salmonellosis in adults
This infection belongs to the category of intestinal, and it can be life-threatening, because it has an unpredictable course and, often, the mass nature of the disease. Let’s find out how to recognize the disease and what to do so as not to get infected.

Often salmonellosis has the character of outbreaks in organized groups or in food production, where sanitary standards are not observed. It can be severe, even fatal.

What is salmonellosis

Salmonellosis is undoubtedly one of the dangerous and serious diseases from the category of intestinal infections and it occurs quite often in our time. It is caused by pathogenic bacteria of the genus Salmonella.

An acute inflammatory process in the intestine leads to diarrhea and vomiting, which provoke severe dehydration, and the waste products of the microbe form severe intoxication. The infection can occur with a clinic similar to typhoid fever, or with manifestations of blood poisoning. Mostly people become infected with salmonellosis through food, outbreaks are often recorded among children or adults.

Causes of salmonellosis in adults

The main cause of salmonellosis is the entry of pathogenic bacteria of the genus Salmonella into the lumen of the gastrointestinal tract. During reproduction, they release toxins, provoke poisoning of the body and an acute inflammatory reaction of the intestine, which causes all the main manifestations of the disease.

Although this disease is classified as an intestinal infection, it has a special social significance, since it can be extremely difficult and often has the nature of outbreaks.

The causative agent of salmonellosis

Salmonella is a separate genus of rod-shaped bacteria. They are anaerobes resistant to adverse environmental factors. In water they can survive up to 5 months, in soil up to 1 year or more, in frozen meat and poultry carcasses up to 1 year or more. In dairy products they can last up to 20 days, in cheeses they survive up to a year, on egg shells and egg powder up to 3 weeks.

Salmonella do not tolerate heat treatment, increasing the temperature above 70 ° C kills them within 5 minutes. But they can withstand boiling inside a piece of meat if it is undercooked. If these are eggs, the bacteria die in 4 minutes when cooked. In meat and dairy products (not thermally processed) they are well preserved and multiplied, while not spoiling the appearance and taste of the products.

Salmonella can withstand salting and smoking; when frozen, the life span of pathogens increases. These bacteria are also dangerous because over the years they have acquired resistance to antibiotics and disinfectant solutions.

Ways of transmission of salmonellosis in adults

The main source of salmonella for humans is poultry, meat of domestic and wild animals, eggs. Animals themselves may be carriers or may also be infected. A person can become infected when treating sick animals, when poultry or livestock are slaughtered, if they eat contaminated foods. Sometimes the person himself is the object of the spread of bacteria. It can spread the infection for up to 3 weeks, in rare cases, a longer carrier is possible.

Mostly the infection is transmitted through dirty hands and food, dishes with raw eggs, dairy and meat products are especially dangerous in terms of infection, less often drinking water becomes the source of infection. In organized groups, the contact path is also dangerous, from sick people to healthy people.

A person is very susceptible to infection, the severity of the disease will depend on a number of factors:

  • the amount of bacteria that have entered the body;
  • pathogen strain and its features;
  • state of immunity;
  • digestive pathology.

The infection is especially dangerous for pregnant women, the elderly and those with chronic diseases.

Forms of salmonellosis in adults

Depending on the clinical picture of the disease and the degree of its spread, doctors distinguish several forms of the infectious process:

  • gastrointestinal (mainly affects the stomach and intestines);
  • generalized (all organs and tissues suffer);
  • bacterial excretion (no symptoms, but the pathogen is sown).

In the gastrointestinal form, experts distinguish several options for the course of the disease:

  • predominantly gastritis (mainly the stomach is affected);
  • gastroenteric (stomach and small intestine are affected);
  • gastroenterocolitic (all parts of digestion from the stomach to the colon suffer).

The generalized form of salmonellosis can proceed according to the type of two variants – typhoid-like, with a clinic similar to typhoid fever, and septic.

Isolation of bacteria can be acute, transient or chronic.

Symptoms of salmonellosis in adults

The incubation period (from the moment the bacterium enters the body to the first manifestations) lasts from several hours to 2 days. Symptoms will depend on the form of the disease, age and other characteristics of the body.

The most common is the gastroenteric type of salmonellosis. For him, the presence of intoxication is typical (due to the waste products of bacteria and the development of the inflammatory process in the body) and a disorder of water-salt metabolism. The disease begins with acute manifestations:

  • the temperature rises, sometimes to extremely high values;
  • there are signs of intoxication – weakness, aching muscles, joints, headache.

A little later, pain in the abdomen joins, mainly in the stomach, near the navel, in the right iliac region. It has the character of excruciating spasms, accompanied by severe nausea and repeated vomiting. Diarrhea develops quickly, it is watery, frothy, greenish and bad smelling. Depending on the severity of the condition, diarrhea and bouts of vomiting may be rare or uncontrollable. Fluid loss from stools and vomit causes severe dehydration.

The patient’s skin is pale, with cyanosis. The tongue is covered with a thick coating, dry, the abdomen is swollen, when palpated, pain and rumbling occur. The pulse also quickens, pressure decreases, the volume of urine released decreases, if dehydration is severe, there may be cramps in the muscles of the legs.

If salmonellosis proceeds according to the type of gastroenterocolitis for 2-3 days, the volume of stool decreases, mucus with blood streaks may be released. The abdomen is painful on palpation, there may be false urge to defecate with soreness.

The gastritis variant is rare, it is characterized by nausea with vomiting, intoxication, pain in the area of ​​the pit of the stomach, and no diarrhea.

The generalized form may resemble the course of typhoid fever. The first to appear are symptoms from the stomach and intestines (vomiting, diarrhea), then they gradually subside, they are replaced by signs of toxicosis – with fever, weakness, headache. In this case, the temperature increase can be either constant or in the form of waves. Small hemorrhages may appear on the skin, the spleen and liver may increase.

In the septic variant, digestive symptoms also appear first, followed by fever with palpitations, chills, severe sweating, enlarged liver and spleen, foci of suppuration in the kidneys, lungs, bladder, endocarditis, phlegmon. After an illness, patients can excrete salmonella for up to a month. If this process is delayed, it is believed that the bacterial excretion has become chronic.

Treatment of salmonellosis in adults

It is important to emphasize that even mild forms of salmonellosis require constant medical supervision and full treatment so that the patient does not infect others and does not provoke an outbreak of infection.

In order to choose the right treatment, you need to confirm the diagnosis and determine the sensitivity of bacteria to antibiotics.

Diagnostics

The basis of diagnosis is an indication of an outbreak of infection, as well as the isolation of bacteria from the body (in vomit and stool). In the septic form, bacteria are also isolated from the blood.

Cultures are carried out with the determination of bacteria and the assessment of their sensitivity to antibiotics. They also perform serological diagnostics using various methods – ELISA, RLA or RIA.

The severity of the condition is determined on the basis of an external examination and blood tests (determination of hematocrit, red blood cells), acid-base balance and ion levels. If the risk of complications is high, a urologist, cardiologist and other doctors are involved in consultations.

Modern treatments

If these are patients with a severe form of the disease, a high risk of complications, they should be hospitalized. For milder cases, treatment at home under the constant supervision of a doctor is acceptable.

Initially, the intake of sorbents is shown, which will bind part of the toxins in the intestines. Then it is important to correct the water-salt metabolism by taking a liquid with a sufficient amount of salts. If this is dehydration of the first or second degree, fractional intake of glucose and saline solutions inside 5-10 ml at a time helps, but very often, every 5-10 minutes. If dehydration is severe, due to diarrhea and vomiting, there is no possibility of administering solutions through the mouth, drip administration of glucose, saline, rehydrating formulations is indicated.

After the water-salt balance is restored, colloidal solutions or destrans are administered to eliminate intoxication. If there are changes in the acid-base balance, a correction is carried out with a sodium bicarbonate solution.

Antibiotics are prescribed for generalized forms to suppress the activity of the pathogen and prevent complications. Simultaneously with antibacterial drugs from the first day, it is recommended to take probiotics.

In gastrointestinal forms, antibacterial drugs are usually not indicated, it is recommended to take chemotherapy drugs, probiotics, sorbents.

In the recovery period, enzyme preparations are indicated, probiotics continue to be taken, against the background of salmonellosis, it is necessary to follow a diet that must be followed for 3-4 weeks.

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Prevention of salmonellosis in adults at home

Specific prevention of infection (vaccine) has not been developed. This is due to the instability of the immune system and a wide variety of antigens in bacteria. Salmonella bacteriophage helps for emergency prevention of contact persons.

General prevention of infection is the observance of all sanitary rules when preparing food, communicating with animals and contacts with people. It is also important to remember about the shelf life, cooking conditions and heat treatment of hazardous products.

Popular questions and answers

We discussed with infectious disease doctor Tatyana Kovaleva some questions concerning salmonellosis, its transmission and danger.

How long is the incubation period for salmonellosis?
The incubation period for salmonellosis is usually short, averaging 12 to 24 hours. In some cases, it is shortened to 6 hours or, conversely, lengthened to 2-3 days.
How is salmonella infection most likely to occur?
The main route of infection for salmonellosis is food. There may be outbreaks of salmonellosis in medical institutions, mainly in maternity hospitals and children’s departments, caused by antibiotic-resistant strains of Salmonella and leading to death. In this case, the spread of infection occurs by contact-household, through the hands of caregivers, bed linen and care items.
What foods can be a source of salmonellosis?
Raw or undercooked meat products. In recent years, infection often occurs by eating meat, poultry and eggs.
What are the complications of salmonellosis?
Complications are typical for severe forms of salmonellosis – acute vascular insufficiency by the type of collapse, the development of infectious toxic shock, acute renal failure, in septic forms, secondary septic foci are formed in various organs (lungs, kidneys, joints, cartilage, bones).
When to call a doctor at home with salmonellosis?
Calling a doctor at home with salmonellosis is necessary for any deterioration in health, the absence of the effect of the treatment.

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