Infectious Disease News

In this blog, ID Care infectious disease specialist Dr. Mohamed Hasham shares his perspective about the recent salmonella outbreak. He also explains what salmonella is, how to treat and how to prevent salmonella infection, and the role of ID Care in treating salmonella bacteria. According to a current notice from the Centers for Disease Control and Prevention, pine siskins – wild songbirds that are members of the finch family – have been linked to a recent salmonella outbreak. A total of 19 individuals across eight states have gotten sick, and eight of these cases have required hospital care. As of April 6, 2021, there are no reported cases of salmonella poisoning in the state of New Jersey. The CDC advises, however, that the true number of sick people in an outbreak is likely much higher than the number reported because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 2–4 weeks to determine if a sick person is part of an outbreak. How This Salmonella Outbreak Came About Dr. Hasham states that “based on reports, these birds migrated to the West Coast for the winter. The infection is initiated when one bird becomes infected, visits bird feeders and congregates with other birds. Basically the bird feeders get contaminated, and then another bird comes in and that bird gets it and passes it on.” It’s the proverbial congregating around the water cooler. Salmonella infection in humans can begin when people come in contact with the birds – whether trying to feed them, or if they see a dead bird or a bird that does not look right and try to catch them. They can then develop the salmonella infection from the bird if they do not wash their hands properly. The main thing, according to Dr. Hasham, “is if you see a bird that is dead, do not pick it up. Important also is to try to keep both kids and pets (particularly cats and dogs) away because that is high risk. You have to call your local wildlife animal control or whoever is in charge where you live and inform them because they will have the correct protocol. If there is an outbreak a local agency will have reports of it already, so they would know what to look out for. What Is Salmonella? How Do You Get Salmonella? Salmonellosis is one of the most common foodborne infections in the United States. The infections are primarily gastrointestinal, but then they can get into the bloodstream and cause infections in the blood. Dr. Hasham states that “there are instances where we have seen salmonella even attached onto pacemakers and prosthetic joints and cause infection there.” Salmonella is a bacteria. It is spread by the fecal-oral route and can be transmitted by food and water, by direct animal contact, and sometimes, though rarely, from person-to-person. An estimated 94%, according to CDC figures, is transmitted by food. Humans usually become infected by eating foods contaminated with feces from an infected animal. As a result, implicated foods are often of animal origin such as beef, poultry, milk, and eggs. What Are Salmonella Symptoms? Dr. Hasham explains that “the main symptoms are abdominal pain, fever and diarrhea, which can be bloody diarrhea. This can be accompanied by nausea and vomiting, which usually occurs within a week to two weeks after coming in contact with the salmonella. It does not necessarily have to be that same day that people get sick. I think the earliest I saw somebody who was sick and we were able to trace it back was two days before that they were in contact with the food that was contaminated.” How Long Does Salmonella Last? The illness is generally self-limited, meaning it will resolve in a few days without any treatment. “Some people may not even know they had it,” Dr. Hasham says. On occasion, if it is a serious infection then you need to get treatment for it. Fever is a sign that the infection has spread, and that means the infection will not resolve without treatment. If this happens, you absolutely should seek the expertise of an infectious disease doctor. This is the case if salmonella bacteria gets into the bloodstream. When this occurs, antibiotics are indicated. What happens first is that the lab would test the salmonella and run different antibiotics against it to see which antibiotics would kill it. The lab would then report that back to us and advise as to which specific antibiotic to prescribe. There are typically a few antibiotics that would work against salmonella, and they are usually very potent. And you can typically use oral antibiotics to get treated. There are instances where we may have a strain of the salmonella that is resistant, but that is not very common at all. Is There a Test for Salmonella? If you suspect that you may have salmonella, a stool culture test can confirm the diagnosis. “This course of action may be adequate for someone with gastrointestinal symptoms only”, according to Dr. Hasham. Dr. Hasham further explains that “if you have a fever or are sick enough to go to the hospital, your doctor will also order blood cultures to identify any infections growing in the blood, including salmonella. Typically what would happen is if somebody is having fevers, abdominal pain and diarrhea, we would request a blood culture. And that would look for bloodstream infection, which is pretty readily detected.” How to Prevent Salmonella Infection? Dr. Hasham provides these two recommendations for preventing salmonella infection. First, we try to educate because education is prevention, and prevention is a cure. This is the best way to avoid getting sick. Especially given the pandemic, our job is to educate people to be careful with hygiene, using soap and water and hand sanitizer when soap and water is not available. Second, pets can also transmit salmonella between birds and humans. So keep dogs, cats, and children away from dead animals. If you see a bird that’s dead, don’t pick it up, or if you do, use some protection. If you are aware of or concerned about a salmonella outbreak where you live, contact your local wildlife or animal control office, as they will be your best resource. I also recommend washing your hands with soap and water, if available, or using hand sanitizer after any contact with wild birds or bird feeders. Obviously, when somebody gets sick, we will be there to treat them. But the best thing is to avoid getting sick because in my opinion, in many ways, salmonella is a preventable disease if we are doing the right thing. How Can ID Care’s Infectious Disease Experts Help You? The expert infectious disease practitioners at ID Care are here to address any concerns you may have about salmonella outbreaks or if you believe you may be infected. As the largest independent infectious disease practice on the East Coast, ID Care is always up to date on the latest information concerning infectious diseases as well as mitigation strategies patients and healthcare organizations can use to stop their spread. To learn more, visit idcare.com or call 908-281-0221 to schedule a consultation with an ID Care expert.