Salmonella illness on rise in North Carolina

Public health officials give tips on prevention

Nearly five times as many cases of the food-borne illness Salmonella enteritidis have been detected by the State Laboratory of Public Health so far this year as compared to the first six months in 2004. The Lab has detected more cases of the bacterial infection this year to date than in the past three years put together for the same time period, indicating a troubling rise in S. enteritidis cases statewide.

Surrounding states are experiencing similar increases in Salmonella enteritidis. North Carolina’s divisions of Public Health and Environmental Health are working with other agencies here and in those states, as well as with the U.S. Centers for Disease Control (CDC), to halt the rapid increase of S. enteritidis. No common source has yet been identified for the North Carolina outbreak, so health officials are continuing their investigation. However, recent outbreaks of the illness in nearby states have largely been associated with eggs, as have several of North Carolina’s previous outbreaks. Beef, poultry, and unpasteurized (raw) milk have also been associated with outbreaks of this type of Salmonella.

Salmonella enteritidis causes fever, nausea, abdominal cramps and/or diarrhea usually beginning 12 to 72 hours after eating food or drinking a beverage contaminated with the bacteria. Symptoms can appear as early as six hours after eating contaminated food. Most people become ill enough to see a doctor, and some people must be hospitalized, a few with life-threatening complications.

Eggs can be an important source of nutrition. However, Salmonella bacteria can be found inside seemingly normal eggs. When those eggs are eaten raw or undercooked, the bacteria can cause sickness and even death. But, people can do a lot to prevent Salmonella infection. Proper handling and storage of eggs help prevent bacterial growth, and thorough cooking destroys the bacteria.

To avoid egg-borne Salmonella illness, follow these food-safety rules when buying, storing, preparing, serving and eating eggs.

• Don't eat raw eggs or foods containing raw eggs, like cookie dough, blender drinks, homemade mayonnaise, or homemade ice cream (don’t even lick the bowl!). Instead, use a pasteurized liquid egg product or pasteurized in-shell eggs if the food will not be cooked before eating.
• Buy clean eggs. Choose Grade A or AA eggs with clean, uncracked shells. Open the carton before you buy and make sure that the eggs are clean, not cracked, and have been refrigerated in the store. Any bacteria present in an egg can multiply quickly at room temperature. Don't wash eggs.
• Keep eggs refrigerated. Store eggs in their carton in the coldest part of the refrigerator, not in the door, and use within three to five weeks. The refrigerator should be set at 40°F (5°C) or slightly cooler. Don't leave cooked eggs out of the refrigerator for more than two hours. When baking or cooking, take out the eggs you need and return the rest to the refrigerator. Keep hard-cooked eggs in the refrigerator, not at room temperature, and use them within one week.
• Freeze eggs for longer storage: break the eggs, beat the yolks and whites together, and put in a freezer container. Egg whites can be frozen alone. Use frozen eggs within one year.
• Cook eggs until yolks are firm. Many cooking methods can be used to cook eggs safely, including poaching, hard cooking, scrambling, frying and baking. If you prefer soft-cooked eggs, use pasteurized in-shell eggs (available in some supermarkets) or a pasteurized liquid egg product. Casseroles and other dishes containing eggs should be cooked to 160°F (71°C) as measured with a food thermometer. Serve cooked eggs and dishes containing eggs immediately after cooking, or place in shallow containers for quick cooling and refrigerate at once for later use. Use within three or four days.
• Cleanliness is very important. Wash hands, utensils, equipment and work areas with warm, soapy water before and after contact with eggs and egg-rich foods. Hands should also be thoroughly washed after using the bathroom and after touching pets, especially reptiles, as animals can also carry the bacteria.

Illness caused by Salmonella enteritidis usually lasts four to seven days, and most persons recover without antibiotic treatment. However, the diarrhea can be severe, and some people may become ill enough to require hospitalization. Very young children, the elderly and people with compromised immune systems have an increased risk of developing serious illness, and should visit a health care provider immediately if they develop these symptoms. In these patients, the infection may spread from the intestines to the blood stream and then to other parts of the body, and can cause death unless the person is treated promptly with antibiotics.

For more information on food safety, visit the U.S. Food and Drug Administration’s Food Safety Web site at www.foodsafety.gov/~fsg/eggs.html. To find out more about Salmonella, visit the CDC Web site at www.cdc.gov.

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Last Modified: June 29, 2005 June 30, 2005