Though it seems like a hidden menace lurking in our kitchens and on our plates, Salmonella remains a staggering global health threat, causing millions of infections and tens of thousands of deaths every single year.
Key Takeaways
- In the United States, Salmonella causes an estimated 1.35 million infections, 26,500 hospitalizations, and 420 deaths annually.
- Globally, Salmonella enterica causes approximately 93.8 million cases of gastroenteritis and 155,000 deaths each year.
- In the EU/EEA, there were 67,989 confirmed cases of salmonellosis reported in 2022, with an EU notification rate of 13.98 cases per 100,000 population.
- Poultry is the source of 23.5% of Salmonella cases in the EU.
- Eggs account for 38% of Salmonella outbreaks in the US from 2006-2017.
- Contaminated produce causes 46% of US Salmonella outbreaks.
- Diarrhea appears in 85-98% of Salmonella gastroenteritis cases.
- Fever occurs in 70-100% of non-typhoidal Salmonella infections.
- Abdominal cramps affect 50-70% of patients within 6-48 hours onset.
- Hand washing reduces transmission by 40-60%.
- Proper cooking of poultry to 165°F eliminates 99.99% Salmonella.
- Pasteurization of eggs reduces risk by 99%.
- Ciprofloxacin resistance increased to 85% in some NTS strains.
- US 2023 outbreak from charcuterie meats sickened 104 with 24 hospitalized.
- Azithromycin cure rate 95% for uncomplicated typhoid.
Salmonella causes millions of global illnesses annually, posing a serious foodborne health threat.
Prevalence and Incidence
- In the United States, Salmonella causes an estimated 1.35 million infections, 26,500 hospitalizations, and 420 deaths annually.
- Globally, Salmonella enterica causes approximately 93.8 million cases of gastroenteritis and 155,000 deaths each year.
- In the EU/EEA, there were 67,989 confirmed cases of salmonellosis reported in 2022, with an EU notification rate of 13.98 cases per 100,000 population.
- In Canada, Salmonella infections numbered 3,194 laboratory-confirmed cases in 2022, with an incidence rate of 8.0 cases per 100,000 population.
- Australia's national Salmonella notification rate was 43.6 cases per 100,000 population in 2022.
- In England and Wales, there were 8,013 laboratory-confirmed Salmonella cases in 2022, a decrease from previous years.
- Salmonella Typhi causes 11-20 million cases and 128,000-161,000 deaths yearly worldwide.
- Non-typhoidal Salmonella (NTS) accounts for 535,000 deaths annually in children under 5 years globally.
- In the US, the incidence of Salmonella infections decreased by 31% from 2019 to 2022 per FoodNet data.
- In 2021, China reported 1,043 Salmonella outbreaks affecting 12,286 cases.
- Brazil's Salmonella incidence rate was 15.4 cases per 100,000 in 2019.
- In South Africa, Salmonella caused 1,300 bloodstream infections per 100,000 HIV patients annually.
- India's estimated annual Salmonella burden is 13.2 million cases.
- In the Netherlands, salmonellosis incidence was 11.5 per 100,000 in 2022.
- Japan's reported Salmonella cases totaled 20,903 in 2021.
- In Mexico, Salmonella prevalence in poultry is linked to 40% of human cases.
- US hospitalization rate for Salmonella is 1.9% of cases.
- Global invasive NTS incidence in Africa is 388 per 100,000 children under 5.
- In 2020, EU saw 55,653 salmonellosis cases with 53 deaths.
- US incidence of S. Enteritidis was 2.34 per 100,000 in 2022.
- In Australia, S. Typhimurium accounts for 40% of cases with 5,678 notifications in 2022.
- Thailand reports 10,000-15,000 Salmonella cases yearly.
- In the UK, 2022 saw 7,000 S. Enteritidis cases.
- Africa's Salmonella fever burden is 3.36 billion DALYs lost annually.
- In 2019, global NTS cases were 87 million with 59,000 deaths.
- US poultry-associated Salmonella incidence is 6.5 per 100,000.
- In Germany, 2022 salmonellosis rate was 15.2 per 100,000.
- Vietnam's Salmonella prevalence in diarrhea patients is 12.5%.
- In 2021, France reported 4,500 Salmonella cases.
- Global S. Typhi multidrug resistance rate is 79% in some regions.
Prevalence and Incidence Interpretation
While these grim statistics remind us that Salmonella remains a formidable global adversary, they also underscore our ongoing battle to curb its reach and mitigate its toll through vigilant public health measures.
Prevention and Control
- Hand washing reduces transmission by 40-60%.
- Proper cooking of poultry to 165°F eliminates 99.99% Salmonella.
- Pasteurization of eggs reduces risk by 99%.
- Refrigeration below 40°F inhibits Salmonella growth by 90%.
- Chlorine washing of produce reduces Salmonella by 2-3 log CFU.
- Vaccination of hens decreased S. Enteritidis by 75% in UK.
- HACCP implementation in poultry processing cuts contamination 50-70%.
- No reptile pets for children under 5 prevents 90% exposures.
- Irradiation of spices reduces Salmonella by 5-log.
- Competitive exclusion cultures in chicks reduce colonization 95%.
- Acidified sodium chlorite sanitizer on poultry reduces by 3.5 log.
- Biosecurity on farms lowers Salmonella prevalence 60%.
- Cooking thermometer use prevents 50% undercooking errors.
- Separate cutting boards reduce cross-contamination 75%.
- Phage therapy trials show 90% reduction in pig Salmonella.
- EU flock monitoring reduced S. Enteritidis 90% since 1990s.
- Organic acids in feed cut cecal Salmonella 2-log in broilers.
- Water sanitation prevents 30% waterborne cases.
- Dry milling of flour post-2016 guidelines reduced outbreaks 80%.
- Vaccination programs in Denmark eliminated S. Enteritidis in layers.
- Peroxyacetic acid rinse on carcasses achieves 4-log reduction.
- Consumer education campaigns lowered US incidence 10%.
- Cleanliness in childcare centers prevents 70% secondary spread.
- Rapid chilling post-slaughter reduces Salmonella growth 50%.
- Traceability systems detect outbreaks 2x faster.
Prevention and Control Interpretation
It turns out the war against Salmonella is best fought with relentless hygiene and intelligent control measures at every stage, from farm to fork, because while cooking can almost guarantee a clean plate, most battles are won before the heat ever hits the pan.
Sources and Transmission
- Poultry is the source of 23.5% of Salmonella cases in the EU.
- Eggs account for 38% of Salmonella outbreaks in the US from 2006-2017.
- Contaminated produce causes 46% of US Salmonella outbreaks.
- Pigs are reservoirs for 10-20% of human S. Typhimurium infections.
- International travel contributes to 22% of US Salmonella cases.
- Reptile exposure causes 6% of US Salmonella infections, highest in children under 5.
- Turkey meat linked to 15% of multistate US outbreaks 1998-2007.
- Waterborne transmission accounts for 10% of global Salmonella cases.
- In EU, table eggs source 42.6% of S. Enteritidis cases.
- Live poultry handling causes 11% of pediatric Salmonella cases in US.
- Tomatoes implicated in 12 US outbreaks 1990-2006 affecting 2700 cases.
- Cattle feces contaminate 20% of leafy greens with Salmonella.
- Person-to-person transmission occurs in 5-10% of institutional outbreaks.
- Sprouted seeds caused 50 EU outbreaks 2001-2011 with 3,425 cases.
- Chicken meat prevalence of Salmonella is 9.2% in US retail samples.
- Melons linked to 31 US outbreaks 2011-2018 affecting 3,450 cases.
- Pet food dry kibble has 0.2-1.5% Salmonella contamination rate.
- Hospital environments harbor Salmonella in 15% of ICU sinks.
- Onions caused 1,127 cases in 2020-2021 US outbreak.
- Backyard flocks source 11% of US S. Enteritidis cases.
- Peanut butter contaminated in 2009 US outbreak with 714 cases.
- Irrigation water with animal manure increases Salmonella on produce by 50%.
- EU pork prevalence of Salmonella is 2.5% at slaughter.
- Frogs and turtles cause 15% of reptile-associated Salmonella in kids.
- Flour raw consumption linked to 17 US outbreaks 2009-2015.
- Beef ground has 0.9% Salmonella prevalence in US.
Sources and Transmission Interpretation
You're not just having a bad day, you're conducting a complex risk assessment where the menu includes poultry playing Russian roulette, your salad being a bovine-derived bioweapon, and your child's pet turtle operating as a tiny, mobile biohazard.
Symptoms and Health Effects
- Diarrhea appears in 85-98% of Salmonella gastroenteritis cases.
- Fever occurs in 70-100% of non-typhoidal Salmonella infections.
- Abdominal cramps affect 50-70% of patients within 6-48 hours onset.
- Vomiting is reported in 30-50% of Salmonella cases.
- Headache accompanies 10-20% of symptomatic infections.
- Incubation period averages 12-72 hours, up to 102 hours.
- Bacteremia occurs in 1-5% of healthy adults, 25% in infants.
- Reactive arthritis follows 1-3% of gastroenteritis cases.
- Dehydration risk is high in 20% of elderly patients.
- In infants, sepsis risk is 10-20% with invasive disease.
- Myocarditis reported in 0.1-0.5% of severe cases.
- Meningitis incidence is 1-10 per 100 invasive cases in neonates.
- Osteomyelitis complicates 0.8% of sickle cell patients with Salmonella.
- Guillain-Barré syndrome post-Salmonella in 1:1000 cases.
- Bloody diarrhea in 10-15% of Campylobacter-like Salmonella strains.
- Chills and myalgia in 40% of febrile patients.
- Aortic aneurysm rupture in 5% of endovascular infections.
- Splenic abscesses in 0.05% of immunocompromised cases.
- Urticaria or erythema nodosum in 2-5% post-infectious.
- Prolonged carriage in 0.2-4% of cases over 1 year.
- Mortality rate 0.5-1% in healthy adults, 20% in elderly.
- Hospitalization needed in 20% of cases, longer in bacteremia.
- Irritable bowel syndrome follows 10% of foodborne illnesses including Salmonella.
- Pneumonia rare, 0.1% but 50% mortality in immunocompromised.
- Seizures in 5% of pediatric meningitis cases.
- Case-fatality rate for invasive NTS in Africa is 20-25%.
Symptoms and Health Effects Interpretation
While it delivers a distressingly comprehensive menu of misery from diarrhea to deadly complications, Salmonella insists you at least get a fever to prove you're taking it seriously.
Treatment and Surveillance/Outbreaks
- Ciprofloxacin resistance increased to 85% in some NTS strains.
- US 2023 outbreak from charcuterie meats sickened 104 with 24 hospitalized.
- Azithromycin cure rate 95% for uncomplicated typhoid.
- EU PulseNet sequenced 90% of Salmonella isolates in 2022.
- 2018 US romaine lettuce outbreak: 210 cases, 5 deaths.
- Ceftriaxone used in 80% pediatric bacteremia cases, 90% success.
- 2021 candy bar outbreak: 34 cases, 10 hospitalized.
- WGS clusters 70% of outbreaks faster than PFGE.
- 2019 US turkey flock outbreak: 216 cases, 52 hospitalized.
- Fluoroquinolone failure in 20% MDR typhoid cases.
- 2022 EU boar's head outbreak investigated via EFSA/ECDC.
- Trimethoprim-sulfamethoxazole resistance 50% in Africa NTS.
- 2012 US peanut butter: 42 cases from 1 plant.
- Hospital stay averages 5.5 days for Salmonella gastroenteritis.
- 2020 onion outbreak US/Canada: 1,127 cases, 167 hospitalized.
- Carbapenems reserved, resistance <1% in US Salmonella.
- 2016 US flour outbreaks: 56 cases over 4 incidents.
- Global surveillance via WHO GLASS covers 80 countries for AMR.
- 2014 cucumber outbreak US: 275 cases, 26 hospitalized.
- Fosfomycin effective 90% against MDR S. Typhi.
- 2023 US salami outbreak: 60 cases, 19 hospitalized.
Treatment and Surveillance/Outbreaks Interpretation
While our genomic surveillance and outbreak tracing have become impressively precise, the unsettling rise of resistance in Salmonella reminds us that our culinary delights are increasingly seasoned with a dash of microbial defiance, turning simple meals into complex gambles.
Sources & References
- Reference 1CDCcdc.govVisit source
- Reference 2WHOwho.intVisit source
- Reference 3ECDCecdc.europa.euVisit source
- Reference 4HEALTH-INFOBASEhealth-infobase.canada.caVisit source
- Reference 5HEALTHhealth.gov.auVisit source
- Reference 6GOVgov.ukVisit source
- Reference 7THELANCETthelancet.comVisit source
- Reference 8NCBIncbi.nlm.nih.govVisit source
- Reference 9SCIELOscielo.brVisit source
- Reference 10RIVMrivm.nlVisit source
- Reference 11NIIDniid.go.jpVisit source
- Reference 12WWWNCwwwnc.cdc.govVisit source
- Reference 13EFSAefsa.onlinelibrary.wiley.comVisit source
- Reference 14UKHSAukhsa.blog.gov.ukVisit source
- Reference 15PMCpmc.ncbi.nlm.nih.govVisit source
- Reference 16RKIrki.deVisit source
- Reference 17SANTEPUBLIQUEFRANCEsantepubliquefrance.frVisit source
- Reference 18EFSAefsa.europa.euVisit source
- Reference 19FSISfsis.usda.govVisit source
- Reference 20FDAfda.govVisit source
- Reference 21MAYOCLINICmayoclinic.orgVisit source
- Reference 22EMEDICINEemedicine.medscape.comVisit source
- Reference 23ARTHRITISarthritis.orgVisit source
- Reference 24MERCKMANUALSmerckmanuals.comVisit source
- Reference 25UPTODATEuptodate.comVisit source