Salmonella

Question 1

Is Salmonellosis nationally notifiable?

Answer 1

Yes - routine, labs, doctors

Labs must also notify detections in food / water

Question 2

Which organism causes Salmonellosis?

Answer 2

Salmonella spp - 2000 serotypes

Most common S. thypimurium

Question 3

What is the reservoir for salmonella?

Answer 3

Domestic and wild animals - poultry and reptiles especially

Question 4

How is salmonella transmitted?

Answer 4

Faecal-oral mainly but also human-human, animal-human

Usually contaminated / poorly cooked food e.g. eggs, raw milk, poultry, unwashed produce, shellfish

Contaminated water

Question 5

What are the clinical features of salmonella?

Answer 5

Acute gastroenteritis - NVDA
Self-limiting - 1-20 days
Severe disease - septicaemia, focal infection (e.g. abscess), post-infectious reactive arthritis

Question 6

Who are high-risk groups for salmonellosis?

Answer 6

Young children, elderly, immunocompromised

Question 7

What are case definitions for salmonellosis?

Answer 7

Confirmed - isolation / detection (excl. those captured under typhoid / paratyphoid definitions)

Question 8

How is salmonellosis diagnosed?

Answer 8

Culture (faeces), PCR
Typing @ MDU, WGS available

Question 9

What is the incubation period for salmonellosis?

Answer 9

Short - 12-36 hours
range (6-72 hrs)

Question 10

What is the infectious period for salmonellosis?

Answer 10

While present in stool - up to several weeks
Prolonged carriage up to 1 years (1% adults, 5% young children)
ABx can prolong carrier state

Question 11

What is the outbreak definition?

Answer 11

2 or more related cases

Question 12

What is the epidemiology of Salmonellosis in Australia?

Answer 12

Majority sporadic
OBs in RACF, CC, retail food

Intermittent OBs - food products, Ix by FSANZ of imported products

Question 13

How is Salmonella prevented?

Answer 13

Food hygiene - thorough cooking, temperature control, separate raw / cooked food, cleaning

Avoid raw eggs, unpasteurised milk / dairy

Question 14

What resources are available for public health management?

Answer 14

DoH guidelines - No SoNG
Various Gastro guidelines

Question 15

How are cases managed?

Answer 15

Single cases are not routinely followed up.

F/U clusters of serovars & specific species of note:
- S. enteriditis (poultry from many countries, not Aus)
- S. paratyphi bioser java - O/S travel, sandpits, acquariums, imported seafood

T - usually self-limiting; standard contact precautions in hospital / RCF
I - exclude from food handling, childcare, healthcare
E - Hygiene, food safety,

Question 16

What type of questionnaire can be implemented?

Answer 16

HGQ - hypothesis generating questionnaire for cases without overseas travel

Info on travel, animals, food history (detailed)

Question 17

What education should cases be given?

Answer 17

Hygiene, food safety, standard contact precautions in hospital / RCF

Question 18

How are contacts managed?

Answer 18

T - nil
I - nil
M - Consider diagnosis in Sx contacts - monitoring; consider active case finding
E - hygiene, food safety, transmission,

Question 19

Who should be excluded?

Answer 19

Food handlers / HCWs / CC workers - no work until 48hrs after symptoms resolved

Primary school / ECEC - until 24 hours post diarrhoea
RCF - isolate while unwell, contact precautions

Question 20

What environmental management is required?

Answer 20

Cleaning esp. CC, RCF, food premises
Environmental assessment where food suspected - VASH - visit, audit, sampling, hygiene

Question 21

Who are key stakeholders?

Answer 21

OzFoodNet, FSANZ, Food Safety Unit