June 1, 2001

Every year, in Houston, salmonella cases increase in June.

Since foods of animal origin may be contaminated with salmonella, the Houston Department of Health and Human Services recommends that people not eat raw or under-cooked eggs, poultry or meat. Poultry and meat, including hamburgers, should be well-cooked, not pink in the middle.

The department also advises people not consume raw or unpasteurized dairy products. Fresh fruits and vegetables should be thoroughly washed before being eaten.

According to a five-year review conducted by the department’s Bureau of Epidemiology, reported salmonella cases rise monthly to anywhere from 30 to 50 cases between late June and October and decline abruptly in November.

Salmonella, a bacterial infection causing fever, diarrhea and abdominal cramps, ranked as the fifth most commonly reported infectious disease between the years 1995 to 1999. During the period, health care providers reported to the department a total of 1,259 salmonella cases, an average of 252 annually.

Children under the age of five accounted for more than 44 percent of the reported salmonella cases, making them the most affected segment of the population. In terms of race and ethnicity, Hispanics had the highest number of cases at 36 percent, followed by whites, 28 percent; blacks, 19 percent; unknown 9 percent; and Asians and others, 8 percent.

Although Asians and other ethnic groups constituted a minority of just 8 percent of the cases, they had significantly higher rates of infection than all other individual groups because their population at risk was very small, less than 4 percent of the general Houston population.

Salmonella usually lasts four to seven days and most people recover without treatment. However, in some people, the diarrhea may be so severe that hospitalization is needed. In these patients, the infection may spread from the intestines to the blood stream, then to other body sites. It can cause death if it is not promptly treated with antibiotics. The elderly, infants and those with impaired immune systems are more likely to have a severe illness.

Salmonella infections often do not require treatment unless the patient becomes severely dehydrated or the infection spreads from the intestines. People with severe diarrhea may require rehydration, often with intravenous fluids. Antibiotics are not usually necessary unless the infection spreads from the intestines.

People with diarrhea usually recover completely, although it may be several months before their bowel habits are entirely normal. A small number of persons who are infected with salmonella will go on to develop pains in their joints, irritation of the eyes and painful urination. This is called Reiter’s syndrome.

Salmonella bacteria are usually transmitted to humans by eating foods contaminated with animal feces. Contaminated foods usually look and smell normal. Thorough cooking kills the bacteria.

It is also possible for infected food handlers, who fail to or inadequately wash their hands with soap after using the bathroom, to contaminate food.