Salmonella Infection

Salmonellosis to infection resulting from the Salmonella bacteria. Majority of the people with Salmonella infection develop fever, abdominal cramps and diarrhea within the first 12 to` 72 hours following infection. Salmonellosis generally lasts from 4 to 7 days, with most people recovering without treatment. In certain cases however, the diarrhea becomes so severe as to require the patient to be hospitalized and treated. In such patients, the Salmonella infection spreads into their bloodstream as well as other body areas from the intestines. For such patients, the Salmonellosis
may result into death if there is no proper and prompt treatment with antibiotics.
Incidence, More than 40,000 cases of Salmonella representing 13.6 cases per 100,000 persons, were reported to the Centers for Disease Control and Prevention (CDC) in 2009, by public health laboratories all over the country. (CDC, 2013).This was a decrease of about 15% from the previous year’s incidence,and an increase of 4.2% since 1996. [1] In general, the incidence of Salmonellosis in the United States has not seen significant change since 1996. [2, 5] It must also be considered that only a small percentage of all Salmonellosis cases are diagnosed and reported to health agenciess. (CDC, 2013).For every reported case, the CDC estimates that approximately 38.6 infections go undiagnosed. (CDC, 2013).The CDC further estimates that about 1.4 million about infections, 15,000 hospitalizations as well as 400 deaths are caused annually by Salmonellosis cases in the United States. (CDC, 2013).Children, infants and elderly as well as those having impaired immune systems are highly likely to get severe illness from salmonella infection.
According to the CDC, approximately 2 to 4 million cases of salmonellosis occur annually in the United States. (Source: FDA Bad Bug Book) Approximately 40,000 cases of salmonellosis are reported annually in the United States, however, many milder cases never get diagnosed or reported and the real number of salmonellosis cases may be much more higher. (CDC, 2013).
The reason for this this disparity in the actual number of infections and those reported is that many infected people do not seek medical attention while those that do not get properly tested leading to many cases of salmonellosis going undiagnosed. For instance, CDC estimated that of each salmonellosis case that is actually diagnosed and reported to public health departments, 38 cases of salmonellosis go unreported(CDC, 2013).In addition to only a small proportion of infected people getiing tested and diagnosed, only as few as 2 percent of these cases are further reported to CDC. Salmonellosis occurs as small and localized incidences in the general population as well as large incidences in, restaurants, institutions and hospitals. (CDC, 2013).
It is currently estimated and indicated that there are between 400-600 salmonellosis related deaths in the United States (Mead et al., 1999; CDC, 2008). Even though risk of death as well as actual deaths from salmonellosis are generally not common within the overall population, salmonella infection is usually particularly potent among the vulnerable groups such as infants and young children, elderly adults as well those whose immune systems have been compromised.
The analysis of multiple cause-of-death (MCD) data retrieved from death certificates in the United States. between 1990 and 2007, there were 1,372 cases of non-typhoidal Salmonellosis related deaths. (CDC, 2013). In these reported deaths, Salmonellosis was indicated as an underlying cause of death for 785 deaths representing 57.2% of the death certificates. Salmonellosis was also indicated as an associated cause of death for 587 deaths representing 42.8% of the death certificates. (CDC, 2013).

Case-fatality

The recognition of Salmonellosis as a significant infection in the united states, little data can be found on salmonellosis as a cause of death. To have a quantitative evaluation of the impact of Salmonella in relation to mortality in the United States, an examination of national multiple-cause-of-death data is called for. (CDC, 2013).

Person Factors

With Salmonellosis reported as an underlying or associated cause of death for 1316 deaths, there is an average yearly age-adjusted mortality rate of 0.03 every 100,000 person-years. Salmonellosis mortality rates is seen to be higher in blacks as well as Asian and Pacific Islanders with a 2.61 age-adjusted rate ratio having 95% Confidence Interval between 2.43 and 2.48. (CDC, 2013). Salmonellosis rates are also higher in males after an age-adjusted rate ratio of 1.84. The highest frequency of deaths is observed in adults of ages 75 to 84. (CDC, 2013).

Place Factors

Analysis was conducted on the St. Clair County community based epidemiological data reported in the 2016 National Center for Health Statistics Report. The data consisted of 18 indicators obtained from the National Center for Health Statistics. (National Center for Health Statistics, 2016).The objective of the core set analysis was to present a broad conclusion of the common public health status of the community. The listing of indicators includes 13 health outcomes together with five risk factors. (National Center for Health Statistics, 2016). These health outcomes comprise of one group of mortality rates. These are community specific infant mortality, cancer and the four groups of reported infectious diseases were AIDS, measles, tuberculosis, and syphilis. (National Center for Health Statistics, 2016).

Time Factors

Salmonellosis infection is more prevalent in the months of summer from June to August than winter. Children below the age of 5 years are highly likely to get Salmonellosis infection
Some types of medications such as medications used in reducing stomach acid may increase the chances of Salmonella infection.

The five risk factors identified were low birth-weight, births to adolescents, inadequate prenatal care, children in poverty, unhealthy living and poor food quality. Local community public health improvement objectives were developed which aligned with the federal and state public health improvement objectives. The local public health strategic planning team must be involved in the decision so as to link the goals of the department to those of the community in order to support the strategies of the public health department.

References

Centers for Disease Control and Prevention (CDC. (2013). Outbreak of Salmonella serotype Saintpaul infections associated with multiple raw produce items--United States, 2008. MMWR. Morbidity and mortality weekly report, 58(35), 839.
Centers for Disease Control and Prevention (CDC. (2011). Vital signs: incidence and trends of infection with pathogens transmitted commonly through food--foodborne diseases active surveillance network, 10 US sites, 1996-2010. MMWR. Morbidity and mortality weekly report, 60(22), 749.
Centers for Disease Control and Prevention (CDC. (2008). Outbreak of Salmonella serotype Saintpaul infections associated with multiple raw produce items--United States, 2008. MMWR. Morbidity and mortality weekly report, 57(34), 929.
Garthright, W. E., Archer, D. L., & Kvenberg, J. E. (1988). Estimates of incidence and costs of intestinal infectious diseases in the United States. Public health reports, 103(2), 107.
Olsen, S. J., Bishop, R., Brenner, F. W., Roels, T. H., Bean, N., Tauxe, R. V., & Slutsker, L. (2001). The changing epidemiology of Salmonella: trends in serotypes isolated from humans in the United States, 1987–1997. Journal of Infectious Diseases, 183(5), 753-761.
Voetsch, A. C., Van Gilder, T. J., Angulo, F. J., Farley, M. M., Shallow, S., Marcus, R., ... Emerging Infections Program FoodNet Working Group. (2004). FoodNet estimate of the burden of illness caused by nontyphoidal Salmonella infections in the United States. Clinical Infectious Diseases, 38(Supplement 3), S127-S134.