Salmonella: what is this bacterium in Kinder?

[Mis à jour le 5 avril 2022 à 12h35] Salmonella are bacteria responsible for salmonellosis. Salmonella infections manifested by acute gastroenteritis. Evolution is generally favorable in a few days. In the cases more serious, this infection may progress to a septicaemic or localized form, which may require hospitalization. On April 4, 2022, Public Health France reported cases of salmonellosis in France which could be linked to the consumption of Kinder chocolates. The Ferrero group, which markets these famous chocolates, carries out the recall of several batches (Surprise, Choko-Bons…).

Definition: what is salmonella and salmonellosis?

Salmonella (or Salmonella) is a bacterium that causes salmonellosis and typhoid and paratyphoid fever. Salmonella are bacteria that accumulate in the digestive system. They can lead to symptoms of gastroenteritis and sometimes evolve into a septicaemic form or localized, which can require hospitalization. It is estimated that 15% of Salmonella are imported into Europe following trips to Africa or Asia. Note that 90% of reptiles, birds and pets carry Salmonella and can transmit it to their owner. As for Salmonella responsible for typhoid and paratyphoid fever, 17 million infections are recorded each year in the world, this time especially in poor countries. The acealmonellosis refers to all infectious diseases caused by bacteria of the genus Salmonella. Most cases of salmonellosis are mild, but sometimes the disease is life-threatening. The severity of illness depends on host factors and the Salmonella serotype.

What are the types of salmonella?

Salmonella is a genus of gram-negative bacilli belonging to the Enterobacteriaceae family. In two species, Salmonella bongori and Salmonella enterica, more than 2500 different serotypes have been identified. They are ubiquitous and resistant bacteria, which can survive for several weeks in a dry environment and several months in water. Among them, the Salmonella typhi and Salmonella paratyphi are responsible for (para)typhoid fever. Paratyphoid fevers are usually less severe than typhoid fever.

Salmonella are found in most domestic and wild animals. They are present in animals intended for human consumption such as poultry, pigs and cattle, but also in pets, cats, dogs, birds and reptiles, such as turtles. Salmonella can pass through the entire food chain, from animal feed, in primary production and back up the entire chain to households, catering services and institutions. Humans generally contract salmonellosis by consuming contaminated food of animal origin (mainly eggs, meat, poultry and milk), but also raw vegetables or some soiled vegetables (cucumbers, salads, etc.) or untreated water. Cases also occur in humans through contact with infected animals, especially pets. Often these animals show no signs of illness.

What is the incubation period for salmonellosis?

the incubation time is 6 to 72 hours (usually 12 to 36 hours) after Salmonella ingestion, andcondition lasts 2 to 7 days.

What are the symptoms of salmonellosis?

Salmonellosis is usually characterized by:

• sudden appearance of fever,
• from abdominal pain,
• of the diarrhea,
• nausea and sometimes vomiting.

Symptoms are generally relatively mild and, in the majority of cases, patients recover without special treatment. In some cases, however, especially in very young children and the elderly, the associated dehydration can become severe and life-threatening.

What foods are at risk for salmonellosis?

Salmonellosis is an infection always caused by the ingestion of salmonella, particularly the consumption of contaminated food. The main food categories identified are eggs and raw egg productsthe meats (bovine, porcine and poultry and dairy products. Of many other foods (plants (germinated seeds for example), shells, etc.) may be carriers of Salmonella. It is able to survive for a long period (years) in a dry environment. It can be found in low water activity products (milk powders including infant formulas, dried fruits, chocolate, cereals, spices…).

Who are the people most at risk?

Salmonellosis can affect the entire population. However, she can affect babies more severelyyoung children, pregnant women, the elderly, people with health problems or immunocompromised.

To make the diagnosis, the indication of a recent trip to tropical countries or those of North Africa can be evocative. It is advisable to preferably consult the attending physician, an emergency or infectiology service.

• A blood test with a study of the markers of the infection will almost always find an increase in C-reactive protein (CRP) in isolation. A blood culture, or blood culture, makes it possible to find the germ in question.
• Coproculture is the most effective method for diagnosing salmonellosis corresponding to the “gastroenteritis” type.
• A serology still carried out on a blood sample is also an argument, particularly in the context of suspected salmonellosis corresponding to the typhoid or paratyphoid type.

The following serology results indicate a recent or old infection:

• Type O antibodies: they occur around the 8th day of illness and disappear in 2 to 3 months. If the titre is >100, they indicate a recent infection.
• H-type antibodies: they appear around the 10-12th day and persist for several years. Their level is higher than that of type O antibodies during the status period.

The presence of type O antibodies, without type H antibodies indicates a recent infection. A high level of O and H antibodies shows an ongoing infection. An isolated elevation of type H antibodies means very old salmonellosis.

“In all cases, salmonellosis requires medical advice. A fortiori, typhoid and paratyphoid fevers require rapid medical treatment” says Dr. Claire Lewandowski, specializing in general medicine.

► One Routine antibiotic therapy is not recommended against mild or moderate forms in otherwise healthy subjects to avoid selecting resistant strains. Only infants, the elderly, pregnant women and immunocompromised patients may need to receive antibiotic therapy. We also administer antimicrobials if the infection spreads from the intestines to other parts of the body.

► In the most serious cases, a electrolyte intake (to replace for example sodium, potassium and chloride ions, lost following vomiting and diarrhoea) and a rehydration intravenous are prescribed during hospitalization.

► At the same time, the patient must be isolated to prevent transmission and relatives should be screened and treated if necessary. A control of blood cultures is necessary at the end of treatment to ensure healing. Besides, declaration of the disease to the Regional Health Agency is compulsory.

► Natural remedies: A decoction of Guava Leaves can be used as a natural remedy in the treatment of gastrointestinal symptoms, to be used only after the agreement of your doctor. I

► The consumption of vegetable activated carbon, blond psylliumor probiotics can also be used in case of diarrhea, just like homeopathy: Arsenicum album 15 CH, Phosphorus 15 CH and Veratrum album 7 CH.

► To help restore intestinal transit, it is advisable to avoid consuming milk, green vegetables and fruits, but to favor rice, ham, meat, fish, bananas, apples, quince, or blueberries and to drink water. water and rehydration solutions.

Do not wash eggs before storing them.

To avoid being contaminated with salmonella, untreated water and questionable foods should not be consumed, especially in risk areas. The French Institute for Public Health Monitoring verifies the correct conditions for preparing and storing food. To avoid contamination, it is advisable to:

• Cook food to heart (70°C) and in particular pork and poultry meat, as well as minced meats.
• Avoid raw milk and raw milk products. Drink only pasteurized or boiled milk.
• Avoid ice unless it has been prepared from safe water.
• When the safety of drinking water is questionable, it should be boiled or, if this is not possible, disinfected with a reliable slow-release disinfectant (usually available in pharmacies).
• Wash hands thoroughly and frequently with soap, especially after contact with livestock or pets or after going to the toilet.
• Wash hands after handling raw eggs, raw meats, unwashed vegetables.
• Carefully wash fruits and vegetables, especially if they are to be eaten raw. Whenever possible, fruits and vegetables should be peeled.
• I’maintenance (scraping, washing with hot water and detergent) of work surfaces and utensils must be rigorous and carried out immediately after each use.
• Clean the refrigerator regularly.
• Contact between infants/toddlers and pets (cats, dogs, turtles, etc.) requires careful supervision. In addition, a preventive vaccine exists, which protects against some of these germs for three years. It is recommended for travel in certain areas of the world.

Eggs are particularly at risk in cases of salmonellosis. Health authorities recommend:

• Keep the eggs always at the same temperature in order to avoid the phenomenon of water condensation on their surface.
• Do not wash the eggs before storing them: washing allows the penetration of micro-organisms.
• No-cook egg preparations (mayonnaise, creams, chocolate mousse, pastries, etc.) should be eaten immediately after preparation or kept cold for consumption within 24 hours.
• It is recommended for the elderly, immunocompromised people, young children and pregnant women not to consume raw or undercooked eggs.
• It is also recommended that the elderly, immunocompromised people, young children and pregnant women takeavoid contact with pet reptiles.

Thanks to Dr Claire Lewandowski for her medical validation.

Source: Salmonella. Handles. June 2021.