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Salmonella

Salmonellosis is an acute infectious disease caused by microbes of the genus Salmonella, occurring mainly with gastrointestinal tract lesions, less often in the form of generalized forms.

Clinical diagnosis

The incubation period with the alimentary route of infection is 12-24 hours, with a contact - 3-7 days.

Gastrointestinal form. Gastritis, enteritis, gastroenteritis. The onset is acute. Fever, epigastric pain, nausea, vomiting. Intoxication (headache, weakness, weakness, anorexia). The stool is liquid, watery, fetid, undigested, dark green in color. Exicosis.

Enterocolitis, gastroenterocolitis, colitis. The onset is acute. Fever, intoxication, nausea, persistent vomiting. epigastric pain. Enlarged liver and spleen. Spasm and soreness of the large intestine. There may be tenesmus. Liquid stool with an admixture of mucus, blood, dark green in the form of “swamp mud”. Prolonged severe toxicosis, less often exicosis, persistent intestinal dysfunction.

Typhoid-like form. The onset is acute. Fever, intoxication. The skin is pale, dry. Cyanosis. Muffling of heart sounds, bradycardia. Thickly coated and thickened tongue, flatulence, infrequent, but persistent vomiting, enlargement of the liver and spleen. Roseolous or roseolopapular rash. The chair is enteric or normal.

Septic form. It develops in newborns and debilitated children. Fever with large daily swings. The clinic depends on the localization of the purulent focus. Pneumonia, purulent meningitis, nephritis, hepatitis, arthritis, enterocolitis.

Nosocomial salmonellosis, especially in young children, is usually more difficult and prolonged, accompanied by significant intoxication and gastroenterocolitis. Toxicodystrophic conditions may develop. In children older than 3 years of age and adults, nosocomial salmonellosis can proceed easily.

Laboratory diagnostics

1. The bacteriological method. From the first days of the disease, a triple (the first - before the start of etiotropic therapy) study of bowel movements is carried out in order to isolate the pathogen. Material for research can also be vomit, gastric lavage, food debris, if a generalized infection is suspected - blood (in the first days of the illness), urine (from the end of the 2nd week), cerebrospinal fluid, sputum. Primary seeding media are selenite (bile broth) or one of the differential diagnostic media for enterobacteria.

2. The serological method. Paired sera are examined in RA and RPHA (with an interval of 7-10 days) in order to detect antibodies and increase their titer.

3. Coprocytoscopy and sigmoidoscopy can judge the nature and localization of the inflammatory process in the intestine.

Activities for patients and contacts

Hospitalization. According to clinical and epidemiological indications.

Isolation contact. Not carried out. Set medical supervision for 7 days to detect recurrent diseases in the outbreak. Workers of food enterprises and persons equated with them, children attending nurseries, kindergartens, as well as orphanages and boarding schools undergo a single bacteriological examination of stool without removal from work and removal from the team.

With the simultaneous occurrence of the disease in several groups of a preschool institution, all children, group personnel, food service workers and all other personnel are examined bacteriologically.
The frequency of the examination is determined by the epidemiologist.

With nosocomial salmonellosis:

- the patient is isolated;

- in case of a group disease (outbreak), a temporary organization of a special department on the spot is possible;

- after removal of the patient hospitalization in this chamber stops

new patients within 7 days;

- contacts remain in the ward and undergo a single bacteriological examination and further clinical observation;

- if 3 or more cases of the disease occur in different rooms or when salmonella is sown from swabs or air in different rooms, the department is closed and all children, mothers and staff are examined.

Such a branch is opened after a complex of anti-epidemic measures is carried out with the permission of TsGSEN.

Statement conditions. Not earlier than 3 days after clinical recovery, normal temperature and stool; negative result of a single bacteriological examination of feces, conducted no earlier than 2 days after the end of etiotropic therapy.

Employees of food enterprises and persons equated with them, children under 2 years old and children attending preschool institutions are discharged under these conditions after a double negative bacteriological examination of the bowel movements.

Admission to the team. After clinical recovery, with the exception of employees of food enterprises and persons equated to them, and children of nurseries and orphanages. These persons are not allowed into the team within 15 days after being discharged from the hospital (they conduct a three-fold bacteriological examination of feces with an interval of 1-2 days). When the pathogen is isolated, the observation period is extended for another 15 days, etc.

Chronic carriers of salmonella are not allowed in nurseries and children's homes, and employees of food enterprises and persons equated with them are transferred to work not related to food.

Bacterial carriers-schoolchildren (including boarding schools) are not allowed on duty at the catering and dining room.

Clinical examination: Workers of food enterprises and persons equal to them, children under 2 years of age and organized preschoolers are observed for 3 months with a monthly study of bowel movements

Specific prophylaxis

Polyvalent salmonella bacteriophage is used for prophylactic purposes according to epidemiological indications to all persons who have interacted with patients or salmonella excretors.

Nonspecific Prevention

Sanitary and veterinary supervision of slaughter of cattle and poultry. Compliance with the rules of storage and preparation of food products. Deratization.
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Salmonella

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