

What is typhoid fever?

One variety of salmonella bacteria leads to typhoid fever, a bacterial infection of the intestinal tract and sometimes the bloodstream. It is caused by the Salmonella Typhi bacteria. It can be a deadly disease.

Typhoid is much more common in developing countries than in the U.S. where it is now considered very rare. In the 1800’s there were numerous outbreaks in New York traced back to one immigrant later identified as a carrier.

She herself was healthy, but she was the cause of many others becoming ill, some of whom died. Because there was no antibiotic salmonella treatment and no immunization for typhoid, she eventually ended up in isolation until her death. She was known as “Typhoid Mary.”

One other possible outcome of salmonella is reactive arthritis (Reiter’s syndrome), although only in a small number of cases. It causes joint pain, eye irritation, and pain when urinating, and can lead to chronic arthritis, a condition that’s difficult to treat.

What are the causes of salmonella infection?

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Most people become infected by eating foods or drinking water that’s been contaminated by feces. Some think this should be easy to avoid, but areas with poor sanitation and a lack of clean water are incredibly vulnerable. A home water filter can make the difference between illness and good health.

Consider just some of the situations that produce unsanitary conditions in the global south. They may drink contaminated water. People can’t clean their hands effectively after using the toilet or changing a diaper.

Raw produce brought in from fields may not be washed free of bacteria. Fish or other seafood could be harvested from contaminated water. Butchered meat might not be processed using safe methods. Food handlers may not have cleaned their hands thoroughly so feces could be left on food.

Cross-contamination during food preparation is likely if surfaces can’t be cleaned sufficiently. Lack of clean water unquestionably makes everything much more complicated.

What are commonly infected foods?

Raw meat, poultry, and seafood often are infected with salmonella bacteria if feces are present. Raw or undercooked eggs are often a culprit, even though eggs have a shell. Sometimes infected chickens produce eggs containing salmonella before the shell has even been formed.

If raw meats or eggs come into contact with foods that are eaten without cooking, like salads, bacteria will be ingested. Unpasteurized milk and milk products like raw milk cheese can be infected. The FDA has even found some salmonella outbreaks traced to contaminated spices.

Any foods can become contaminated if you touch animals (especially birds and reptiles) and then transfer bacteria by touching inside your mouth or eating without properly cleaning your hands.

Salmonella can even spread from person-to-person. Medicine.net explains that The organisms can be transferred from person-to-person by both direct (via saliva, fecal/oral spread, kissing) and indirect contact (for example, using contaminated eating utensils).

It’s easy to understand why sanitary practices such as safe food handling and hand washing are crucial, yet the difficulty of accomplishing them without clean water.

What are risk factors for salmonella infection?

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International travel in areas with poor sanitation raise your risk. Salmonella infection, including the varieties that cause typhoid fever, are more common in developing countries.

Owning a pet bird or reptile that may carry salmonella bacteria. Reptiles (which includes turtles) are not considered appropriate pets for kids.

Stomach or bowel disorders may leave you at higher risk.

The human body has natural defenses against salmonella infection, but certain medications or physical problems lower those defenses. Here are examples:

  1. Stomach acid can kill many types of salmonella bacteria. Taking antacids lowers the stomach’s acidity allowing more bacteria to survive.
  2. Anti-rejection drugs after an organ transplant
  3. Corticosteroids
  4. Inflammatory bowel disease makes your intestinal lining more vulnerable to salmonella bacteria taking hold.
  5. Recent antibiotic treatment may reduce “good” bacteria in your intestines, making it harder to battle salmonella.
  6. Immune problems, AIDS, Sickle cell disease, and malaria.

How Can You Prevent Salmonellosis?

Can you imagine the dilemma of those in developing countries who must function with no clean water? Keep their plight in mind as you consider a list of best practices to avoid salmonella infections.

Common sense dictates that avoidance of sources is the best defense against the infection. Beyond that, there are rules to steer clear of the spread of salmonella:

  • Wash hands thoroughly after using the toilet, changing a diaper, cleaning up after pets, before, during and after food preparation.
  • Cook food thoroughly, then refrigerate or freeze food without delay.
  • Those with diarrhea shouldn’t prepare food, care for hospitalized patients, the elderly or children.
  • Cook ground poultry and poultry pieces to a minimum temperature of 74°C (165°F), whole poultry to 82°C (180°F), other ground meats to 71°C (160°F). A probe thermometer is the way to verify cooking temperatures.
  • Place cooked foods on clean surfaces only, not where food was prepped, and not onto a plate which was used for the item before cooking.
  • Don’t leave food at room temperature for more than two hours.
  • Use pasteurized milk and milk products.
  • Thoroughly cook eggs. Don’t use eggs with cracked or damaged shells.
  • Avoid homemade ice cream, eggnog, or unbaked cookie dough made with raw eggs. Products made commercially like eggnog and ice cream are made with pasteurized eggs, not raw.)
  • Thoroughly wash fruits and vegetables in clean water before eating them.
  • When buying, bagging, prepping or storing food under refrigeration, keep raw meat separate from fruits, vegetables, already-cooked foods or ready-to-eat items.
  • Use separate cutting boards for meats versus fruit and veggies.