Salmonella Infections in Children - HealthyChildren.org

By: Robert W. Frenck, Jr., MD, FAAP

Salmonella bacteria cause more than a million infections each year in the United States. Most often, people get sick after eating food contaminated with Salmonella. Their symptoms usually include diarrhea, fever and stomach cramps. Salmonella illness can sometimes be severe enough to require a hospital stay.

Here's what families need to know about Salmonella, how to recognize symptoms of infection and how to prevent it.

Learn about recent Salmonella outbreaks here.

Who is most at risk from Salmonella?

Infections occur most often in infants and children younger than 4 years because their immune systems are still developing. Babies who are not breastfed are also more likely to get sick from Salmonella. Infants may be exposed to Salmonella if they eat contaminated food or come into contact with contaminated surfaces or sick family members.

Elderly people and those whose immune systems are weakened from certain medical conditions (such as diabetes, liver or kidney disease and cancer) or treatments also are at increased risk.

How does Salmonella spread?

Salmonella bacteria usually spread to humans by animal products such as poultry, beef, fish, eggs and dairy products. At times, though, other foods such as fruits, vegetables and bakery products have caused outbreaks. Most often, this happens when these foods were contaminated by contact with an animal product.

The bacteria can also be spread by drinking contaminated water. Salmonella outbreaks have been linked to infected pets such as backyard poultry, snakes, small turtles, lizards and other reptiles. And, it can spread by contact with contaminated pet food. Typhoid fever, which is also caused by Salmonella, is only spread through contact with an infected person or an item contaminated by an infected person.

Recent Salmonella outbreaks

Charcuterie meats

As of Jan. 18, 2024, 47 people in 22 states have reported Salmonella illness from certain brands of charcuterie products. Ten people have been hospitalized. Do not eat Busseto brand Charcuterie Sampler from Sam's Club or Fratelli Beretta brand Antipasto Gran Beretta from Costco. Throw them away. Wash surfaces and containers that may have touched these products using hot soapy water or a dishwasher. (More information here.)

Granola bars & granola cereals

On Jan. 11, 2024, Quaker Oats Company explanded its recent recall of specific granola bars and granola cereals (More information here.). The products were sold in all 50 states, Puerto Rico, Guam and Saipan. To date, no confirmed illnesses have been reported. Do not eat the recalled products. Check your pantries and dispose of the recalled products. (To request a refund, visit the company's recall webpage here.)

Pet food

As of Jan. 10, 2024, 7 people in 7 states got sick from touching recalled pet food or things like bowls, poop or saliva of dogs or cats that were fed the pet food. Most who got sick are infants. This outbreak investigation is over, but the recalled pet foods have long shelf lives. Check your home for the recalled pet food. Do not let children touch the recalled pet food, and don't feed it to pets. (More information here.)

Signs & symptoms of Salmonella infection

Salmonella bacteria are best known for being a cause of diarrhea. This type of illness, called gastroenteritis, typically happens after eating food that has been contaminated with Salmonella.

When your child has a Salmonella infection that causes gastroenteritis, they may have symptoms such as:

While the overwhelming number of people with Salmonella infection have gastroenteritis, the bacteria also can cause a variety of other disorders, including:

• Bacteria in the blood (bacteremia)

• Inflammation of the membranes of the brain or spinal cord (meningitis)

• Inflammation of the bone (osteomyelitis)

Any recent travel?

Although very rare in the United States, travelers to India, Latin American, Africa and parts of the Asia may become infected with a strain of Salmonella called typhoid. This is a long lasting febrile illness which if untreated can be fatal in up to 30% of cases. So, if you return from travel and have an unexplained fever, it is important to let your doctor know about your recent travels.

What to know about typhoid fever

Typhoid fever develops gradually. It's signs and symptoms may include fever, headache, loss of appetite, lethargy, abdominal pain, changes in mental status, an enlarged spleen and constipation or diarrhea.

The incubation period for gastroenteritis ranges from 6 to 48 hours, while typhoid fever has a longer incubation period of 3 to 60 days.

When to call your pediatrician

Contact your pediatrician if your child shows no improvement within 2 to 3 days of symptoms appearing or if they have blood in their stools or shows signs of dehydration (such as an absence of tears when crying, a decline in urination).

How is Salmonella diagnosed?

Your pediatrician can test for Salmonella organisms from cultures of stool, blood, or urine that are examined in the laboratory.

Treatment for Salmonella infections

If your child only has Salmonella-associated diarrhea, the treatment is supportive (fluids and rest). Antibiotics are not prescribed as they do not make your child get better faster and actually may increase the length of time your child has Salmonella in the stool. An exception is infants under 3 months of age, because they have an increased risk of the infection spreading from the intestine to the blood and other organs in the body. However, when the infection is found in the blood, brain, bone or other organs, antibiotics are needed.

A child with severe diarrhea may get very dehydrated and need intravenous (IV) fluids or extra fluids given by mouth.

How long does a Salmonella infection last?

Most Salmonella gastrointestinal infections last for 4 to 7 days and clear up on their own without treatment.

How to prevent Salmonella infection

Salmonella infections can often be prevented by practicing good hygiene techniques during food preparation, as well as regular hand washing. Be sure to thoroughly cook eggs, poultry and ground beef. Hands should always be washed after playing with pets, especially lizards and pet turtles.

• If your child has a problem with their immune system: Avoid reptiles used as pets, such as lizards and snakes. Children with sickle cell anemia are at risk for Salmonella infection of the bones. Families of these children should avoid having reptiles and amphibians as pets.

• If you plan travel to an area where typhoid exists: Make an appointment with your doctor (preferably 1-2 months before travel) to discuss vaccination against the infection. See Precautions for International Travel: Information for Parents.

More information

About Dr. Frenck

Robert W. Frenck, Jr, MD, FAAP, is board-certified in general pediatrics and pediatric infectious diseases. He practices at Cincinnati Children's Hospital Medical Center and is a Professor in the Department of Pediatrics at the University of Cincinnati School of Medicine in Cincinnati, Ohio. Within the American Academy of Pediatrics, Dr. Frenck is a member of both the Section on Uniformed Services (SOUS) and the Section on Infectious Diseases (SOID).

The information contained on this Web site should not be used as a substitute for the medical care and advice of your pediatrician. There may be variations in treatment that your pediatrician may recommend based on individual facts and circumstances.

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