Primary prevention
Most human cases of Salmonella (>95%) involve ingestion of a contaminated food item. Salmonella outbreaks have been associated with a great diversity of food products. Meat and poultry are responsible for the majority of outbreaks, followed by produce, eggs, and dairy products, respectively.[59]
Consumers should avoid ingesting raw or undercooked eggs. For example, homemade salad dressings, beverages such as eggnog, and tiramisu may contain raw eggs; consumers should inquire whether raw eggs were used and, if so, avoid that particular food item. All meats (especially poultry and ground beef) should be well cooked; for example, for poultry, the internal temperature should reach at least 74°C (165°F).[60] In addition, dairy products such as milk should be pasteurised before consumption. Because vegetables and fruits also can be contaminated with Salmonella, these should be thoroughly washed before ingestion. People preparing food should follow the concept of "clean, separate, cook, and chill" to assist in primary prevention of salmonellosis. USDA: basics for handling food safely Opens in new window The food industry has been given farm-to-table opportunities to decrease the risk of Salmonella contamination of foodstuffs.[60]
In addition, contact with animals carrying Salmonella (e.g., live poultry, frogs, hedgehogs, and reptiles such as iguanas, turtles, snakes, and bearded dragons) may result in human infection.[61][62] Hence, people should wash their hands after touching pets, especially after handling reptiles or live poultry.[18][63] Guidance on measures to prevent acquisition of infectious diseases, including Salmonella, in the setting of animal contact is available.[63]
Animals may appear healthy and still carry Salmonella. Avoiding natural pet treats and raw-food diets for pets also is recommended to decrease the likelihood of pets becoming infected or carrying Salmonella.[64] Even handling pet food or treats has been linked to Salmonella infections, so washing hands after feeding pets is recommended.[65] Those who are immunocompromised or at the extremes of age should be particularly mindful of these preventive strategies.
There is no vaccine to protect against non-typhoidal Salmonella infections. The development of a vaccine against the leading invasive non-typhoidal Salmonellaserotypes (i.e., Typhimurium and Enteritidis) is needed.[21]
Secondary prevention
Antibiotics for salmonellosis should not be prescribed in an attempt to reduce secondary transmission, as antimicrobials may actually increase carriage times. The best method of reducing spread is good hand hygiene.
Salmonellosis cases within the hospital should be managed with standard precautions to avoid nosocomial transmission. Items soiled by faeces should be handled using barrier methods of protection. One review of nosocomial outbreaks involving Salmonella found almost 60% of the outbreaks were foodborne and recommended more emphasis on improving food handling practices, such as training food workers, monitoring food temperatures, and not using raw foods of animal origin.[131]
For healthcare workers with salmonellosis, experts advise that they may return to their jobs after the cessation of diarrhoea and with the use of good hand hygiene.[44] However, those working with high-risk patients may be required to have 2 negative stool samples 24 hours apart before returning to work.
Food handlers should pay particular attention to good hand washing practices. In addition, they should strictly adhere to temperature standards set by industry.
Local guidelines concerning healthcare workers and food handlers must be followed. Some geographical regions require 2 negative stools (off of antibiotics) before food handlers can return to work. Local guidelines through the public health department should be sought and followed.
Also, in cases in which a foodborne outbreak of salmonellosis is suspected, local health officials should be contacted. Guidelines on the assessment of a suspected foodborne disease outbreak, developed by the World Health Organization, are available.[132]
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