THE CHALLENGE OF SALMONELLOSIS: MAJOR PUBLIC HEALTH PROBLEM

Bilateral salmonella salpingo-oophoritis

A previously healthy nulliparous caucasian female presented with lower abdominal pain and a history of diarrhoea and vomiting for 2 weeks. Repeated stool examinations and blood culture were negative. A lump in the lower abdomen became more apparent over the next 2 weeks and a subsequent laparotomy revealed bilateral tubo-ovarian abscess formation. One ovary which was endometriotic and both the tubes were excised and the pus yielded a heavy growth of Salmonella stanley.

Porcine pancreatin as a source of salmonella infection in children with cystic fibrosis

Contamination of a powdered preparation of pancreatin with Salmonella schwarzengrund and S. eimsbuettel resulted in the infection of at least 31% of one group of paediatric patients with cystic fibrosis. The pancreatin contained very small numbers of Salmonellae, the infecting dose in at least one child being less than 44 organisms. More stringent bacteriological standards are needed for pharmaceuticals and foods used by paediatric patients.

Small pet aquarium frogs as a source of Salmonella

Salmonellae were isolated from 21% of the samples of freshwater aquarium frogs tested and from 25% of the samples of aquarium water containing these frogs. The salmonellae were Salmonella arizonae, S. bovis-morbificans, S. hadar, S. saint-paul, S. typhimurium, and S. worthington. These isolations were made over a period of 9 months and from three different cities. This association of salmonellae with frogs may contribute to cases of human salmonellosis since other aquarium species have already been shown to contribute to such cases.

Incidence of salmonella infection in animals in England and Wales 1968--1974

Of a total of 23,609 incidents of salmonella infection reported during the period 1968--74, 20,326 occurred in cattle, 1744 in poultry and other birds, 675 in sheep, 558 in pigs and 306 in other species of animals. Despite the large number of serotypes isolated (153), 88% of incidents were due to only two stereotypes: S. dublin (15,929 incidents of which 15,446 occurred in cattle ) and S. typhimurium (4842 incidents of which 3785 occurred in cattle and 732 in birds). S. choleraesuis was the third (314 incidents which with only 5 exceptions occurred in pigs) and S. abortusovis (243 incidents all in sheep) was the fourth most commonly isolated serotype. The following six serotypes were each recorded in more than 100 incidents: S. newport (177), S. agona (170), S. virchow (169), S. anatum (152), S. enteritidis (150) and S. montevideo (111). The other 143 serotypes accounted for only 5-8% of total incidents. The trends of annual incidence of salmonella infection in cattle, sheep, pigs, poultry and other birds during the 17-year period 1958-74 and the distribution of the main serotypes in the individual species of animals from 1968 to 1974 are discussed.

Isolation of salmonellae and other potential pathogens from the freshwater aquarium snail Ampullaria

The freshwater aquarium snail (Ampullaria spp.) was demonstrated to carry as many as 10(8) viable mesophilic bacteria per g of meat plus shell. Some 16 genera of bacteria were identified, with gram negatives predominating. Enrichment culture techniques enabled the isolation of salmonellae from 24 to 42 lots of 200 g each. The salmonellae comprised eight different serotypes, including Salmonella newport, Salmonella saint-paul, and Salmonella infantis. This association of salmonellae with snails may contribute to cases of human salmonellosis, since other aquarium species have already been shown to contribute to many such cases. The snails were also found to commonly harbor Pseudomonas aeruginosa and, occasionally, Edwardsiella tarda.

Canine salmonellosis: A review and report of dog to child transmission of Salmonella enteritidis

Dogs have been shown to harbor 53 salmonellae serotypes. Multiple simultaneous infections with 2 to 4 serotypes have been observed. The prevalence of canine salmonellosis may be a high as 27 per cent. Salmonella typhimurium and S. anatum are the most common etiologic agents. Dogs commonly experience a sub-clinical course of salmonellosis. Some investigators state that the dog may serve as a source of human infections. A few reports in the literature have documented this fact. The transmissions of S. enteritidis from dog to child is described in this article.

A bacteiological assessment of meat, offal and other possible sources of human enteric infections in a Bantu township

1. From the Municipal abattoir, specimens of liver, spleen, lymph node, surface meat, bile and faeces from a sheep and a bovine, were examined fortnightly for 14 months for the presence of possible pathogenic bacteria. The results suggest that slaughtering procedures are satisfactory.

2. Offal, consisting mainly of tripe and intestine, is eaten in large quantities by the Bantu population and is both nutritious and economical. The high incidence of salmonella isolations in the tripe (48%) and intestines (29%), and faecalE. coliandCl. welchii, show that this commodity is distributed in an inadequately cleansed condition.

3. FaecalE. coliwas isolated from 86% of samples of sour milk collected from street pedlars.

4. Dog faeces collected from the township pavements yielded 21% salmonellas, and faeces from fowls sold live by shopkeepers 14%.

5. From the offal specimens,S. typhimurium(23%) andS. london(18%) were the salmonella types most frequently isolated.S. dublinwas isolated on only one occasion.

6. Throughout the survey no shigellas were isolated.

7. The significance of theCl. welchii, coagulase positiveStaphylococcus aureusandB. cereusisolations from the various specimens tested is not known.

8. It is emphasized that although there is a definite need for improved treatment of the offal before distribution to the consumer, the resulting increase in cost must not be such as to deprive the population of this important source of protein.

We wish to thank the Director of this Institute, Professor J. H. S. Gear, for permission to publish this paper, Dr P. J. Meara, Director of the City of Johannesburg Abattoir and Livestock Market Department for facilities granted, and Mr C. J. Franklin for collecting all the abattoir specimens. Our thanks are also due to Dr A. Smith, Medical Officer of Health, and Dr I. H. F. Spencer of the Johannesburg City Health Department for help and advice; to Mr A. J. MacG. Bryce for collecting all the specimens from the Soweto township; to Mrs Leonie Jonk for typing the salmonella organisms and Mr R. G. Robinson for investigating the micro-organisms' sensitivity to antibiotics.

Salmonellae and shigellae in a group of urban South African Bantu school children

1. Faeces from apparently healthy Bantu children from schools in Soweto township near Johannesburg were examined eight times at fairly regular intervals over a period of 1 year.

2. Only fifty-five children were present for all eight investigations and, of these, 36·4% yielded salmonellae and 9·1% shigellae. Taking the group as a whole, 26·2% of the children had salmonella infections and 6·2% shigella infections.

3. Parasites were shown to be present in sixty-four of the 130 children during the period of the investigation.

4. As in other surveys, there were more isolations in summer than in winter.

5.S. labadiandS. typhimuriumwere most frequently isolated, with the group B–E constituting 75% of the total isolations.S. typhi, S. paratyphi A, BandCwere not found.

6. Water supplied to each house by the Johannesburg municipality was of good quality, yet it did not affect the incidence of salmonellosis and shigellosis.

7. In spite of better socio-economic conditions the incidence of salmonellosis is comparable to the two previously mentioned surveys. These findings indicate a lack of instruction on personal hygiene and the importance of public health measures.