Recent nationwide salmonella outbreaks due to contaminated poultry highlight the need for more awareness and education.
According to the Centers for Disease Control and Prevention, an estimated 1.2 million cases occur annually. Approximately 400 result in death.
What is this relatively common bacteria and, more importantly, how can individuals prevent its spread?
What is salmonella?
Salmonella is the bacteria that causes the salmonellosis infection. There are more than 2,000 identified strains, but three of the most common — enteritidis, Newport and typhimurium — are commonly associated with poultry.
“It’s usually the result of a foodborne cause or from contact with an infected animal,” said Dr. John Dilworth, an infectious disease specialist at The Everett Clinic.
“The most common symptoms are gastroenteritis — diarrhea — and fever. It can stay in your system for a week or two.”
According to Dilworth, many individuals with salmonellosis mistakenly believe they have contracted the flu and recover without medical intervention.
However, some people experience more severe reactions, depending on exposure and whether they are an at-risk individual.
“Older folks, children under 5 years old and infants are particularly vulnerable,” Dilworth said.
“One risk from prolonged gastroenteritis is dehydration. Especially with kids, they dehydrate more quickly, which is why it’s important to watch for that.”
According to the CDC, the rate of infection for children under 5 years is higher than for any other group. Immunocompromised individuals — for example, those already battling an infection or cancer patients undergoing treatment — are also at high risk.
The CDC’s conservative estimate is that 30 percent of the U.S. population is immunocompromised at any given time. Salmonellosis is generally more common in summer than winter.
While most cases resolve themselves, an untreated, prolonged salmonella infection can have long-term impacts. A minority of cases result in reactive arthritis: joint pain, eye irritation and painful urination.
Contaminated chicken is one of the most common culprits. Since March 2013, tainted Foster Farms chicken has caused a national salmonella outbreak spanning 25 states from coast to coast.
With 51 new cases just reported in 2014, the total number of people sickened is 481. According to the CDC, that includes 16 Washington state citizens.
There are multiple ways for tainted chicken — frozen or fresh — and eggs to cause salmonellosis. After handling the product or any surface it touched, the bacteria can enter your system through a cut, rubbing one’s eyes, licking one’s fingers and more.
Frequent washing — with soap — of hands and food-preparation utensils and surfaces is a must.
Also, ensure that items are refrigerated properly before use and cooked thoroughly before eating.
According to the United States Department of Agriculture, salmonella bacteria is killed when food is cooked at 165 degrees and higher.
What should you do if prepared chicken — at a fast-food chain, restaurant or elsewhere — appears undercooked?
“Send it back!” Dilworth said emphatically. “Chicken is not the kind of meat to eat undercooked. I would definitely do so when dealing with a child or older adult. Even for me, though, I feel like I’ll do it more often after rereading some of these guidelines.”
Be aware of possible cross-contamination, too. Raw chicken chopped on a cutting board can subsequently infect vegetables if the board is not properly washed between uses.
In some cases, fresh vegetables can be tainted on their own through the use of manure during the growing process. In general, thoroughly wash all food items.
“It’s probably not even a good idea for an infant to ride in a shopping cart next to a bunch of fresh produce. It’s too easy for them to touch it and then put their fingers in their mouths,” Dilworth said.
Contact with live animals is an increasing concern. Raising chickens either for meat and eggs or as pets is one cause of an increased number of salmonella-related illnesses.
In 2013, 19 people in Washington contracted salmonellosis due to handling live poultry. Of those, 13 were children under 10 years old.
“Kids are usually the ones affected the most because they’re more aggressive in their curiosity. They touch and lick and stick things in their mouth,” said Dr. Ron Wohrle, public health veterinarian for the Washington State Department of Health.
Spring is a particularly concerning time because parents sometimes buy chicks as gifts. Wohrle strongly recommends buying “a stuffed animal” instead.
“Even a normal, healthy chicken that appears clean can be a salmonella carrier. The animals are not diseased themselves. They’re carriers of a pathogen that doesn’t harm them, but hurts us,” Wohrle said.
For those raising chickens, keep them outside the house. Do not let children nuzzle or kiss them. Anyone who works with chickens or harvests eggs should wash their hands immediately after.
Parents should be wary of allowing children to even play around empty chicken coops.
“Salmonella can live in the environment for up to nine months under certain conditions,” Wohrle said. “It’s not uncommon for it to remain present for two or three weeks after chickens have left.”
Veterinarians and health experts frequently hear from older generations that they grew up around chickens and rarely experienced problems.
Is current concern perhaps overblown?
“Be mindful that there is a whole class of bacteria and viruses emerging. These aren’t the same bugs many of us or our parents grew up with,” Wohrle said. “The Newport strain is one of the most prominent, and it’s really developed in poultry since the mid-1990s.”
Likewise, families should be cautious when visiting petting zoos. Experts advise against taking infants at all. Younger children should be supervised and properly instructed on how to handle animals. Reptiles — such as turtles, iguanas and lizards — are also common salmonella carriers.
As always, simple hand-washing is one of the most important means of preventing transmission. While hand sanitizers can work, consider turning on the faucet and using old-fashioned methods.
“You have to wash around the fingers, cuticles and nails to really get your hands clean. Soap and water with the friction of scrubbing your hands actually washes germs off and physically removes it,” Wohrle said.
In contrast, hand sanitizers kill bacteria and viruses. To be effective, hands must be entirely saturated — not just the palms — and the sanitizer must set for 10 seconds.
- Do not eat raw or undercooked eggs or meat. The USDA recommends that chicken be cooked to 165 degrees to kill salmonella bacteria.
- Send restaurant food back if you believe it is undercooked.
- Be aware of and avoid foods that sometimes contain raw eggs, such as homemade Caesar dressing, Hollandaise sauce, homemade ice cream and mayonnaise, and cookie and pastry doughs.
- Thoroughly wash hands and kitchen work surfaces with soapy water after they have come into contact with raw meat, poultry or eggs.
- Wash hands with warm, soapy water after handling reptiles or birds, particularly chickens.
- Infants, young children and immunocompromised individuals should avoid contact with reptiles such as turtles, iguanas and lizards.
- Wash hands thoroughly after coming into contact with any animal feces.
- When washing hands, use soap and warm water and thoroughly clean around fingers, nails and cuticles.
- When using hand sanitizers, spread all over the hands and allow the sanitizer to saturate hands for 10 seconds.