Salmonella Lawyer & Attorney : Marler Clark : Salmonella Blog

Perhaps the most interesting statistic about salmonella is that only 6.1 percent of all the thousands of illnesses it was responsible for in 2006 could be attributed to the recognized outbreaks that are laid out in this week's Morbidity and Mortality Weekly Report (MMWR).

And while the Centers on Disease Control & Prevention (CDC) acknowledges that its picture is incomplete, it's Foodborne Disease Outbreak Surveillance System (FBDSS) with the states did manage to track  total of 1,270 Food-Borne Disease Outbreaks, resulting in 27,634 confirmed illnesses and 11 deaths.

Salmonella was second only to Norovirus in causing the most food-borne illnesses. And among bacteria, Salmonella was No. 1, being the most commonly reported bacterial etiologic agent causing 112 or 52 percent of the confirmed outbreaks attributed to bacteria.

Salmonella serotype Enteritidis caused most of those outbreaks, a total of 28 or 13 percent.

Salmonella was responsible for four of the 11 multi-state outbreaks. The salmonella bacteria was transmitted by tomatoes in two of those four multi-state outbreaks. Together they made 307 sick.

Fruit salad was the transmission source in the third multi-state salmonella outbreak, making 41 people sick. And, finally, there was the 2006 peanut butter outbreak that cross many state lines in jars of Peter Pan peanut butter that carried salmonella. That outbreak made 715 sick.

CDC also looked pathogen-commodity pairs responsible for the most outbreak-related cases. Salmonella came up as a partner with fruits and nuts in 776 cases; and with vine-stalk vegetables in 331 cases.

Read the entire report, "Surveillance for Foodborne Disease Outbreaks --- United States, 2006," in MMWR.

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A rainy night in Georgia
A rainy night in Georgia
I believe that it's raining all over the world
I feel that it's raining all over the world

Scientific American is out with a report today that says when you add that famous rain to Georgia you end up with lot's of Salmonella.   Talk about taking the romance out of a famous Ray Charles song!

The magazine reports that:

Researchers at the University of Georgia in Athens (U.G.A.) have found that rain ups the risk of salmonella in rivers and streams—and, in turn, in products nourished by and washed in tainted runoff waters. The scientists report in Applied and Environmental Microbiology that 79 percent of water samples from rivers and streams in southern Georgia collected and tested over a year contained the rod-shaped bacteria; concentrations were highest in specimens gathered in the summer months and right after it rained.

Study co-author Erin Lipp, an associate professor of environmental health sciences at U.G.A.'s College of Public Health, says the findings indicate that officials trying to trace the source of salmonella contamination should put untreated surface water at the top of their suspect list.

After a downpour, rainwater accumulates on ground surfaces or in bodies of water. Before it reaches a final destination, the surface water may come into contact with salmonella—which lives in the intestinal tract of humans and animals and can be spread via their feces and vomit. Contaminated water may seep into porous soil—and thereby infiltrate irrigation systems used to nourish fields and wash produce.

There were reports of ponding on the roof and leaks into the Peanut Corporation of American facility in Blakely, GA, which is responsible for the largest ongoing recall of peanut products in U.S. history.

Check here for more from Scientific American.

 

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We decided not to comment on this one before now because it seemed to be a battle of the experts and we did not have the resources to sort it out. California voters have now spoken and by a 63-36 percent margin, they've said the calves, pigs and chickens will get new housing by 2015.

Passage of California's Proposition 2 " will prohibit the confinement of certain farm animals in structures or cages that do not allow them to turn around freely, lie down, stand up, and fully extend their limbs. The measure will phase out California’s use of battery cages for layers, veal crates, and sow gestation crates," according to Pork Magazine.

Cattle Network says " Florida, Arizona, Colorado and Oregon have passed similar laws for swine and veal. California, however, becomes the first state to require that all egg-producing chickens be kept in more spacious enclosures or free to roam a henhouse. Most pig and veal farmers in the state have already expanded their pen sizes. As a result, the law’s requirements will have the most significant impact on poultry farmers."

Will the change mean more salmonella in California if egg production is shifted elsewhere?  Does open air space like some Chinese bird market bring with it risks of bird flu in the Golden State?  It went back and forth in the campaign.  Farm Sanctuary, the sponsoring group out of Washington, D.C., produced a study that found the existing battery cage operations are 20 times more like to be contaminated with Salmonella than cage-free facilities.

One thing upon which everyone agrees: what happens in California won't stay there!

 

 

 

 

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Let's see.   You cook up a scheme to evade the law.   You get caught.  You then conclude you must be just like Mahatma Gandhi and Martin Luther King Jr.  Ordinarily we'd say "Only in America," but this two-bit drama is going on in Canada.

We refer to Michael Schmidt, who was found guilty of contempt of court for ignoring an order to cease selling raw milk.   Selling unpasteurized milk is illegal in Canada because health officials say it can carry salmonella, E. coli and Listeria.

You can drink raw milk from your own cow and the scheme Schmidt was using to evade the law was to sell shares of his cows to willing city residents.

Schmidt clearly wants to be Canada's poster boy for raw milk.  Outside the courtroom, where prosecutors want the judge to impose a $5,000 fine and charge the so-called organic farmer court costs of $53,000; Schmidt indulged in drinking raw milk and made his lofty comparisons.

"When Gandhi picked up the salt, he kept marching, and when Martin Luther started the Montgomery bus strike, he kept going until the law was changed," Schmidt said.

For more from The Canadian Press, go here.

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Salmonella is a bacterium that causes one of the most common enteric (intestinal) infections in the United States – Salmonellosis.  In some states (e.g. Georgia, Maryland), salmonellosis is the most commonly reported cause of enteric disease, and overall it is the second most common bacterial foodborne illness reported (usually slightly less frequent than Campylobacter infection).

The reported incidence of Salmonella illnesses is about 14 cases per each 100,000 persons (MMWR Weekly, 2006), amounting to approximately 30,000 confirmed cases of salmonellosis yearly in the U.S. (CDC, 2005, October 13).  In 2005, just over 36,000 cases were reported from public health laboratories across the nation, representing a 12 percent decrease compared with the previous decade, but a 1.5 percent increase over 2004 (CDC, 2007).

As only about 3 percent of Salmonella cases are officially reported nationwide, and many milder cases are never diagnosed, the true incidence is undoubtedly much higher (Mead, 1999).  The CDC estimates that 1.4 million cases occur annually (CDC, 2005, October 13).  Approximately 600 deaths are caused by Salmonella infections in the U.S. every year, accounting for 31 percent of all food-related deaths (CDC, 2005, October 13; MMWR Weekly, 2001).

Theobald Smith, research-assistant to Daniel E. Salmon, discovered the first strain of Salmonella – Salmonella cholerae suis – in 1885.  Since that time, the number of strains (technically termed serotypes or serovars) of Salmonella known to cause salmonellosis has increased to over 2,300.  Salmonella typhi, the strain that causes typhoid fever, is uncommon in the U.S., while Salmonella enterica serotype Typhimurium and Salmonella enterica serotype Enteritidis have been the most frequently reported illnesses since 1993.  Salmonella enterica serotypes Newport, Mississippi and Javiana have been increasingly identified as the source of illness (MMWR Weekly, 2006).

Symptoms of Salmonella Infection

An infectious dose of Salmonella is small, probably from 15 to 20 cells.  Typically, non-typhoidal Salmonella produces a self-limiting febrile gastrointestinal illness that is indistinguishable from that caused by other bacterial enteric pathogens. Dehydration is the principal clinical concern. The incubation period – the time between ingestion of Salmonella bacteria and the onset of illness – varies from six to 72 hours (Mayo Clinic, 2007, April 12; MMWR Recomm Rep, 2001).

Salmonella can cause three different kinds of illness:  gastroenteritis, typhoid fever, and bacteremia.

Symptoms of Salmonella gastroenteritis include diarrhea, abdominal cramps, fever, nausea, and/or vomiting. In mild cases diarrhea may be non-bloody, occur several times per day, and not be very voluminous; in severe cases it may be frequent, bloody and/or mucoid, and of high volume.

Fever generally occurs in the 100°F to 102°F (38°C to 39°C) range. Vomiting is less common than diarrhea. Headaches, myalgias (muscle pain), and arthralgias (joint pain) are often reported as well. Whereas the diarrhea typically lasts 24 to 72 hours, patients often report fatigue and other nonspecific symptoms lasting 7 days or longer.

Complications of Salmonella Infection

Typhoid fever, also known as enteric fever, is caused by Salmonella serotype typhi.  The onset of symptoms usually occurs between 5 and 21 days after ingestion of Salmonela typhi bacteria.  Symptoms may include constipation, cough, sore throat, headache, and a rash on the infected individual’s chest, as well as the slowing of the heartbeat and enlargement of the liver and spleen (Mayo Clinic, 2007, April 12).

Bacteremia is characterized by infection of tissues surrounding the brain and spinal cord (meningitis) and infection within the bloodstream (sepsis).  This condition occurs when Salmonella enter and circulate within an infected individual’s bloodstream, and is accompanied by few symptoms (Mayo Clinic, 2007, April 12).

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Since April, 613 persons infected with Salmonella Saintpaul with the same genetic fingerprint have been identified in 33 states and the District of Columbia. These were identified because clinical laboratories in all states send Salmonella strains from ill persons to their State public health laboratory for characterization.

The marked increase in reported ill persons since the last update is not thought to be due to a large number of new infections. The number of reported ill persons increased mainly because some states improved surveillance for Salmonella in response to this outbreak and because laboratory identification of many previously submitted strains was completed. In particular, one new state, Massachusetts reported ill persons.

The number of ill persons identified in each state is as follows: Arkansas (3 persons), Arizona (34), California (8), Colorado (4), Connecticut (4), Florida (1), Georgia (14), Idaho (3), Illinois (45), Indiana (9), Kansas (9), Kentucky (1), Maryland (18), Massachusetts (12), Michigan (4), Missouri (12), New Hampshire (1), New Jersey (1), New Mexico (79), New York (18), North Carolina (1), Ohio (3), Oklahoma (17), Oregon (5), Pennsylvania (5), Rhode Island (2), Tennessee (4), Texas (265), Utah (2), Virginia (21), Vermont (1), Washington (1), Wisconsin (5), and the District of Columbia (1).

Among the 316 persons with information available, illnesses began between April 10 and June 13, 2008. Patients range in age from <1 to 99 years; 50percent are female. At least 69 persons were hospitalized. No deaths have been officially attributed to this outbreak. However, a man in his sixties who died in Texas from cancer had an infection with the outbreak strain of Salmonella Saintpaul at the time of his death. The infection may have contributed to his death.

States with persons with the outbreak strain of Salmonella Saintpaul, by state of residence.

Source: Centers for Disease Control & Prevention, Atlanta

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Salmonella is one of the most common enteric (intestinal) infections in the United States. Salmonellosis (the disease caused by Salmonella) is the second most common foodborne illness after Campylobacter infection. It is estimated that 1.4 million cases of salmonellosis occur each year in the U.S.; 95% of those cases are foodborne-related. Approximately 220 of each 1000 cases result in hospitalization and eight of every 1000 cases result in death. About 500 to 1,000 or 31% of all food-related deaths are caused by Salmonella infections each year. Salmonellosis is more common in the warmer months of the year.

Salmonella infection occurs when the bacteria are ingested, typically from food derived from infected food-animals, but it can also occur by ingesting the feces of an infected animal or person. Food sources include raw or undercooked eggs/egg products, raw milk or raw milk products, contaminated water, meat and meat products, and poultry. Raw fruits and vegetables contaminated during slicing have been implicated in several foodborne outbreaks.

Symptoms of Salmonella infection

The acute symptoms of Salmonella gastroenteritis include the sudden onset of nausea, abdominal cramping, and bloody diarrhea with mucous. Fever is almost always present. Vomiting is less common than diarrhea. Headaches, myalgias (muscle pain), and arthralgias (joint pain) are often reported as well. The onset of symptoms usually occurs within 6 to 72 hours after the ingestion of the bacteria. The infectious dose is small, probably from 15 to 20 cells.

Reiterís Syndrome, which includes and is sometimes referred to as ìreactive arthritis,î is an uncommon, but debilitating, result of a Salmonella infection. The symptoms of Reiterís Syndrome usually occur between one and three weeks after the infection. Reiterís Syndrome is a disorder that causes at least two of three seemingly unrelated symptoms: reactive arthritis, conjunctivitis (eye irritation), and urinary tract infection. The arthritis associated with Reiterís Syndrome typically affects the knees, ankles, and feet, causing pain and swelling. Wrists, fingers and other joints can be affected, though with less frequency. With Reiterís Syndrome, the affected person commonly develops inflammation where the tendon attaches to the bone, a condition called enthesopathy. Some people also develop heel spurs, bony growths in the heel that cause chronic or long-lasting foot pain. Arthritis from Reiterís Syndrome can also affect the joints of the back and cause spondylitis, inflammation of the vertebrae in the spinal column. The duration of reactive arthritis symptoms can vary greatly. Most of the literature suggests that the majority of affected persons recover within a year. The condition, can, however, be permanent. For more information, visit the Marler Clark sponsored Web site about Reiterís Syndrome.

Detection and treatment of Salmonella infection

Salmonella bacteria are discovered in stool cultures. Although blood cultures are rarely positive, bacteremia (bacteria in the blood stream) does occur in 5% of adults with Salmonella gastroenteritis and can result in spread to the heart (endocarditis), spleen, bone (osteomyelitis), and joints (Reiterís Syndrome or reactive arthritis). However, blood cultures are often not performed and in most cases the blood stream is not infected. In the stool, the laboratory is challenged to pick out Salmonella from many other similar bacteria that are normally present. In addition, many persons submit cultures after they have started antibiotics, which may make it even more difficult for a microbiology lab to grow Salmonella. So, the diagnosis of salmonellosis may be problematic and many mild cases are culture negative.

Salmonella infections usually resolve in five to seven days, and many times require no treatment, unless the affected person becomes severely dehydrated or the infection spreads from the intestines. Persons with severe diarrhea may require rehydration, often with intravenous fluids. Treatment with antibiotics is not usually necessary, unless the infection spreads from the intestines, or otherwise persists, in which case the infection can be treated with ampicillin, gentamicin, trimethoprim/sulfamethoxazole, or ciprofloxacin. Some Salmonella bacteria have become resistant to antibiotics, possibly as a result of the use of antibiotics to promote the growth of feed animals.

For those persons who develop Reiterís Syndrome, symptomatic treatment with high doses of a nonsteroidal anti-inflammatory drug and steroid injections into affected joints can be helpful in reactive arthritis. For people with severe joint inflammation, injections of corticosteroids directly into the affected joint may reduce inflammation. A small percentage of patients with reactive arthritis have severe symptoms that cannot be controlled with these treatments, in which case medicine that suppresses the immune system, such as sulfasalazine or methotrexate, may be effective. Exercise, when introduced gradually, may help improve joint function. Topical corticosteroids can be applied directly on the skin lesions associated with reactive arthritis.

Preventing Salmonella infection

To prevent salmonellosis, cook poultry, ground beef, and eggs thoroughly before eating. In order to insure that eggs do not contain viable Salmonella they must be cooked at least until the yoke is solid, and meat and poultry must reach 160∫F or greater throughout. Be particularly careful with foods prepared for infants, the elderly, and those with a compromised immune system.

Do not eat or drink foods containing raw eggs, such as homemade eggnog and hollandaise sauce. Avoid drinking raw (unpasteurized) milk or products made from raw milk.

Wash hands, kitchen work surfaces, and utensils with soap and water immediately after they have been in contact with foods of animal origin. Also, wash hands with soap after handling reptiles, amphibians or birds, or after contact with pet feces. Infants and immunocompromised persons should have no direct or indirect contact with such pets.

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