By Dr. Anthony Policastro

On Aug. 12 there was a chicken recall due to Salmonella. On Aug. 17 there was a frozen shrimp recall due to Salmonella. On Aug. 25 there was an Italian cold cut recall due to Salmonella.

These stories get reported in a very matter of fact manner. It is like they figure everyone knows what Salmonella is. I suspect that most people know that it is bad. However, beyond that, it is just something else that can cause disease. That makes it bad.

As usual things are more complicated than that. Salmonella is a bacterium. There are many different types of Salmonella. Some of them are more likely to cause disease than others. Many people will develop an asymptomatic infection. Those that do develop symptoms usually will have intestinal symptoms.

This symptoms include fever, abdominal cramps, vomiting and diarrhea. In most cases these symptoms go away without treatment. However, sometimes the vomiting and diarrhea can be so bad that they can cause dehydration. This can be serious.

There are two major categories of Salmonella. One is Salmonella Typhi. It is the cause of typhoid fever. The rest of the organisms are grouped into what are called non-typhoidal Salmonella.

There are about 1,200,000 cases of non-typhoidal Salmonella in the U.S. every year. They account for about 450 deaths. That is a fatality rate of 0.03 percent. Thus the rate is very low (much less than one percent).

Globally these organisms cause more problems than they do in our country. There are about 90,300 deaths globally each year from non-typhoidal Salmonella. Typhoid fever causes an additional 178,000 deaths globally each year.

The infections usually last for 4-7 days and then improve. The goal is to keep the patient from dehydrating from the fluid losses.

These organisms are sensitive to antibiotics. The problem is that antibiotic treatment can cause them to go into hiding in the intestinal tract. That prolongs the infection. Therefore, it does not make sense to use antibiotics for routine cases. They should be reserved for more severe cases.

In patients with immune system problems or in children, Salmonella can enter the blood stream. When that happens it can cause infections in places far from the intestine. It can cause meningitis. It can cause bone infections. It can cause joint infections.

The infection comes from contaminated food. Thus it is a form of food poisoning. It is often found in animal feces. That means transmission can occur when hands touch food contaminated with that. That means that almost any food can carry it.

There are other means of getting it. About 10 percent of the infections in our country each year come from undercooked chicken eggs. That is why I will not eat soft boiled eggs. Pet turtles are also a source of infection.

Good hand hygiene is essential. Washing hands after touching raw meat is necessary. Care when washing raw meat is important so that there is not a lot of splashing onto you. A lot of the approach is prevention.

The good news is that you are now informed. Sometime in the future you will read a story about food being recalled because of Salmonella. The writer will assume you know it means. Now you do.

COVID update- This week we became the 20th country in the world to reach 2,000 deaths per million population from COVID-19. If you do the math, that means that one out of every 500 Americans has now died from COVID-19.

 The number of new cases nationally was 1,120,000 last week. This week it rose slightly to 1,140,000. The number of cases in Sussex County last week was 712. This week it was 806.

 The virus continues to prove my point. One of two things will happen to everyone. You can either get the vaccine or wait until you get the infection. Those are the only two options.