INTRODUCTION

Salmonella is a genus of rod-shaped, Gram-negative bacteria. Salmonella species are zoonotic

bacteria that can infect people, birds, reptiles, and other animals. They were isolated by Salmon
and Smith in 1885 from pigs with hog cholera. Hence Named after him. There are only two
species of Salmonella, Salmonella bongori and Salmonella enterica, of which there are around
six subspecies and innumerable serovars. There are six subspecies of S enterica , i.e enterica ,
salamae , arizonae ,diarizonae , houtenae, indica. No subspecies of S bongori .The genus
belongs to the same family as Escherichia, which includes the species E.coli. Salmonellae are
found worldwide in both cold-blooded and warm-blooded animals, and in the environment.
Found in the intestine of pigs ,cows ,goats , sheeps ,rodents ,hens , ducks and poultry. They cause
illnesses such as typhoid fever, paratyphoid fever, and food poisoning. They causes three types
of diseases in human i.e enteric fever, entercolitis and septicaemia. Most vertebrates can be
infected with Salmonella. Free-ranging birds can be sub-clinical carriers and serve as a reservoir
of bacteria.

Picture 1: Salmonella
HISTORY OF SALMONELLA

The Salmonella was discovered in 1985 from pigs with hog cholera. by medical research
scientist Theobald Smith who was working as a research laboratory assistant in the Veterinary
Division of the United States Department of Agriculture. The department was under the
administration of Daniel Elmer Salmon, a veterinary pathologist. Hence the organism was named
Salmonella. It was found that the organism is the causal agent for cause of hog cholera and
named Salmonella.

TAXONOMY OF SALMONELLA

The genus Salmonella is part of the family of Enterobacteriaceae. Its taxonomy has been
revised. It comprises two species, Salmonella bongori and Salmonella enterica, the latter of

which is divided into six subtypes: enterica, salamae, arizonae, diarizonae, houtenae and indica.
The bongori species has no subtypes. The taxonomic group contains more than 2500 serovars,
defined on the basis of the somatic O (lipopolysaccharide) and flagellar H antigens (Kauffman
White classification). Kauffmann-White scheme classifies Salmonella according to three major
antigenic determinants composed of flagellar H antigens, somatic O antigens and virulence (Vi)
capsular K antigens. This was adopted by the International Association of Microbiologists in
1934. The full name of a serovar is given as, for example, Salmonella enterica subsp. enterica
serovar Typhimurium, but can be abbreviated to Salmonella Typhimurium.
Super kingdom: Bacteria
Kingdom: Bacteria
Phylum: Proteobacteria
Class: Gammaproteobacteria
Order: Enterobacteriales
Family: Enterobacteriaceae
Genus: salmonella
Species: S. bongo, S. enterica
MORPHOLOGY OF SALMONELLA

Picture 2: Salmonella

Salmonella are non-spore-forming, predominantly motile enterobacteria 0.7 to 1.5 m wide,

lengths from 2 to 5 m long.

They has peritrichous flagella all around the cell body.

They obtain their energy from oxidation, hence are chemoorganotrophs.

They are facultative anaerobes as they also obtain energy from reduction reactions using
organic sources, and are facultative anaerobes.

They are Gram negative and rod shaped bacteria

They are non spore forming and non capsulated bacteria

Many of them posses fimbriae.

Grow readily on simple media.

EPIDEMIOLOGY OF SALMONELLA

Salmonella are found worldwide in both cold-blooded and warm-blooded animals, and in the
environment.

Salmonella are primarily intestinal parasites of humans and many animals including wild
birds, domestic pets and rodents; they may be isolated from their blood and internal organs.

Found frequently in sewage, rivers and other waters and soil in which they do not multiply
significantly.

Under suitable conditions they may survive in waters and for years in soil

Have been isolated from many foods, vegetables and fruit and are important contaminants of
animal protein feed supplements.

CHARACTERITICS OF SALMONELLA

They can multiply under various environmental conditions outside the living hosts so they

are non-fastidious.
They do not require sodium chloride for growth, but can grow in the presence of 0.4 to 4%.
Most Salmonella serotypes grow at temperature range of 5 to 47C with optimum
temperature of 35 to 37C but some can grow at temperature as low as 2 to 4C or as high as

54C
They are sensitive to heat and often killed at temperature of 70C or above.
Salmonellae grow in a pH range of 4 to 9 with the optimum between 6.5 and 7.5.
Many strains are protrophic which are capable of growing on a glucose - ammonium
minimal medium while some are auxotrophic that require enrichment of some amino acids

and/ or vitamins on minimal medium , most Typhi strains require Tryptophan.

Grow on simple media nutrient agar.

SALMONELLA AS PATHOGENS

Salmonella species are facultative intracellular pathogens. They can be divided into two groups
typhoidal and nontyphoidal Salmonella serovars. These are as follows:-

Nontyphoidal Salmonella serovars:-

They are most common. They cause self-limiting gastrointestinal disease such as diarrhea They
can infect a range of animals. They are zoonotic, that can be transferred between humans and
other animals. Infection with nontyphoidal serovars of Salmonella will generally result in food
poisoning. Infection usually occurs when a person ingests foods that contain a high concentration
of the bacteria. This disease is most common in infants and young children.
Pathogenesis of gastrointestinal disease
Sight of infection is the small or large intestine. Nontyphoidal serovars preferentially enter M
cells on the intestinal wall by bacterial-mediated endocytosis, a process associated with intestinal
inflammation and diarrhea. They are also able to disrupt tight junctions between the cells of the
intestinal wall, impairing their ability to stop the flow of ions, water and immune cells into and
out of the intestine. The combination of the inflammation caused by bacterial-mediated
endocytosis and the disruption of tight junctions is thought to contribute significantly to the
induction of diarrhea.

Typhoidal Salmonella serovars:-

Typhoidal serovars include Salmonella Typhi and Salmonella Paratyphi A, which are adapted to
humans and do not occur in other animals. Typhoid fever is caused by Salmonella serotypes
which are strictly adapted to humans or higher primatesthese include Salmonella Typhi,
Paratyphi A, Paratyphi B and Paratyphi C. These causes illness such as Typhoid fever,
Paratyphoid fever and food borne illness.
Pathogenesis of typhoidal salmonella infection:Salmonellae are also able to breach the intestinal barrier via phagocytosis and trafficking by

CD18-positive immune cells, which may be a mechanism key to typhoidal Salmonella infection.
This is thought to be a more stealthy way of passing the intestinal barrier, and may therefore
contribute to the fact that lower numbers of typhoidal Salmonella are required for infection than
nontyphoidal Salmonella. Salmonella are able to enter macrophages via macropinocytosis. In the
systemic form of the disease, salmonellae pass through the lymphatic system of the intestine into
the blood of the patients (typhoid form) and are carried to various organs (liver, spleen, kidneys)
to form secondary foci (septic form). Endotoxins first act on the vascular and nervous apparatus,
resulting in increased permeability and decreased tone of the vessels, upset thermal regulation,
vomiting and diarrhea. In severe forms of the disease, enough liquid and electrolytes are lost to
upset the water-salt metabolism, decrease the circulating blood volume and arterial pressure, and
cause hypovolemic shock. Septic shock may also develop. Shock of mixed character are more
common in severe salmonellosis. Oliguria and azotemia develop in severe cases as a result of
renal involvement due to hypoxiaand toxemia.

SYMPTOMS OF SALMONELLA

Lethargy.
Anorexia.
Diarrhea.
In chronic cases

Arthritis may be present.

With high dose infections:

Excessive thirst.
Conjunctivitis.
Indications of liver, spleen, kidney or heart damage can occur.

TRANSMISSION VEHICLES FOR SALMONELLA

Picture 3:- Transmission vehicles for Salmonella

Salmonella are widely distributed in nature and they survive well in a variety of foods.
Poultry, eggs and dairy products are the most common vehicles of salmonellosis. In recent
years, fresh produce like fruits and vegetables have gained concern as vehicles of

transmission where contamination can occur at multiple steps along the food chain.
Environment contaminated with Salmonella serves as the infection source because

Salmonella can survive in the environment for a long time.

Salmonella is transmitted by vectors such as rats, flies and birds.

Following the direct transmission, moving animals such as swines, cows and chickens act as
the important risk factor for infection. These animal reservoirs are infected orally because
Salmonella normally originates from the contaminated environment and also contaminated

feed.
Human get infected when eating the food or drinking the water that is contaminated with

Salmonella through animal reservoirs.

Spread of Salmonella may be facilitated in water storage tanks in a building, from wild

animal feces or even from carcasses.

Poor sanitation, improper sewage disposal and lack of clean water system cause the
transmission of typhoid fever. Water from lakes or rivers which are used for public

consumption are sometimes contaminated by raw sewage are the main sources of infection.
Aggravated by widespread use of animal feeds containing antimicrobial drugs that favor

proliferation of drug-resistant salmonellae and potential transmission to humans.

Salmonella is transferred from contaminated eggs to uninfected baby chicks during the

hatching process.
The bacterium is shed from an infected bird in: Nasal and or ocular secretions, Fecal material
or Feather dust. This dust or aerosol contaminates the air that is then inhaled by another
possible host. Transmission may be primarily through the air. Salmonella spp. are mainly
transmitted by the fecal-oral route.

DIAGNOSIS
Diagnosis of Salmonella can be done by following ways:

BLOOD CULTURE :-

90% isolation in first week, Bone Marrow culture 100% in First week .Adults 8 ml to10 ml and
in Children 3 ml to 4 ml. Site of Venupuncture swabbed with 70% Alcohol and 1% Iodine for 03
minutes.5-10 cc blood collected in Syringe is injected through the stopper aseptically in Blood
culture bottle with 50 ml. of BHI (Brain Heart infusion).

WIDAL TEST:

2nd week onwards, 3 cc clotted blood is taken serum separated. Antibodies in patients serum
against O, H, and Vi (virulence antibody) are looked for by an agglutination reaction known as

widal test. Antigens like TO, TH. AO, AH, BO, BH are used. Serial dilution in 07 test tubes
are made of the patients serum: and mixed with antigen to look for agglutination reaction.
Increase in O titer means active infection. Increase in H titer means Past infection or vaccination.
Vi antibody is present in carriers.

Faeces & Urine Culture:-

In 2nd and 3rd week, Culture on Mac Conkeys medium, use Enrichment medium like
tetraethionite broth are used.

Other tests:-

TYPHIDOT Ig G and Ig M tests are looked for.

TREATMENT
Treatment of salmonella infections is more successful if salmonella species is first determined.
Once the particular species of salmonella has been identified, the appropriate antibiotic can be
administered. Take following antibiotics such as:- Chloramphenicol , Ampicillin or
Trimethoprim Sulfamethoxazole ,Ciprofloxcin and Norfloxacin . Vaccines are available for
typhoid fever and are partially effective, especially in children. Initially TAB Acetone killed
vaccine. Now oral live attenuated vaccine by brand name VIVOTIF is given. Researchers say
they have paved the way toward an effective Salmonellavaccine by identifying eight antigenic
molecules from human and mouse infections. These antigens provide the research community
with a foundation for developing a protective salmonella vaccine.

INCIDENCES OF OUTBREAK OF SALMONELLA:-

Following outbreaks of Salmonella were observed. These are:-

Alexander the Great died mysteriously in 323 B.C. In 2001, a group of doctors at the
University of Maryland suggested that Salmonella was the cause of death, based on a
description of Alexanders symptoms written by the Greek author Arrian of Nicomedia.

Picture 4:- Alexander

Scholars working on the history of Jamestown, Virginia, believe that a typhoid outbreak was
responsible for deaths of over 6,000 settlers between 1607 and 1624.

Picture 5:- Jamestown

Prince Albert, the consort of Queen Victoria, died of a Salmonella infection in 1861. During
the Victorian era, an estimated 50,000 cases per year occurred in England

Picture 6:- Prince Albert

During The South African War (1899-1902), more soldiers suffered from typhoid fever than
from battle wounds. British troops lost 13,000 men to typhoid, as compared to 8,000 battle
deaths. Outbreak was largely due to unsanitary towns and farms throughout Africa, and
polluted soil was washed into the network of streams and rivers during the rainy season

Picture 7:- British Troops during South African War

Typhoid Mary Mallon was the first famous carrier of typhoid fever in the U.S. She was
hired as a cook at several private homes in the New York area in the early 1900s. Mary
Mallon caused several typhoid outbreaks, moving from household to household, always
disappearing before an epidemic could be traced back to the particular household Mary was
working in. She had worked for 7 families, with 22 cases of typhoid and one death. She was
finally overtaken by the authorities in 1907 and committed to an isolation center on North
Brother Island, NY. There she stayed until she was released in 1910, on the condition that
she never accepts employment involving food handling. But she was found to work as a cook
and to cause typhoid outbreaks again. She was admitted back to North Brother Island, where
she lived until her death in 1938.

Picture 8:- Marry Mallon

In 1985,A salmonellosis (S. typhimurium) outbreak occurred involving 16,000 confirmed

cases in 6 states by low fat milk and whole milk from one Chicago dairy farm. This is the
largest outbreak of food-borne salmonellosis in U.S. Investigations discovered that

accidentally mixixing of raw and pasteurized milk was reason for this outbreak.
In September 1984, 10 area restaurants in the Dalles, Oregon, were involved with outbreaks

of S. typhimurium.
Contamination of eggs and particularly egg contents by S. Enteritidis are believed to be a

cause of the large outbreak in Europe and North America in1980s.

In 1997, the consumption of unboiled water results in typhoid outbreak in
Dushanbe,Tajikistan . This outbreak had caused 2200 cases of illness and 95 deaths.