Salmonellosis in children
Last reviewed: 23.04.2024
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Salmonellosis is an acute infectious disease of humans and animals caused by numerous serovars of salmonella and occurs in children more often in gastrointestinal (A02), less often typhoid-like and septic forms (A01).
Diseases caused by salmonella in humans are divided into typhoid fever and paratyphoid A, B, C - anthroponous infections with well-defined clinical and epidemiological features and "proper" salmonella, the pathogens of which are pathogenic for both humans and animals. The term "salmonella" is used only to refer to the second group of diseases.
ICD-10 code
- A02.0 Salmonella enteritis.
- A02.1 Salmonella septicemia.
- A02.2 Localized salmonella infection.
- A02.8 Other specified salmonella infection.
- A02.9 Salmonella infection, unspecified.
Epidemiology of Salmonella
Salmonellosis is widespread throughout the world and throughout the country. On the incidence among intestinal infections of established etiology, salmonellosis ranks second after shigellosis. Mostly sick children of preschool age (65%). The leading causative agent is Salmonella enteritidis.
The main source of infection - domestic animals: cows, sheep, pigs. Dogs, cats, birds, etc. The disease in animals can occur in a pronounced form or is wiped off, but more often there is an asymptomatic carriage of salmonella. Infection of a person can occur both with direct contact with a sick animal, and with the use of food products of animal origin (milk, meat, cottage cheese, sour cream, eggs, etc.).
Older children are infected mainly by alimentary route through meat, dairy and other products of animal origin, as well as through vegetables and fruits (salads from cabbage, cucumbers, tomatoes, carrot juices, fruits, etc.), which can be infected during storage, transportation and implementation. Outbreaks of salmonella associated with the food pathway of infection occur mainly in children's institutions, where the rules for cooking and storing food are violated.
The contact-household way of infection is noted mainly in young children, especially in newborns, premature babies and weakened by other diseases. Infection often occurs in hospitals through care products, staff hands, towels, dust, changing tables, pots.
The children of the first two years of life are most susceptible to salmonellosis. At this age, the incidence is 5-10 times higher than in other age groups. Salmonellosis is recorded throughout the year with the highest incidence of morbidity in summer and autumn. The incidence varies in different areas and varies by year.
[Causes of Salmonella
According to the structure of the O-antigen, salmonella is divided into groups A, B, C, D, E, etc., and by flagellate H-antigen - into serovars. There are about 2000 serovars. More than 700 serovars have been allocated from man. In our country more than 500 are recorded. Salmonella of groups B, C, D, E - Salmonella enteritidis, S. Typhimurium, S. Derby, S. Panama, S. Anatum, S. Choleraesuis dominate among them.
Pathogenesis of salmonella
The development of the infectious process largely depends on the mechanism of infection (food, contact, etc.). The magnitude of the infectious dose and the degree of pathogenicity of the pathogen, the immune defense of the macroorganism, age, etc. In some cases, intestinal infection proceeds violently, with the development of endotoxin shock. Expressed toxicosis with exsicosis or generalized infectious process (septic forms) and with significant bacteremia (typhoid-like forms), and in others - there are erased, subclinical forms or bacteriocarrier. Regardless of the form of the disease, the main pathological process develops in the digestive tract and mainly in the small intestine.
Symptoms of Salmonella
The incubation period of salmonella varies from several hours (with massive infection by the food route) to 5-6 days (with a contact path of infection or a small dose of the pathogen). The clinical symptoms, their severity, the sequence of appearance and duration of the course of the disease depend on the clinical form. Distinguish typical (gastrointestinal, typhoid-like and septic) and atypical (stale, subclinical) forms of salmonellosis. As well as bacteriocarrier.
Gastrointestinal form of salmonellosis in children is most common. Depending on the primary lesion of a particular gastrointestinal tract, gastritis, enteritis, colitis, gastroenteritis, enterocolitis, etc. Can be leading.
Where does it hurt?
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Diagnosis of Salmonella
Typical forms of salmonellosis begin acutely with the increase in the severity of the general condition; fever relatively long, not typical. But prolonged "unmotivated" vomiting, soreness and rumbling in the right ileal region, densely lined tongue, phenomena of flatulence ("full belly"), enteric or enterocolitis chair of the "marsh mud" type with an unpleasant, fetid smell. With moderate and severe forms of hepatosplenomegaly, especially in young children, changes in the central nervous system in the form of lethargy, deafness, drowsiness, in the peripheral blood - pronounced leukocytosis, neutrophilia with a shift to the left (rod-nuclear shift), increased ESR.
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Treatment of salmonella
In the case of mild and moderate forms of salmonellosis with exsicosis:
- oral rehydration with glucose-saline solutions: rehydron, glucosolan, etc .;
- enterosorbents: filtrum-STI;
- enzyme preparations taking into account the topic of gastrointestinal lesions: abomin, festal, pancreatin (mikrazim, creon), panzinorm, etc.
To children of early age it is expedient from the first days of illness to appoint:
- bacterial preparations (acipol, bifystim, bifidumbacterin 10-20 doses / day, lactobacterin, linex, enterol, etc.);
- prebiotics (lactofiltrum);
- or include in food bifidokefir (bifid) for 200-400 ml / day fractional.
Drugs
Prevention of Salmonella
Prevention of salmonellosis in children is primarily directed at the source of infection and is carried out by the medical and veterinary services.
Activities include the rehabilitation of domestic animals, prevention of the spread of salmonella among them. Compliance with the sanitary regime at meat processing plants, poultry farms and dairy enterprises. In order to exclude the infection of raw materials in the process of slaughtering animals and birds, cutting carcasses, storing. Transportation and sales. The sale and consumption of raw duck and goose eggs is forbidden due to their high contamination with salmonella.
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