Salmonella Symptoms - Causes, Treatment and Prevention

Salmonella symptoms strike when you are infected with salmonella bacteria. This usually happens through food poisoning although there are other ways you can be infected like through contact with animals. The severity of your symptoms will vary depending on a number of things.

There are at least 2,500 different strains of salmonella. Most cause the same set of symptoms but how ill you are will depend on how big a dose of salmonella bacteria you ingest, how healthy you are and which strain you come up against. Some strains will cause severe illness and some a milder form.

Salmonella Symptoms - Rod Shaped Salmonella BacteriaRod Shaped Salmonella Bacteria

How Common is Salmonella Infection?

Every year 1.2 million people in the USA become ill through being infected with salmonella bacteria, approximately 23,000 of these unlucky people are so ill that they have to be treated in hospital and 450 people will die from their infection.

In the UK approximately 10,000 people each year are diagnosed with gastroenteritis (stomach upsets) caused by salmonella.

We have to remember that many people will have this type of infection without having a diagnosis or it being reported so their cases will not appear in the figures.

What Are The Main Salmonella Symptoms?

  • Diarrhea - The main symptom of salmonella poisoning is diarrhea. Sometimes your diarrhea will contain blood and or mucus but not always.
  • Stomach cramps - Stomach cramps and pain are very common but are not suffered by everyone.
  • Nausea
  • Vomiting (sometimes)
  • Fever (often)
  • Chills (in some people)
  • Aching muscles (in some people)
  • Loss of appetite

How Long Does It Take For Salmonella Symptoms To Show?

If you have been infected with Salmonella you will start to have symptoms 12-72 hours after coming into contact with the bacteria.

If you start to suffer the typical salmonella symptoms then think back to what and where you have eaten just before that time period.

Salmonella Symptoms - Complications

Most people will recover from their infection within a week and will have no further problems but some people will go on to have a disturbed bowel function with persistent diarrhea for many months and some go on to develop irritable bowel syndrome.

It is possible to develop temporary lactose intolerance following a salmonella infection. This means that you will develop bowel symptoms like bloating, gas and pain after eating dairy products, especially milk.

Sometimes the infection can spread to other parts of the body like the gall bladder, joints, the brain or the blood stream. This is very rare however.

Reiter's syndrome or reactive arthritis is an unusual complication which causes arthritis (pain and swelling in the joints), inflammation of the eye and urinary tract, rashes on the soles of the feet and palms of the hands and ulcers, especially on the penis. It is more common in men.

Am I At Risk?

As we have seen some people will need to be treated in hospital but most people will recover from their infection in 4-7 days with no special treatment if they make sure that they do not get dehydrated.

There are some groups of people who are more at risk. The very young, the elderly, pregnant women and people already suffering from other chronic illnesses are more vulnerable.

If you are taking medication which suppresses your immune system, for example if you have had an organ transplant then you are especially at risk.

Typhoid and Paratyphoid Fever A Special Case

Salmonella (enterica) typhi and Salmonella (enterica) paratyphi A B and C deserve a special mention because unlike other strains of the bacteria these infect only humans.

They are passed between humans in crowded unsanitary conditions as the bacteria is found in the feces or blood of infected persons. You are more at risk where water supplies and sewerage are not effectively separated. They cause a more severe illness than other types of salmonella and are often life threatening.

You are more likely to pick up one of these illnesses if you are traveling in underdeveloped countries. For example there are about 5,700 cases of typhoid fever in the USA annually and 75% of them are picked up by travelers in the developing world.

The symptoms normally start between six and thirty days after coming into contact with the bacteria. Diagnosis is by blood and stool tests.

The symptoms of typhoid and paratyphoid fever are similar to a common salmonella infection only more severe and with the addition of:

  • Weakness
  • Headache
  • High fever
  • Constipation (and or diarrhea)
  • Severe abdominal pain
  • Rash with rose colored spots (in some people)

If traveling to a non-industrialized nation it is a good idea to be vaccinated against typhoid. No vaccine exists for paratyphoid but the typhoid vaccine does give partial protection.

Treatment is with fluid replacement and antibiotics.

Do not confuse this with Typhus which is an entirely different infection passed on by fleas and ticks.

Typhoid and Paratyphoid Fever A Special Case

Salmonella (enterica) typhi and Salmonella (enterica) paratyphi A B and C deserve a special mention because unlike other strains of the bacteria these infect only humans.

They are passed between humans in crowded unsanitary conditions as the bacteria is found in the feces or blood of infected persons. You are more at risk where water supplies and sewerage are not effectively separated. They cause a more severe illness than other types of salmonella and are often life threatening.

You are more likely to pick up one of these illnesses if you are traveling in underdeveloped countries. For example there are about 5,700 cases of typhoid fever in the USA annually and 75% of them are picked up by travelers in the developing world.

The symptoms normally start between six and thirty days after coming into contact with the bacteria. Diagnosis is by blood and stool tests.

The symptoms of typhoid and paratyphoid fever are similar to a common salmonella infection only more severe and with the addition of:

  • Weakness
  • Headache
  • High fever
  • Constipation (and or diarrhea)
  • Severe abdominal pain
  • Rash with rose colored spots (in some people)

If traveling to a non-industrialized nation it is a good idea to be vaccinated against typhoid. No vaccine exists for paratyphoid but the typhoid vaccine does give partial protection.

Treatment is with fluid replacement and antibiotics.

Do not confuse this with Typhus which is an entirely different infection passed on by fleas and ticks.


Salmonella Symptoms - Treatment

The main treatment to combat salmonella symptoms is to make sure that you drink clear fluids. Clear broth and sports drinks like Gatorade and Lucozade sport are good because they replace lost salts as well as fluid. Children should have oral replacement fluids like Pedialyte or Dioralyte.

You can eat a normal diet as soon as you feel well enough but eating bland foods or the brat diet for 24-48 hours is a good idea. Children and babies should be given their normal diet with additional fluids.

Normally this is enough and your body will heal and recover. If you do not start to get better in 2-3 days, if you have blood in your diarrhea, a high temperature, severe abdominal pain or your salmonella poisoning symptoms are worsening then seek medical attention because sometimes antibiotics are needed.

If the person with salmonella symptoms is very young, elderly, pregnant or vulnerable due to other illnesses or a weakened immune system then seek advice sooner.

Antibiotics are only used if the bacteria has entered the blood stream or the infection is very severe as their use can cause the bacteria to stay in your system longer.

Anti-diarrheal medications like loperamide (Imodium) can reduce trips to the bathroom but they often also prolong the infection.

Do not go to work or school or any other place where people gather while you still have symptoms as salmonella infection can be passed from one person to another through contact with towels, toilet handles or anything else touched by the infected person if they have not washed their hands carefully.

How Did I Get Infected With Salmonella?

The most common ways to get infected and uf are to eat contaminated food or touch contaminated animals. Think back to what you have been doing in the last few days.

If you have been to a restaurant or catered event with other people then contact them to see if they are ill. Likewise if you have visited a petting farm or zoo.

If you suspect that you may have been infected in this way or through eating take away food then report your worries to the correct authorities so that they can be investigated.

If you have recently returned from traveling abroad then you may have a less common strain of salmonella bacteria.

How Do I Find Out If My Symptoms Are Caused By Salmonella?

You may be suffering from classic salmonella symptoms but these symptoms can also be a sign of other illnesses so how do you know if you have a salmonella infection?

The only way to know for sure is to have a stool sample analyzed in the laboratory.

My Brush With Horrible Salmonella Symptoms

When I was a student nurse I had been away on holiday and by the time I got back I had frequent diarrhea, really bad abdominal cramps, and nausea. I was lucky that we had a dedicated health clinic for staff.

I was still suffering symptoms after two weeks and so a stool test was ordered. The results showed I was infected with Salmonella enteritidis. Of course I could not go near any patients until I had a clear sample and was symptom free. This took three weeks. Believe me I would have rather been at work. If you have the classic salmonella symptoms then I sympathize with you!

Which Foods Cause Salmonella Symptoms?

Any food can potentially be infected as poor food handling can cause cross contamination where the bacteria from one food gets onto another. There have even been some outbreaks in unusual foods like chocolate but some foods are more likely to cause salmonella symptoms than others.

Chocolate Mousse With Cream

It is important to note that you cannot tell if a food is contaminated by looking at it or smelling it. Foods carrying salmonella bacteria look and smell completely normal.

The foods which most commonly cause salmonella symptoms are:

  • Undercooked poultry, like chicken, turkey etc.
  • Lightly cooked or raw eggs (homemade mousse, tiramisu, mayonnaise etc.)
  • Undercooked ground/minced meat
  • Unpasteurized milk, cheese, cream
  • Contaminated peanut butter (salmonella survives better in fatty food)
  • Unpasteurized carton fruit juices
  • Fresh fruit juices made using juicers in restaurants and cafes which have often found to be contaminated
  • Contaminated water (usually contaminated with animal feces)


How to Prevent Salmonella Symptoms

The first thing to know is that salmonella is killed by cooking and pasteurization. Cooking to the right temperature is important. So:

  • Cook poultry until the juices run clear after skewering or use a food thermometer (see temperatures below)
  • Do not stuff birds; cook stuffing separately
  • Never wash chicken because this spreads the germs around the kitchen
  • Cook eggs well, wash hands after touching the shells and do not use eggs if the shells are cracked
  • Eat burgers well done
  • Wash or peel fruit, vegetables and salad
  • Thoroughly defrost raw meat before cooking so it can get up to the correct temperature
  • Keep separate boards for cutting raw meat; wash boards and knives in very hot soapy water
  • Wash your hands carefully after using the bathroom, changing diapers/nappies, touching animals, and handling raw meat
  • Refrigerate or freeze food to slow down the multiplication of bacteria
  • Organize your fridge so that raw and cooked food is separate and one cannot drip on the other
  • Keep surfaces in your kitchen disinfected and regularly change dish cloths and tea towels (wash on a hot temperature)
  • Clean the bathroom with disinfectant including the flush handle
  • Remove limescale if you live in a hard water area as dirt and germs can stick to limescale
  • Take notice of any food hygiene rating system for restaurants in your area
  • Be careful when traveling. Street food can be delicious but it might be contaminated where washing facilities are sparse. In developing countries eat only well cooked food, peel all fruit, drink bottled water, avoid ice cubes and salad.
  • If you are ill with salmonella symptoms do not prepare food, do not share towels and wash any soiled bedding or clothing on as high a temperature as possible

I have to say here that my husband would be horrified at my suggestion of never eating raw egg products and cooking eggs very well as he does not like his food well done but he is fit and healthy and not in a vulnerable group. He loves to eat steak tartare for example (chopped raw steak with a raw egg) however even he would never eat underdone chicken.

Look out for schemes which exist in some countries which are designed to prevent outbreaks of salmonella poisoning symptoms - like the British Lion scheme in the UK where eggs are stamped with a lion if the laying hen has been vaccinated against salmonella.


Safe Internal Temperatures of Cooked Food

  • Chicken, turkey, guinea fowl, goose, duck 165F/74C
  • Beef, veal, lamb. pork roasts, chops and steaks 145F/63C
  • Ground/minced beef, lamb, pork, veal 160F/71C
  • Casseroles, eggs 160F/71C
  • Leftovers 165F/74C; boil sauces, gravy and soups when reheating
  • Fish 145F/63C

Temperature Information from the United States Department of Agriculture  Food and Safety Inspection Service

N.B. Duck breasts are often left pink in the middle as there is a lower chance of salmonella with duck as they are not usually as intensively farmed as chicken but never do this with other types of poultry. Do not give pink duck to vulnerable groups.


Can Vegetarians Get Salmonella Food Poisoning?

Many people think that because salmonella bacteria is normally found in animals that if you are vegetarian you are safe and will not develop symptoms of salmonella. Unfortunately this is not the case. Cross contamination is very common.

The chef only has to prepare the chicken and then the salad without washing his hands properly and the salad will be contaminated with enough bacteria to cause salmonella symptoms. 

Many people like to buy organic products because they consider them to be healthier.

Unfortunately there have been cases where the fertilizer used to promote healthy growth is animal manure (chemicals not being allowed on an organic farm). This can cause the crops to be contaminated with salmonella bacteria if the manure has come from infected livestock.

If at any point in the food chain the food is not stored properly it can be cross contaminated. For example raw meat should always be stored separately from other products but many refrigerators do not have optimum organization.

Sprouts such as alfalfa have been particularly connected with salmonella outbreaks because the seeds are often contaminated and the warm and humid conditions needed to grow the sprouts are exactly what the salmonella bacteria like.

Animals to Avoid If You Don't Want to Catch Salmonella

Some animals carry salmonella bacteria in their intestines without coming to any harm but they can pass on the infection to humans.

Reptiles are notorious for this. Pet snakes, terrapins, turtles, lizards, frogs, geckos, and other types of reptiles very often carry salmonella and handling them or touching the water or environment they live in can put you at risk of developing symptoms of salmonella.

Do not let children under five, the elderly, or people with long term illnesses near reptiles. Wash your hands thoroughly after touching them.

Other pets like small rodents especially hamsters can also pass on this infections.

It is also possible to catch salmonella after touching farm animals or their bedding or enclosures. This is especially true of chickens, baby chicks and ducklings but other farm animals can also put you at risk. If you or your children visit a farm wash your hands carefully afterwards and do not put your hands near your mouth.

The hedgehog is the wild animal most associated with carrying salmonella.

Salmonella Symptoms - Conclusion

It is not always easy to know if your salmonella symptoms are actually caused by a salmonella infection but if the symptoms fit and you are not getting better quickly then please seek medical attention and get tested.

If poor hygiene practices in the food chain are discovered then they need to be fixed so that other people are protected.

Please see the page Diarrhea Treatment for Adults, Children and Babies for more information if you have diarrhea symptoms.


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Photo attributions:

Chocolate mousse by Romainhk https://upload.wikimedia.org/wikipedia/commons/f/f2/Chocolate_Mousse.png

Terrapin by CITES https://en.wikipedia.org/wiki/Diamondback_terrapin#/media/File:Diamondback_Terrapin._Taken_by_CITES.jpeg


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