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Medical Author:

Charles Patrick Davis, MD, PhD

Charles Patrick Davis, MD, PhD

Dr. Charles "Pat" Davis, MD, PhD, is a board certified Emergency Medicine doctor who currently practices as a consultant and staff member for hospitals. He has a PhD in Microbiology (UT at Austin), and the MD (Univ. Texas Medical Branch, Galveston). He is a Clinical Professor (retired) in the Division of Emergency Medicine, UT Health Science Center at San Antonio, and has been the Chief of Emergency Medicine at UT Medical Branch and at UTHSCSA with over 250 publications.

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Medical Editor:

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, Chief Medical Editor

Melissa Conrad Stöppler, MD, is a U.S. board-certified Anatomic Pathologist with subspecialty training in the fields of Experimental and Molecular Pathology. Dr. Stöppler's educational background includes a BA with Highest Distinction from the University of Virginia and an MD from the University of North Carolina. She completed residency training in Anatomic Pathology at Georgetown University followed by subspecialty fellowship training in molecular diagnostics and experimental pathology.

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The greatest risk factor for getting a Salmonella infection is ingesting the bacteria in contaminated food or water. Another high risk factor for people in industrialized countries is eating and drinking when visiting in a developing country where sources of food and drink may be contaminated. However, even industrialized countries like the U.S. can have outbreaks of Salmonella infection if a food or water source is not properly sanitized or screened for contamination. An example was a recent (2008-2009) outbreak of Salmonella infections that were traced to a peanut processing plant that sold processed peanut material (paste) that was subsequently put into many food products (candy, cookies, ice cream, cereals, dog food). This contaminated paste caused about 600-700 cases of salmonella in 46 states; more than 125 products were eventually recalled and the company plant closed. The most common source of contamination in the U.S. is from eggs and poultry products.

People older than 70 years of age and less than 20 years of age are in the highest risk groups. About 25%-35% of pediatric typhoid infections occur in children under 5 years of age. Older individuals may have underlying diseases and compromised immunity that lead to higher risk while children may have less gastric acidity which allows bacteria to better survive passage through the stomach and into the GI system beyond the stomach.

Eating raw meat or raw eggs or eating unwashed vegetables or fruits also increases the risk of Salmonella infection. In 2008, raw tomatoes were linked to over 160 Salmonella infections. Salmonella can be cultivated from animals, birds, and reptiles; outbreaks have been linked to exposure to turtles, snakes, and house pets. About 90% of amphibians and reptiles contain S. spp in their feces. Any dusty, dirty material may carry Salmonella as well as mycotic (fungal) diseases. Most animal, reptile, and bird feces may contain these infectious agents and may be the primary source of the bacteria for individuals who have close contact or clean the cages of these animals. Consequently, hand-washing and eating well-cleaned and thoroughly cooked foods decrease the risk of exposure to Salmonella and other infectious agents.

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