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[Salmonellosis: retrospective study of 136 cases hospitalized at the C.H.U. of Tours].

136 cases of salmonellosis were seen in the Tours Hospital Center from 1965 to 1971. Salmonella typhi produced 32 cases of typhoid fever and 2 focal infections: a bacterial pleural effusion and an osteoarthritis. Salmonella para B induced 16 cases of typhoid fever. All these 50 patients were given chloramphenicol that was effective in vitro and in vivo as well. They usually exhibited very few and mild signs or symptoms but long lasting fever. Complications were very rare. There was no death. Paradoxically, the 86 "minor" salmonellosis (i.e. caused by other Salmonella species than S. typhi, S. paratyphi A, B or C) exhibited a much more overt symptomatology. Though all the "major" salmonellosis occurred in previously healthy patients and caused no death, the "minor" salmonellosis occurred mostly in seriously ill patients and had a lethal outcome for 5 out of 86. There was no typhoid fever epidemic in Touraine during recent years. Lysotyping ruled out the hypothesis of an endemic local reservoir. On the other hand, two hospital outbreaks of "minor" salmonellosis were recognized: one in a psychiatric ward due to S. java in 1967, the other in a pediatric ward due to S. wien in 1971-1972 respectively.

Adolescent

[Current aspects of human salmonellosis in Upper Volta. Study carried out at Centre Muraz (Bobo-Dioulasso) from 1966 to 1977: isolation of 1,013 Salmonella strains].

In a long term research programme of Centre Muraz a study on salmonellosis in Upper Volta has been carried out, at Bobo-Dioulasso, from 1966 to 1977. Investigations have been executed at Centre Muraz, at Bobo-Dioulasso hospital and at Ouagadougou hospital. All the strains of Salmonella were collected at Centre Muraz by biology laboratory, which is a reference service for Upper Volta. This country is include; among the 32 countries which collaborate with W.H.O. and are involved in the world epidemiological surveillance of salmonellosis. For twelve years, 1.013 Samonella strains have been isolated : 1.002 from man and only 11 from animals. The study, which is presented, deals with human salmonellosis. These diseases have been considered from several points of view : bacteriology, clinic, treatment and epidemiology. The various origins of these strains have been specified. The different technics used for diagnosis are discussed briefly : hemoculture (for typhoïd fever and few other types of salmonellosis), coproculture (for "minor" salmonellosis) are the most common and useful methods. Among the 1.013 which have been found, S. typhi is highly predominant (67 p. 100). In the other hand, S. dublin and S. typhi murium play an important role in the various serotypes which occured. A total of 76 serotypes, already known elsewhere, but found for the first time in Upper Volta, have been observed. Three new serotypes have been described : S. bobo, S. kua and S. farakan. As far as clinical problem is concerned, two main aspects are frequent : either typhoid fever syndrome (caused by S. typhi and, scarcely, by other germs, like S. dublin) or gastrointestinal infections, which present different forms and are more or less severe. Up to now, one single strain of S. typhi murium, suspected to be resistant to chloramphenicol has been isolated in 1977. Such a problem would need more complete research in a reference centre. Otherwise, no epidemic multiresistance has been observed. Checking strictly all the strains by systematic antibiograms is now absolutly essential in the plan of a steady epidemiological surveillance.

Adult

[Post-salmonellosis rheumatism].

Reports of forty-six cases of aseptic polyarthritis following intestinal Salmonlla infections have been published. The organism involved is always a "minor" Salmonella either typhimurium or enteritidis. The interval separating the diarrhoea from the joint manifestations is usually one or two weeks. Post-salmonellosis rheumatism is most frequently polyarthritis involving the large joints accompanied by fever that is sometimes high. The sedimentation rate is increased and hyperleucytosis and discrete anaemia may also be present. Salmonella infection is established by the presence of the organism in the stools and a positive sero-diagnosis. In all cases the polyarthritis is cured by anti-inflammatory treatment in 1-6 months. HLA W27 antigen is present in the majority of the patients although spondylarthritis is not seen during the evolution. Although the number of cases of post-salmonellosis rheumatism is very small and the connection between the salmonellosis and the rheumatism has not been demonstrated, it is valuable, in cases of acute polyarthritis following enteritis, to carry out coproculture and serodiagnosis of salmonellosis.

Adolescent

The significance of the serotype in the clinical and pathological features of naturally occurring porcine salmonellosis.

Salmonellosis was the diagnosis in 63 of 327 consecutive porcine necropsy accessions during a one year period in Indiana, an incidence four to ten times that previously reported in other areas. A herd outbreak was usually either a septicemic disease characterized by sudden mortality. Little overlap between these two syndromes were seen. Animals dying with the septicemic form usually yielded Salmonella choleraesuis var. kunzendorf on culture. Salmonella typhimurium was the usual isolate from cases of enteric salmonellosis. Oral inoculation of SPF pigs with S. typhimurium resulted in a disease similar to naturally occurring enteric salmonellosis. The pathology of porcine salmonellosis due to S. typhimurium is described.

Acute Disease

[Salmonellosis in children in Ivory Coast, (A study on 69 cases) (author's transl)].

Salmonellosis are still endemic in Ivory Coast. In 1975 they were responsible for 1,75 p. 100 of the admittances in the pediatric department of Treichville University Hospital. In children, the conventional distinction between major and minor salmonellosis is not always obvious. Interpretation of Widal sero-diagnosis is often difficult and awkward. Chloramphenicol generally leads to satisfactory evolution. Salmonellosis are still a problem for Public Health Service. Immunization, is the only effective prophylaxis, but is not carried out yet in Ivory Coast.

Adolescent

[Salmonellosis in Dakar: bacteriological, clinical, epidemiological and therapeutic aspects. Ten years records (author's transl)].

A study on salmonellosis in Senegal has been carried out in Dakar at the University Hospital of Fann from 1966 to 1976. The authors describe the various methods of isolating the germs (mainly hemoculture and coproculture) and the techniques used for bacteriological research (antibiograms, tests on plasmidic resistance). The results of these investigations, which took the whole of 10 years, are presented below, in accordance with their different aspects: - bacteriological: 1 335 strains of Salmonella have been isolated. Significantly, S. typhi is predominant (56,6 p. 100). But 7 serotypes represent 90 p. 100 of the total strains which are now in existence in Dakar; - clinical: the aspects of these diseases vary: typhoïd fever, encephalitis, diarrheic syndrome, especially among infants, and purulent meningitis, which is generally severe; - therapeutic: 880 strains have been tested with 10 antibiotics. Two groups of Salmonella serotypes are opposed: those which are sensitive (S. typhi, S. typhi murium, S. enteritidis, S. paratyphi C), those which have become resistant (S. stanleyville, S. havana, S. ordonez). The most frequent antibiotype of this kind is ASKCTSu. This is a phenomenon of plasmidic resistance, demonstrated by in vitro experiments; - epidemiological: the lysotypes of 86 strains have been determined. Two epidemiological features must be described: either a stable endemic situation with sensitive strains - or epidemics, lasting several years, with resistant serotypes. Different therapeutic schemes can be used: chloramphenicol for typhoid fever, or sometimes cotrimoxazole, or ampicillin for meningitis. In diarrheic syndrome, symptomatic treatment is enough. Then, the authors give their comments on the special characteristics of salmonellosis in Dakar: - the influence of environment on the various clinical aspects of these diseases: very serious cases of meningitis, typhoid fever, which is more severe than in France, and complications when treatment has gone wrong at the beginning; - antibiograms, which are essential, in order to choose the adequate therapeutics; - and the different aspects of epidemillogy, which are linked to the sensitivity of the serotypes to the most active antibiotics. The existence of several resistant serotypes in Senegal is a real danger: plasmidic resistance could be transferred to S. typhi. In such a situation, epidemiological surveillance of salmonellosis is absolutely necessary, and control of enteric diseases, characterized by foecal transmission, must be carried out, with the techniques available in the country.

Anti-Bacterial Agents

[Studies on Salmonellosis in the calf. 5. Clinical testing of Smd-Salmonella-dublin vaccine for oral administration].

The oral vaccine, prepared on the basis of streptomycindependent mutants for administration to control S.-dublin infection, was clinically tested on 2,210 calves of 22 herds. The experimentally obtained findings regarding good tolerance and sufficient effectiveness of oral live vaccines were thus confirmed under field conditions. Good effectiveness of the oral vaccine was reflected in the recorded decline of clinical salmonellosis cases and of calf losses due to salmonellosis, and it was established also by bacteriological identification of S. dublin in faecal samples, histological sections, and material obtained from emergency slaughter carcasses. A comparison between this oral vaccine and "Mellavax" an imported vaccine for subcutaneous adminstration with good effectiveness, revealed superiority of the oral vaccine by almost all criteria of action. Particular importance was attributed to the significant reduction of the number of Salmonella-excreting animals (faeces) following oral immunisation. The oral vaccine against Dublin salmonellosis of calf was disembargoed for production in 1975 under the name of "Salmonella-dublin Live Vaccine Dessau".

Administration, Oral

Salmonellosis in children with cancer: review of 42 cases.

Forty-two episodes of culture-proved salmonellosis were found retrospectively among 2,262 patients treated for malignant diseases at St Jude Children's Research Hospital, Memphis. These cases were reviewed in an effort to determine whether Salmonella infections in childhood cancer patients are associated with an increased frequency of septicemia and death, as has been reported for adults with cancer. Septicemia occurred in only 10% of the patients studied, consistent with the frequency established in general populations. There were no deaths attributable to Salmonella infection. Most of the patients (57%) with salmonellosis had gastroenteritis, and the clinical course of this syndrome was no more severe or prolonged than that seen in otherwise normal children. We recommend that management of Salmonella infections in children with cancer follow presently accepted guidelines for normal hosts.

Adolescent

Prevalence of intestinal parasitic infestation, salmonellosis, brucellosis, tuberculosis, and hepatitis B among immigrant children in Glasgow.

Two hundred Asian and 100 each of African, Chinese, and Scottish children were screened for intestinal parasitic infestations, salmonellosis, brucellosis, hepatitis B antigen (HBsAg), and tuberculosis. There was a fairly high incidence of Giardia lamblia among Asian and Scottish children and of Trichuris trichiura among the Chinese. Hookworm ova were seen only in Africa children. There were no chronic carriers of Salmonella or Brucella, and no one was suffering from salmonellosis or brucellosis. Tuberculin sensitivity was found in only 4% of immigrant and 1% of Scottish children: the difference was small and neither figure suggests a continuing high incidence of tuberculosis in Glasgow. Only seven immigrant children were found to be HBsAg carriers. Among the families of these carriers there was a high incidence (84%) of HBsAg or antibody (HBsAb). The survey shows that immigrant children in Glasgow do not constitute a health hazard to the indigenous population. Moreover, severe overcrowding is not a prominent feature among the immigrant families in Glasgow but is greatest among the local Scots.

Adolescent

A large outbreak of foodborne salmonellosis on the Navajo Nation Indian Reservation, epidemiology and secondary transmission.

In September 1974, the largest outbreak of foodborne salmonellosis ever reported to the Center for Disease Control--affecting an estimated 3,400 persons--occurred on the Navajo Nation Indian Reservation. The responsible agent was Salmonella newport and the vehicle of transmission was potato salad served to an estimated 11,000 persons at a free barbecue. The cooked ingredients of the potato salad had been stored for up to 16 hours at improper holding temperatures. The magnitude of the outbreak allowed us to study secondary transmission by calculating the rates of diarrheal illness during the 2 weeks following the outbreak in persons who did not attend the barbecue and by examining the results of stool cultures obtained after the outbreak. We found no secondary transmission. We conclude that a health official should monitor food preparation and service at large social gatherings and that person-to-person transmission of salmonellosis probably does not normally occur even in settings considered highly conductive to cross-infection.

Adolescent

Prevalence and epizootiology of equine salmonellosis.

Feces from 1,451 horses entering a veterinary hospital over a 13-month period were cultured for salmonella. A total of 46 horses (3.2%) yielded 1 or more salmonella-positive fecal cultures. Twenty horses were found to be excreting salmonella in the feces on admission, and 5 of these later had severe diarrhea associated with enteric salmonellosis. Abdominal surgery and other severe stresses were associated with all cases of severe enteric salmonellosis. Serotypes of salmonella isolated included Salmonella agona (15), S anatum (14), S typhimurium (7), S typhimurium var copenhagen (4), S infantis (2), S montevideo (1), S meleagridis (1), S drypool (1), and an unnamed Salmonella serotype (1). Seven deaths were attributed to 4 serotypes (S typhimurium, 3; S anatum, 2; S typhimurium var copenhagen, 1; and S montevideo, 1). A marked seasonal incidence is isolations was found with isolations highest in later summer to early fall and lowest in the spring. It was also found that horses can shed salmonella intermittently, and a minimal of 5 consecutive negative fecal cultures is recommended before considering a horse not to be infected with salmonella.

Animals

[Ulterior acquisitions regarding the salmonellosis (author's transl)].

The Authors report the results of the bacteriological researches on the incidence of the Salmonella of our zone, after a brief consideration of general aspects salmonellosis. Our observations are refered to 1005 samples of feces of which 84 cases proved positive to Salmonella. It is pointed out that morbidity, represented by Salmonella typhi, paratyphi A and B is low, while it is high for the Salmonella typhimurium and Salmonella enteritidis. The Authors conclude stating that epidemiological situation of salmonellosis still represents a problem of remarkable importance which demands the intensification and the use of efficacious measures of prophylaxis.

Disease Outbreaks

Immunization of calves against salmonellosis.

Salmonella typhimurium bacterins, containing adequate antigenic mass, protected calves against clinical signs of salmonellosis and death. Protection against salmonellosis was correspondingly reduced when the bacterin was diluted 1:10 and 1:100. A mouse protection test revealed that 17 of 18 (94%) of the S typhimurium-containing bacterin serials produced in 1977 stimulated adequate immunity.

Administration, Oral

Injury of liver in experimental salmonellosis of rabbits infected by salmonella agona.

Liver injury was investigated in the course of salmonellosis evoked by Salmonella agona in experimental infection of rabbits. Histological and biochemical examination (proteinogram, the level of bilirubin, fibrinogen, cholesterol and its esters in blood, activity of asparine and alanine aminotransferases and alkaline phosphatase and guanase in blood) were carried out in 70 animals. Liver injury showing degeneration, steatosis and necrosis was found in the course of salmonellosis. Hepatitis gigantocellularis was sporadically observed. Biochemical parameters were not in correlation with the observed histological changes.

Animals

Salmonellosis in Equidae: a study of 23 cases.

Salmonellosis in Equidae is a serious global problem. The prevalence may range from 0.36% to 27%. Probably 5% to 10% of the equine population in the U.S. is or has been infected. Over 40 serotypes of Salmonella have been cultured from Equidae. S. typhimurium (66.31%), S. enteritidis (9.6%), S. newport (5.16%) and S. heidelberg (4.89%) have been the most common equine isolates. The clinical and bacteriological studies of 23 naturally occurring infections in a large veterinary hospital were studied. Nine patients were infected with S. typhimurium, 8 with S. anatum, 1 with S. newport, 4 with dual serotype infections (3-S. typhimurium/S. anatum and 1 S. anatum/S. newington) and 1 untyped Salmonella. The roles of physical, surgical and environmental stress factors were analyzed. The fecal shedder state persisted for over 3 1/2 months. Feces of a foal contained 10(5) salmonella per gram. Salmonella were isolated from the feces of horses during and following antimicrobial therapy regimes. Supportive and symptomatic treatment as well as good nursing care are imperative in handling cases of equine salmonellosis.

Animals

Salmonellosis associated with homemade ice cream. An outbreak report and summary of outbreaks in the United States in 1966 to 1976.

During the period 1966 to 1976, 22 outbreaks with 292 individual cases of salmonellosis associated with the consumption of homemade ice cream were reported to the Center for Disease Control. Salmonella typhimurium accounted for 45% of the outbreaks. The source of eggs used was known in 13 outbreaks, and all were ungraded farm- or home-produced eggs, a potential source of salmonellae. In 11 outbreaks, the method of preparation was known, and in all, the ice-cream custard had not been cooked before freezing.

Adolescent

Studies on oral adjuvants against murine salmonellosis.

1) Attempts were made to develop oral adjuvants against murine salmonellosis. 2) Streptomycin, levamisole and PHA show potential immunoenhancing properties against salmonella infection. 3) The mode of action of these agents remain to be elucidated. Observed results of PHA enhancement may be related to its blastogenic effects in the splenic T-cells. 4) Decrease in certain bacterial flora resulting in less antigenic competition may be the mode of action of streptomycin as adjuvant when added to oral salmonella vaccine.

Adjuvants, Immunologic

Colonic involvement in salmonellosis.

Although small intestine is generally regarded as the principal site involved in human salmonella infection of food-poisoning type, the pathophysiology of salmonella diarrhoea remains obscure. A sigmoidoscopic and biopsy study of 23 hospital inpatients with acute salmonella infection revealed presence of active colitis in 21. It is suggested that colonic involvement is common in human salmonellosis and probably plays an important role in the causation of diarrhoea.

Adolescent