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.
Dr. Shiel received a Bachelor of Science degree with honors from the University of Notre Dame. There he was involved in research in radiation biology and received the Huisking Scholarship. After graduating from St. Louis University School of Medicine, he completed his Internal Medicine residency and Rheumatology fellowship at the University of California, Irvine. He is board-certified in Internal Medicine and Rheumatology.
Salmonellosis is spread to people by ingestion of Salmonella bacteria that contaminate food.
Salmonella is worldwide and can contaminate almost any food type, but outbreaks of the disease have involved raw eggs, raw meat (ground beef and other poorly cooked meats), egg products, fresh vegetables, cereal, pistachio nuts, tomatoes, and contaminated water. The most recent major outbreak (summer 2010) involved
Salmonella-contaminated eggs from several U.S. producers that have caused the recall of over 500 million eggs (see the unusual causes section below). Contamination can come from animal or human feces that contact the food during its processing or harvesting. New data about types of food contamination (food poisoning by
Salmonella spp.) is available from the U.S. Centers for Disease Control and Prevention (CDC) or the FDA. Potential direct sources of
Salmonella are pets such as pet turtles, dogs, cats, most farm animals, and humans that are infected or are carriers of the organisms.
Although typhoid and paratyphoid fevers can be transmitted by the same
methods as salmonellosis listed above, the most frequent manner of transmission
is by the feces of infected people contaminating the water or food source of
uninfected people.
What are the unique situations that allow Salmonella to contaminate eggs?
Although eggs have been known to occasionally transmit Salmonella bacteria to
humans, there have been outbreaks in the last few years involving egg production
plants. In the summer of 2010, an extremely large egg recall due to mainly
Salmonella enteritidis contamination caused about 1,500 people (as of September
2010) to become ill. As a result, the FDA recalled over 500 million eggs.
What
is unique about the 2010 Salmonella disease outbreak is that it is related to
the "modern egg farming" situation found in many industrialized countries and
how Salmonella is transmitted in domestic hens to their eggs.
Salmonella is
reportedly transmitted in hens in at least three ways:
1. Direct surface
contamination of eggs by contact with Salmonella-contaminated feed, feces, and
cage material
2. Salmonella organisms transferred from hen ovaries to the yolk
before the shell is formed in the hen's body
3. After the egg is laid and its
surface contaminated with Salmonella, some of the bacteria reportedly can
penetrate the shell and migrate to the yolk
Unfortunately, "modern egg farming"
techniques that are practiced by some producers augment Salmonella transfer to
eggs by practicing techniques that result in massive egg production in extremely
poor sanitary conditions for the hens. Once a "farm factory" gets Salmonella
contamination, most of the hens and many of their eggs become contaminated. This
cross-contamination in egg-producing facilities is usually due to lack of
sanitary facilities and poor housing conditions for the hens. Many times,
egg-producing hens are contaminated from outside sources, such as cattle feces
and rodent feces due to poor quality control in feed and hen cage conditions.
Currently, the FDA (and even the FBI) are looking into this ongoing egg recall
to help determine if some producers have been negligent, especially in the
housing methods used for poultry.
The two main producers under investigation are Hillandale Farms and Wright County Farms. However, eggs from these farms have
been sold to at least 16 different suppliers. In industrialized countries, mass
production techniques that make food readily available can also spread disease
rapidly to many people. Vigilance by quality-control agencies and people who
purchase foods (in this case, eggs) from bulk suppliers needs to be constant.
The FDA suggests that if people are not sure if they have contaminated eggs,
they should simply dispose of the eggs. Even in times when there are no recalls,
people are advised to thoroughly cook items such as eggs and meat (especially
hamburger meat) and drink from treated water sources. Other fluids need to be
adequately pasteurized (heat-treated to reduce or eliminate pathogens) or
sterilized. The FDA publishes its list of product recalls on the Internet and
the site is frequently updated; the following web site, http://www.fda.gov/Safety/Recalls/default.htm
will allow individuals to check on specific products and how to identify them.
Gastroenteritis (viral gastroenteritis, stomach flu) is an infection caused by a variety of viruses that results in vomiting and/or diarrhea. Even though it is often called the "stomach flu," it is not caused by the influenza viruses. Viruses that can cause gastroenteritis (stomach flu) include: rotaviruses, adenoviruses, caliciviruses, astroviruses, Norwalk virus, and a group of Noroviruses. Gastroenteritis is not caused by bacteria. The main symptoms of gastroenteritis include vomiting and watery diarrhea, however, headache, fever, and abdominal cramps (stomach ache) may also be present.
Diarrhea is a change is the frequency and looseness of bowel movements. Cramping, abdominal pain, and the sensation of rectal urgency are all symptoms of diarrhea. Absorbents and anti-motility medications are used to treat diarrhea.
There are many symptoms involved in the 1st, 2nd and 3rd trimesters of pregnancy. The first early pregnancy symptom is typically a missed period, but others include breast swelling and tenderness, nausea and sometimes vomiting, fatigue and bloating. Second trimester symptoms include backache, weight gain, itching, and possible stretch marks. Third trimester symptoms are additional weight gain, heartburn, hemorrhoids, swelling of the ankles, fingers, and face, breast tenderness, and trouble sleeping. Read more to learn about recommended procedures and tests for each stage of a healthy pregnancy.
Dehydration is the excessive loss of body water. There are a number of causes of dehydration including heat exposure, prolonged vigorous exercise, and some diseases of the gastrointestinal tract. The best way to treat dehydration is to prevent it from occurring.
Nausea is an uneasiness of the stomach that often precedes vomiting. Nausea and vomiting are not diseases, but they are symptoms of many conditions. The causes of vomiting differ according to age, and treatment depends upon the cause of nausea and vomiting.
Although a fever technically is any body temperature above the normal of 98.6 degrees F. (37 degrees C.), in practice a person is usually not considered to have a significant fever until the temperature is above 100.4 degrees F (38 degrees C.). Fever is part of the body's own disease-fighting arsenal: rising body temperatures apparently are capable of killing off many disease- producing organisms.
Sepsis (blood poisoning) is a potentially deadly infection with signs and symptoms that include elevated heart rate, low or high temperature, rapid breathing and/or a white blood cell count that is too high or too low and has more than 10% band cells. Most cases of sepsis are caused by bacterial infections, and some cases are caused by fungal infections. Treatment requires hospitalization, IV antibiotics, and therapy to treat any organ dysfunction.
Typhoid fever is an illness caused by the Salmonella typhi bacteria. The illness is contracted by ingesting the bacteria in contaminated water or food. Symptoms include headaches, fever, diarrhea, lethargy, aches and pains, and poor appetite. Treatment focuses on killing the Salmonella bacteria with antibiotics.
Food poisoning is common, but can also be life threatening. The most common form of food poisoning is caused by bacteria and include symptoms such as fever, abdominal pain, diarrhea, nausea and vomiting.
Inflammation of the inner lining of the colon is referred to as colitis. Symptoms of the inflammation of the colon lining include diarrhea, pain, and blood in the stool. There are several causes of colitis including infection, ischemia of the colon, inflammatory bowel disease (Crohn's disease, Ulcerative colitis, or microscopic colitis). Treatment depends on the cause of the colitis.
Septic arthritis, or infectious arthritis, is infection of one or more joints by bacteria, viruses, or fungi. Symptoms and signs of septic arthritis include fever, joint pain, chills, swelling, redness, warmth, and stiffness. Treatment involves antibiotics and the drainage of the infected joint.
Shigellosis is a disease caused by the Shigella bacteria. Bloody diarrhea, stomach cramps and fever are common symptoms. Mild infections usually resolve on their own. Antibiotics are used to treat more severe cases.
Drug resistance (antimicrobial resistance) is the ability of bacteria, fungi, parasites, and viruses to grow, even in the presence of a drug that would normally kill it (or limit it's growth). Drug resistance is a growing problem, particularly for infections such as MRSA, VRE (vancomycin-resistant enterococci), tuberculosis, HIV, STDs, gonorrhea, flu, pneumonia, malaria, E. coli, salmonella, Campylobacter, which causes diarrhea and gastroenteritis. Learn how to protect yourself from resistance to drugs.
Bioterrorism is a form of terrorism where there is the intentional release of biological agents such as viruses, germs, or bacteria. Diseases caused by bioterrorism agents include anthrax, botulism, plague, smallpox, tularemia, brucellosis, food poisoning, Q fever, ricin toxin poisoning, cholera, epidemic typhus, viral encephalitis, XDR TB, and MDR TB.
Enterovirulent Escherichia coli (E. coli) are strains of related bacteria that have a strong propensity to cause gastrointestinal tract infections. Examples of strains include: EHEC (enterohemorrhagic E. coli), ETEC (enterotoxigenic E. coli), EPEC (enteropathogenic E. coli), EIEC (enteroinvasive E. coli), EAEC (enteroadherent E. coli), and EAggEC (enteroaggregative E. coli). Symptoms may vary depending on the strain the individual contracts. Infection is spread generally through contaminated food or drink.
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