Is Salmonella Deadly?

Salmonella is a type of bacteria that belongs to the Enterobacteriaceae family and can cause a foodborne infection known as salmonellosis if a person eats food that is contaminated with waste from an animal or person that contains the bacteria. Both domestic and wild animals can carry this bacteria, and it can be found in pigs, cows, and rodents. It is also found in reptiles such as turtles, iguanas, and bearded dragons. Some pets, including cats and dogs, can also carry the salmonella bacteria.

The infection is most likely to be mild and present with gastrointestinal symptoms such as diarrhea, stomach cramps, nausea, and vomiting. Fever or headaches can also occur. These symptoms will typically appear anywhere from six hours to six days after the initial transmission and last for four to seven days. There are some instances, though, where symptoms can take weeks to show up or can last up to several weeks.

According to the Centers for Disease Control and Prevention, salmonella is quite common and roughly 1.3 million people become ill with the bacterial infection each year in the United States. While the vast majority of cases are mild and lead to a full recovery, it’s estimated that over 26,000 of those who become ill will be hospitalized and 420 people will die.

Tomatoes which failed quality control are discarded at West Coast Tomato June 21, 2008 in Palmetto, Florida. The Food and Drug Administration sent officials to Florida and Mexico to investigate tomato farms as part of a salmonella probe. Over 550 people in the U.S. and Mexico had been sickened with salmonella because of tainted tomatoes.

Robert Browman / Getty Images

High-Risk Groups

Some people may become seriously ill or experience life-threatening symptoms, including:

Some people are also more susceptible to the illness if they come into contact with the bacteria, including:

  • People who have had gastric surgery
  • Those who take medications designed to reduce acid barriers in the stomach
  • People with pernicious anemia

Research has shown that the incidence of salmonella infection is highest among children under 5, followed by those between 5 and 10 years old and people over 85.

Salmonella Complications

Even though salmonella complications rarely occur, they can be dangerous or even life-threatening.

Dehydration

Dehydration is a complication that occurs due to the fluid loss that happens when someone has persistent diarrhea and vomiting. When a person continuously loses fluids and cannot replenish them, the body loses water and electrolytes. People who become dehydrated may require hospitalization if the fluids in the body become too low. Dehydration, if not addressed, can lead to serious complications, such as urinary and kidney problems, seizures, low blood volume shock, dizziness, and death.

Dehydration Treatment

The only way to treat dehydration is to replenish the body with fluids. This can be done at home by drinking lots of water and other fluids, such as broth, frozen water or ice pops, or sports drinks with electrolytes. For more serious cases of dehydration, intravenous fluid administration at a hospital may be needed.

Invasive Salmonella

If salmonella leaves the gastrointestinal tract and makes its way to other parts of the body, it is called an invasive infection. This type of salmonella infection can affect the blood, the membranes surrounding the brain and spinal cord, and linings around the heart, bones, and joints. The following can happen if salmonella becomes an invasive infection:

  • If the bacteria happen to enter the bloodstream, the body can experience septic shock, where your blood pressure drops to a dangerously low level after an infection. Septic shock can be life-threatening if left untreated, and hospitalization is required when the infection has spread to the blood.
  • Although it is rare, if an invasive infection spreads to the membranes around the brain and spinal cord, it can lead to meningitis, which presents with swelling of those membranes and can lead to death in a few hours. Those who recover may have brain damage, hearing loss, and cognitive dysfunction that affects their ability to learn.
  • Salmonella can also cause the lining that surrounds the heart to become inflamed, a condition known as endocarditis. This is another severe complication that can lead to death. It is rarely reported in cases of salmonella infection, and research has shown that it accounts for less than 0.01% to 2.9% of all cases of bacterial endocarditis that were reported between the mid-70s to 2014.
  • When an invasive salmonella infection affects the bones, it leads to osteomyelitis. Osteomyelitis is a rare bone infection that occurs in only 0.8% of salmonella cases. In children with sickle cell disease, the risk of developing salmonella osteomyelitis is much higher, although it has been reported in healthy children as well.
  • When invasive salmonella affects the joints, it causes septic arthritis. Those with sickle cell disease are more susceptible to developing septic arthritis caused by salmonella, but those with compromised immune systems are also at higher risk of developing the condition.

Reactive Arthritis

Those with salmonella infections can also develop reactive arthritis, or Reiter’s syndrome, which is triggered by an infection and causes joint pain and inflammation. The joints that are most commonly affected by reactive arthritis are typically found in the lower limbs or the pelvis. Reactive arthritis can also affect the eyes and the renal system by causing inflammation to occur in the membrane that lines the eyelids as well as in the urinary tract.

Although the condition is rare, it is not as rare as invasive salmonella and has been shown to occur in 4.4% of people who have the infection.  

Typhoid Fever

Typhoid fever can occur following an infection with the Salmonella enterica Typhi bacteria. It is more commonly found in young adults and children, though it can develop in people of all age groups. Roughly 200 to 300 cases of salmonella-driven typhoid fever are reported in the United States every year.

Although many people recover from typhoid fever, there are some complications that can happen in 10% to 15% of people that have the infection, including:

  • Gastrointestinal hemorrhage: This complication is also known as a GI bleed. Gastrointestinal hemorrhage is characterized as any kind of bleeding that occurs in the GI tract and can come with symptoms such as vomiting red or black blood and passing bloody or black stool.
  • Intestinal perforation: Also referred to as bowel perforation, this condition is characterized by a hole in the wall of the intestines. Food, waste, bacteria, or digestive juices can leak through the hole and into other parts of the body. When this happens, it can collect into an abscess (collection of pus) and can lead to other infections or septic shock.
  • Typhoid encephalopathy: When there is an infection or disease in the brain affecting its structure or function, it is referred to as encephalopathy. This condition can be caused by typhoid fever and lead to severe health complications, such as agitation, delirium, or coma vigil (where individuals may appear alert and aware, but do not respond to stimuli in any adaptive, meaningful way).

Inflammatory Bowel Disease

Inflammatory bowel disease (IBD) refers to a range of different health conditions that affect how well the gastrointestinal tract functions. They are typically caused by an improper immune system response, environmental factors, and genetics. For those who already have IBD, their condition can worsen following a bout of salmonella.

Research has also found that those without IBD could develop it after being infected with salmonella because of the permanent damage the bacteria can cause to the intestines and microbiota. Salmonella infections are also thought to affect the immune response within the intestines as well as lead to issues with the barrier of the GI tract.

Death

The majority of salmonella poisoning will not lead to severe complications or death, but in rare cases the infection can result in death. Globally speaking, there are 93.8 million cases of salmonella infection reported each year, with 155,000 deaths caused by the infection.

Prevention

The World Health Organization recommends that people follow these safety tips while at home, especially while traveling, to prevent a salmonella infection:

  • Making sure that food is properly cooked and hot when eaten
  • Avoid all raw milk products and only consume milk that has been pasteurized
  • Do not consume ice unless it was made from safe water
  • If the safety of drinking water is in question, boil it or disinfect it with a disinfectant
  • Practice good hand hygiene by washing hands regularly using soap, especially after contact with pets or farm animals, following a trip to the bathroom, and before eating
  • Always wash fruits and vegetables thoroughly before eating and peel whenever possible
  • Always keep a sanitary kitchen area and ensure proper cleaning of hands and surfaces after dealing with raw meat

Salmonella is rarely deadly, but it can lead to serious health complications in some cases. Even in the best-case scenario of salmonella poisoning, an uncomfortable illness will occur, so the best way to keep yourself healthy and free from the bacteria is by doing what you can to avoid becoming sick with salmonella.

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