Salmonella Poisoning (Salmonellosis): Causes, Symptoms & Treatment

Salmonella poisoning is also called salmonellosis or salmonella enteritis in medicine. As the name itself expresses, this disease is a poisoning or inflammation of the gastrointestinal tract by salmonella bacteria. The symptoms resemble a stomach flu and can therefore be easily underestimated. Medical treatment is strongly advised, especially for children and the elderly.

What is salmonellosis?

Schematic diagram of first aid for food poisoning and salmonellosis. Click to enlarge. During the warm season, the number of illnesses with salmonella poisoning always increases. Salmonella poisoning, also known as salmonellosis, is the most common foodborne infectious disease in Germany. The gastrointestinal tract is disturbed by the invasion of Salmonella. These rod-shaped bacteria occur in numerous species. About 120 different species cause salmonella poisoning in humans. Depending on the bacterial species, salmonella poisoning presents a different clinical picture in each case. The bacteria enter the body through spoiled food. However, not all ingested bacteria lead to severe salmonella poisoning. In contrast, a relatively short duration of illness of one to two days is very common.

Causes

It is certain that the cause of salmonella poisoning is infection from spoiled food. At suitable temperatures, salmonellae find a good breeding ground especially in poultry, meat, egg dishes, and dairy products. Some species cannot be destroyed even by cooking. Salmonella is also viable for several months. Even when food is frozen, they do not die and can still cause salmonella poisoning after thawing. They multiply quite rapidly and thus enter the body in large quantities when infested food is eaten. Stomach acid destroys a large number of the salmonellae with its germicidal action. Less gastric acid is present in children or elderly people. Therefore, these groups are especially at risk and suffer severe salmonella poisoning even with low levels of salmonella. In salmonella poisoning, the bacteria migrate to the intestine and settle in the intestinal mucosa. They damage it by secreting bacterial toxin. The disease can break out after only a few hours.

Symptoms, complaints, and signs

Salmonellosis manifests itself in different ways in different people. How severe the symptoms turn out depends on how strong the defense system is. The disease usually begins with sudden nausea and vomiting. The patient suffers from headaches and extreme abdominal cramps. This is accompanied by watery diarrhea, which is very painful. Since the bacterium attacks the intestine and causes inflammation there (enteritis), blood may also appear in the stool due to the damaged intestinal mucosa. Fever occurs in about 50 percent of those affected. Vomiting diarrhea causes the body to lose large amounts of fluid, which can lead to a deficiency of electrolytes. This is noticeable in a general feeling of weakness and dry skin. The mouth and mucous membranes are also dry. If the lack of fluids and electrolytes is not compensated, heart palpitations, muscle cramps and clouded consciousness may occur. Usually, the symptoms disappear after a few days and the patient recovers. In rare cases, the disease can take a severe course. If the bacteria travel through the bloodstream to other organs, they cause violent infections there. Abscesses can develop in the lungs, liver or kidneys, and the joints, meninges, inner lining of the heart or urinary tract can also become infected. As a result, life-threatening salmonella sepsis with circulatory collapse and organ failure is possible.

Course of disease

Salmonella poisoning begins with general symptoms, such as malaise, nausea, and vomiting. In addition, there are abdominal cramps and diarrhea. Severe salmonella poisoning is accompanied by vomiting diarrhea and fever. In severe cases of salmonellosis, chills may also occur. The affected person feels seriously ill in a short time. The disruption of intestinal function causes a deficiency in the body’s water balance and electrolyte balance.Thus, salmonella poisoning can also affect heart function and temperature regulation. This can lead to a drop in blood pressure and even collapse. While healthy and younger people recover after a few hours of discomfort, salmonella poisoning can also be fatal in children and elderly sufferers.

Complications

If salmonella poisoning is treated properly, complications rarely occur. The risk of negative sequelae exists primarily in people who suffer from a weakened immune system. These include primarily children and senior citizens. In Germany, however, deaths due to Salmonella complications are very rare. One of the greatest dangers of salmonellosis is the great loss of fluid. This in turn can trigger circulatory collapse or circulatory failure. The loss of fluid is mostly due to prolonged vomiting or persistent diarrhea. The lack of fluid can be recognized by dry mucous membranes in the mouth, a dry tongue, dry, wrinkled skin and a reduced amount of urine. Because the blood plasma also thickens, the risk of blood clot formation (thrombosis) increases. This also increases the risk of blood vessel occlusion. If the patient suffers from previous damage to his kidneys, there is sometimes a risk of kidney failure. If the salmonellae penetrate into the bloodstream, salmonellosis can spread further through the body. This increases the risk of liver inflammation (hepatitis), inflammation of the gall bladder (cholecystitis), meningitis, pneumonia, heart inflammation (endocarditis), spondylitis or osteomyelitis. Furthermore, reactive arthritis, a disease of the joints, can occur. In the worst case, life-threatening sepsis (blood poisoning) occurs. Another life-threatening complication is also considered to be the development of intestinal ulcers, which cause intestinal rupture.

When should you go to the doctor?

If symptoms such as nausea and vomiting, diarrhea and headache suddenly appear, salmonella poisoning may be present. A doctor’s visit is advised if the symptoms do not subside with bed rest and rest. If severe fever occurs or painful defecation with blood and mucus is noticed, immediate medical attention is recommended. Salmonella poisoning often occurs in connection with the consumption of spoiled food. If symptoms develop after consuming eggs, meat, fish, dairy ice cream and other perishable products, the family physician should be consulted. Persons with a weakened immune system, as well as children and the elderly, require prompt treatment. Signs of dehydration such as decreased urine output and a dry mouth should be clarified immediately. In the case of typical symptoms of bacteremia such as high fever and palpitations, emergency medical services should be called. The patient requires inpatient treatment to prevent life-threatening complications. Salmonella poisoning can be treated by a family doctor or a gastroenterologist. If this is done in time, a positive course of the disease can be expected. Most patients are largely symptom-free again after three to four days. The family physician must be informed of any persistent signs of illness.

Treatment and therapy

Treatment of salmonella poisoning is primarily aimed at compensating for fluid loss and restoring mineral balance. The sufferer should drink sufficient fluids. This can be slightly sweetened or even slightly salted. The standard is that the fluid should taste at most like tear fluid. If the body is already severely dehydrated, an electrolyte solution from the pharmacy will also help. In case of strong vomiting during salmonella poisoning, the sick person must consume the liquid only in small quantities. During the treatment of salmonella poisoning, the circulatory functions of the sick person must be well monitored. To relieve the intestines, the sick person is given only light food, such as clear soups, rusks or grated apple. This also stimulates the natural intestinal activity again. The administration of anti-nausea and anti-vomiting medications as well as constipating medications can alleviate the course of the disease somewhat. Antibiotics may also be used if the course of salmonella poisoning is severe.However, this makes it take longer for salmonella to leave the body and delays the progression of the disease.

Aftercare

Salmonella poisoning often irritates the nervous system of the intestine. Therefore, in follow-up care, care should be taken to avoid further irritation of the nerve cells, or at least to reduce the risk of it. People who work in food sales or manufacturing and have contracted salmonella must refrain from working until the salmonellosis has resolved. An important part of the aftercare of salmonella poisoning is a restorative diet. This includes regular intake of fluids at short intervals. It should continue for two to three days after the symptoms have subsided. The patient takes two to three sips of lukewarm water every 10 to 15 minutes. Drinking a traditional power broth or teas such as chamomile, fennel, anise or caraway tea is also considered helpful. About three to four days after the improvement of the symptoms, only light food should be consumed, which includes small portions. Boiled carrots, rice, small amounts of bananas and soft-boiled oatmeal without bran are recommended. From the fourth day on, foods containing protein, such as boiled chicken, may be served again. On the other hand, red meat, sugar, sausage, dairy products, sweetened drinks, pastries, nuts and whole grain products should be avoided for the first ten days. It may also be useful to administer a probiotic, which contains beneficial strains of bacteria that strengthen the intestinal flora.

What you can do yourself

If samonella poisoning is suspected, a doctor or the nearest hospital should be visited immediately. As a self-help measure against the often agonizing diarrhea, natural remedies have proven themselves, which are able to bind toxins in the intestine. Healing clay dissolved in water is particularly effective. These preparations are available over-the-counter in pharmacies and drugstores. A similar effect is attributed to psyllium and psyllium husks, which are sold primarily in health food stores and organic supermarkets. Severe diarrhea and vomiting dehydrate the body very much. It is therefore important that sufferers ensure an adequate supply of fluids and minerals. Vegetable broth is particularly suitable, as the high salt content helps the body to retain water in the body. In severe cases or if diarrhea persists for a long time, taking dietary supplements, especially a multi-mineral preparation, may also be useful. In addition, those affected should take it easy and, if possible, maintain bed rest so that the body can recover from the infection as quickly as possible. Since salmonella is highly contagious, increased hygiene should also be observed. Under no circumstances should the infected person prepare food for the family. Cups, plates and cutlery should not be shared with others and must be cleaned with water at least 60 degrees hot. There is also a risk of smear infection when sharing towels or other hygiene items.