Several commercial immuno-diagnostic kits for S. enteriditis and S. typhimurium are available. These kits should be validated prior to use for surveillance purposes and are not suitable for vaccinated animals. PCR and micro-array based antigen tests are available and are in use for additional voluntary monitoring for Salmonella spp., but have not been validated for statutory use.
Need for validation of diagnostic tests and kits
Several commercial diagnostic kits for S. enteriditis and S. typhimurium are available. A validated ELISA diagnostic kit has been developed at the OIE Reference Laboratory at the Veterinary Laboratories Agency in Weybridge UK.
A validated ELISA diagnostic kit has been developed at the OIE Reference Laboratory at the Animal Health Veterinary Laboratories Agency in Weybridge UK.
Numerous commercial diagnostic kits for Salmonella detection in foodstuffs are validated according to the EN ISO 16140 standard (validation managed from Afnor Certification). A molecular serotyping tests targeting the main Salmonella serovars including typhimurium and enteritidis has been developed and OIE validated
Validation procedures for molecular typing methods ( ie molecular serotyping)
Live and inactivated vaccines are available. Other attenuated vaccines include auxotrophic mutants used to prevent Salmonella infections in farm animals in Germany and for S. enteriditis and typhimurium in the UK and elsewhere. Mutant vaccines attenuated rationally by molecular biological gene deletion techniques have been developed including aroAmutants and strains with mutations in the genes encoding adenylate cyclase and the cyclic adenosine monophosphate receptor protein which is available in the United States of America.
Work to define efficacy of live-killed vaccine combination programmes
Multi -serovar/serogroup protection.
Genetically modified vaccines are available in certain countries but not universally. No marker vaccines are available currently
GAP:Development and availability of Marker vaccines
The current vaccines are claimed to reduce the infection and mortality in poultry and other species and therefore are not guaranteed to prevent infection. On this basis it is conceivable that infection may occur and also that this could lead to a carrier state without the knowledge of the animal keeper as the animal potentially did not exhibit clinical signs.
GAP:Quantification of potential for reduced detection and design of monitoring programmes to correct for this.
Vaccination of poultry already occurs and therefore there will be commercial potential for vaccines particularly if they can be designed to be readily identifiable from wild strains and also prevent infection.
There is great potential for development of multivalent salmonella vector vaccines to a range of organisms if objections to GMO vaccines can be overcome
There is currently a surveillance scheme in Europe for salmonella in including turkeys and this will be expanded to pigs over the coming years. Any vaccine that cannot be distinguished from wild strains will not be approved for use.
The period of excretion of vaccine strains after administration should be reduce to avoid the risk of contamination of the food chain with vaccine strains in light weight broiler production.
Generally, antibiotic treatment of flocks of poultry is not permitted for control of salmonella unless there is a welfare implication or rare genetic stock would be lost if culled. Some Member States have interpreted this to only apply to S. enteritidis and S. typhimurium Prevention may be aided by the use of prebiotics, probiotics and competitive exclusion agents of organic acids added to feed or water
GAP:Effective interventions and assays for approval of such products
The use of antibiotics and supportive therapy (e.g. rehydration, antisera, anti-inflammatories) will continue. Any new antibiotics to which the bacterium has not yet developed resistance will probably be restricted to use in human medicine for the foreseeable future.
GAP:Animal specific treatments
In agricultural use the potential is thought to be limited. There may be some potential for human use of antibiotics.
GAP:There may be a role for immune modulators – e.g. at the onset of lay in poultry or at calving in cattle and sheep
Synthetic antisera, plantibodies, bacteriocins, phage therapy..
GAP:Linked to this if disinfectants can be developed that are effective in heavily contaminated environments and therefore used to treat excreta before coming into contact with outside environments this may be of assistance.
. Better quantification, in situ detection, Multiple organism tests that can rapid detect and characterise organisms. Simple lateral flow device type penside tests.
GAP:Better quantification, in situ detection, Multiple organism tests that can rapid detect and characterise organisms. Simple lateral flow device type penside tests.
The time to develop a vaccine along the lines above would be considerable, not only for the development of the vaccines but also for convincing the authorities and the public to accept the principle of genetically modified organisms
GAP:Improved Programmes for best use of existing vaccines
The development and licensing of new pharmaceuticals is a time consuming business and it is not unusual for this to take a minimum of 5 years.
GAP:Investigate ways to speed up the authorisation process
Salmonella enterica serovars, especially S. enteritidis and S. typhimurium
Serovar variability in different countries and variability within a serovar
Emerging monophasic Salmonella variant of typhimuriumMolecular identification
Among the salmonellae there are considered to be at least 2500 serovars, although the two most commonly encountered in cases of food poisoning of humans are the two mentioned above. There are other S enterica serovars that have specific hosts, e.g. S.abortusovis in sheep. Others tend to be associated with certain hosts but can also infect others, including humans for example S dublin infects cattle, sheep, humans and rarely poultry., but all seem capable of causing varying degrees of disease in most mammalian species. There is also a significant reservoir of antimicrobial resistance among these serovars.
Serovar variability in different countries and variability within a serovar
Poor knowledge of virulence factor, host:pathogne interaction in poultry
Salmonella can survive for months outside a living body and have been found in dried excrement or contaminated feed after over 2.5 years. Ultraviolet radiation, heat and moisture accelerate their demise.
GAP:Infectivity of environmental survivors
Salmonellae are found worldwide in both warm and cold blooded animals but also in non living environments. The symptoms of disease in animals vary according to the serovar involved and infection may be asymptomatic or symptoms may be mild enough to be missed, but equally may be severe enough to kill. Once infected, even if recovered, some animals may continue to shed certain serovars for years afterwards. Carriage and recycling of infection between older and younger or recently introduced animals or between livestock and wildlife vectors is common
Detailed longitudinal and quantitative data on herd infection and environmental contamination dynamics are needed
Humans are predominantly infected via ingestion of contaminated food but can also become infected as a result of direct contact with animals, especially cattle or pets, or by contact with faecally-contaminated environments, including contamination caused by infected cats and wildlife. Cross contamination of food during processing or preparation readily occurs.
GAP:Risk ranking for food and contact sources, role of subclinical infection in humans and humans as a source of infection for animals and people
On farms rodents, wild birds and insects may act as vectors along with the carriage of Salmonella on overalls, boots and hands of farm workers. Anyone who handles the carcasses of animals may also act as a vector along with mechanical objects used either on farm or in food processing facilities. Aquatic vertebrates may also act as vectors.
GAP;Relative Risk of different vectors and infectious doses
Salmonellae are relatively common in the natural world and therefore any animal or environment may act as a reservoir anywhere in the world. Some serovars have spread within certain animal species or production sectors (e.g. S.enteritidis in laying hens) thus permitting further spread into the environment. The act of spreading animal manure on land as fertilizer and wash water for irrigation can contaminate crops also.
GAP:Genetic or management reasons for species association
Both horizontal and vertical transmission can occur. In poultry eggs may be vertically contaminated within the reproductive tract and the faecal-oral route allows horizontal spread. The bacterium has also been isolated from the litter and dust from poultry houses. Horizontal transmission to humans occurs via contaminated food, sometimes prepared by human carriers of the bacterium, excretions from carriers, inadequately cooked food and even by association with reptiles (pet tortoises and snakes). Most animal infection results from spread by carrier animals or contaminated feed. In poultry the hatchery is also an important potential source.
Relative risk of different sources
There are no specific life cycle stages involved although small numbers of organisms can survive in a dormant form that may be difficult to culture for long periods . Disease is caused by the rapid multiplication of the bacterium with secreted proteins permitting adhesion and invasion of the cells of the intestine with subsequent further proliferation causing an inflammatory reaction leading to dysentery. Invasion of intestinal cells is promoted by secreted proteins that subvert the host cells metabolic systems leading to internalisation of Salmonella cells and subsequent survival within macrophages. Systemic infection result from passage of viable organisms beyond the local lymph nodes into major lymphatics and the circulatory system. This is more likely with host-adapted strains in the relevant species.
GAP:Detailed host pathogen reactions in main target species (as opposed to mice)
Salmonellosis manifests usually as diarrhoea although clinical signs in animals can include septicaemia and abortion, as well as pneumonia and lesions of the distal extremities in calves. In humans the disease manifests itself by a watery and sometimes bloody diarrhoea, abdominal pain, fever, headache, nausea and vomiting. Acute cases in animals and poultry can lead to death and there is a serious loss of production. Death can occur in humans, especially amongst the elderly, but more normally the infected person is treated at home or occasionally in hospital. People who have been infected are not permitted to work in the preparation of food until they have been shown to no longer be excreting the bacterium.
Level/cost of long term sequelae and risk of later premature death. Level of sub-clinical infection
The incubation period is generally 12 to 72 hours
GAP:Detailed analysis of range in relation to infectious dose, matrix and strain
Mortality may be high among acutely infected animals, particularly cattle, and also among the young and elderly of the human population. Mortality rates can vary significantly between the species infected and also the serovar involved. The type of strain within a serovar is more important than the serovar itself (virulence factors).
Quantitative role of management and intercurrent disease to risk of mortality
Infection in most animals and humans resolves spontaneously within a period of weeks. Some animals that apparently recover from salmonellosis caused by certain serovars may become permanently infected and a small number may excrete the organism in their faeces for years. Others may harbour the disease in a latent form and only excrete the bacterium during periods of stress. Infection may circulate within an animal population, being passed to newly introduced animals which then excrete high numbers of organisms that may overcome the ‘immunity’ of some previously exposed animals. Infected humans are not allowed to work in food preparation until tests have confirmed that they are no longer shedding the bacterium.
GAP:Details of shedding – variability, time and numbers – in food animals and in humans
Disease is caused by the rapid multiplication of the bacterium with secreted proteins permitting adhesion and invasion of the epithelial cells of the intestine and loss of fluid and blood from the intestine. Proteins that appear to protect the bacterium from destruction by macrophages are also present. Once the bacterium has attained its intracellular state the cells metabolism is used to produce bacterial protein and bacteria can accumulate within membrane bound Salmonella containing vacuoles. Several serotypes of medical importance, including typhimurium,enteritidis, newport, dublin, and cholerae-suis, are known to harbour virulence plasmids containing genes that code for fimbriae, serum resistance, and other factors, but the full repertoire of virulence mechanisms is very complex, varying between serovars and clonal lines, and is still not fully understood. Systemic infection can result in sepsis within vital organs, bacteraemia and septic shock.
Key virulence factors that could be targeted for sub-unit vaccines
In 2005 the number of reported cases of salmonellosis in humans was 176,395 giving an incidence rate of 39.2 per 100,000 of the population in the EU. By 2008 the number of reported cases had reduced to 133,258 ( 131,468 confirmed; 26.4:1000 population). By 2009, it had reduced to 108 614 cases. This reduction has resulted largely from improved control of S.enteritidis in poultry, but there has been an increase in S.typhimurium, thought to be largely associated with increased pig meat- related cases in Denmark and in monophasic DT193 variants originating from pigs in many European countries.
True level of under-diagnoses in most MS. Possible role of sero-surveillance and sentinel groups
The whole human population is at risk including those who work closely with cattle, have companion animals or are involved in the processing of food. The most serious cases are generally among infants, small children, the elderly and those with suppressed immunity. A more specific risk factor would appear to be an apparent lack of understanding of the need to maintain safe handling and storage of food, kitchen hygiene and proper cooking.
Level of contact infections – esp. via environment – v. food
In humans the disease manifests itself by a watery and sometimes bloody diarrhoea, abdominal pain, fever, headache, nausea and vomiting. In severe cases a septicaemia may develop and this can lead to complications which can give rise to conditions such as arthritis, septic aneurisms or other localised infections and osteomyelitis. Reactive arthritis and irritable bowel syndrome may also be sequels to enteric infection.
GAP:Quantitative distribution of such symptoms in comparison with other causes of IID
Since in its mildest forms the onset of diarrhoea may be relatively long and the duration short (up to 7 days) it is considered that the level of unreported cases may be as high as 30 times the number of reported cases in some countries. An overall rate of 10 cases per reported case is considered to be likely in the EU.
As above – also – how significant are mild unreported cases in further spread and economic loss?
Need for an harmonised notification system in EU
This is dependent on the level of hygiene among the population and spread of infection has been reported in care homes. Meticulous hygiene may prevent the spread from infected humans and animals but it is not uncommon for a breakdown in the hygiene to occur and for cases to become apparent. This is emphasised in Europe by the need to prevent people known to be infected from working in the food preparation industry. In less well developed countries the likelihood of spread is significantly greater especially where the sanitary treatment of human excrement is lacking. Salmonella can also survive in water and thus drinking supplies may also become contaminated.
Detailed mechanisms of spread and doses involved
Salmonellosis control measures, disinfection, removal of excrement, spreading of manure only on fields that are not going to be grazed for a significant period, will help to control outbreaks and also improve the welfare of animals. Statutory monitoring of the situation in breeding and production flocks of poultry also effects control of the disease. Vaccination and culling of infected flocks are also important control measures in poultry.
Lack of welfare studies in sick animals, assessment of pain and pain relief.
Salmonellosis is widespread and worldwide and therefore there is no reason to believe endangered wild species would not be susceptible. However, the disease is usually associated with intensively reared livestock and the aftermath of such systems so it may be argued that wild species may not often come into contact with intensively reared livestock so the risk is minimised. Some wild animals, particularly reptiles, pigeons, small garden birds, badgers and hedgehogs carry specific types of Salmonella and there have been outbreaks of disease and deaths in finches caused by salmonellosis.
Role in wild bird fluctuationsRole of rodents in contamination of endangered species consuming rodents.
During outbreaks, especially if humans are infected, those animals that are harbouring the disease and acting as a reservoir are often subject of compulsory slaughter, but the disease itself is not normally associated with compulsory slaughter of large numbers of animals or birds, except in the case of breeding chickens or turkeys when S.enteritidis or S.typhimurium is confirmed or in certain countries where there is a ‘stamping out’ policy for most Salmonella infections in most food animal species.
GAP:Impact of culling versus restrictions
GAP:Reason for global spread of some strains but not others
Endemic – with periodic emergence of specific epidemic strains about every 10 years
GAP;Reason for rise and fall of epidemic strains. Source identification of new emerging strains.
There is no true seasonality in the risk of outbreaks of the disease although the very young and young animals/birds are considered more susceptible and therefore there may be a perceived seasonality corresponding to the period when the young are particularly vulnerable. In some cases there may be an association with seasonal events, e.g. use of new season grain or movement of rodents from hedgerows. Human infection is greatest in the summer and this is thought to be associated with difficulties in maintaining low temperatures of food and use of undercooked meat after outdoor cooking.
Good quality logitudinal studies on infection in relation to environmental temperature
Dependant on animal welfare and the removal or minimising of risk factors in the environment. Among young animals, especially those in intensive rearing situations, the spread of the disease is rapid. Spread between holdings can also be rapid if carrier animals, e,g, replacement breeding pigs, are distributed widely. Spread within a flock and sensitivity of the flock to high level of healthy carriage is dependant from the density in laying hens.
Quantitative data to populate transmission models
Salmonellosis has been readily spread across boundaries, for example from breeder birds to layers and broilers and among calves taken to market and sold to calf rearers. Contract spreaders of manure may also be responsible for the spread of Salmonellosis if the manure has not been treated or the machinery carefully disinfected between farms. Spread between holdings and countries can also be rapid if carrier animals, e,g, replacement breeding pigs or hatching eggs, are distributed widely. Some cases related to exchange between EU member states, of contaminated straw used for animal litter were identified as a source of infection with SE in poultry flocks.
GAP:Strain variation in spread
GAP:Certainty about this
There are a large number of vectors and in warmer climates the activity of wild birds, rodents and flies may be greater thus increasing the risk but generally there are no major climactic factors for the spread of the disease.
GAP:Certainty about this
This is a possibility as extreme rainfall, for example, may cause flooding which permits the transfer of water from polluted waterways to clean waterways thus increasing the environmental burden.
GAP:Detailed studies on translocation by water – including non-municipal water supplies
As the climate warms the activity of potential vectors may increase and therefore the risk of spread increases and the incidence of outbreaks will also be likely to rise unless greater care is taken in general hygiene.
GAP:Spread in relation to vector population density and reproduction rate.
The faecal-oral route is the normal mode of transmission among animals and for humans this route may also be important but the more accepted route of transmission to humans is via the consumption of contaminated food
GAP:Quantification of infectious doses from different matrices and exposure routes
Among intensive poultry in particular vertical transmission via the egg is a recognised route of transmission, probably due to a special affinity of some strains to the uterine mucosa of hens. Contamination collected semen, e.g. from turkeys is also possible. Airborne spread may also occur via contaminated dust or aerosols.
Relative risk of airborne spread
Intensive rearing of animals and poultry and lack of suitable hygiene procedures, especially all-in/all-out production and disinfection of housing between batches are the conditions favouring spread.
GAP:Validated procedures for establishing and maintaining minimal salmonella populations on large farms – especially pig farms
The innate immune system is initially involved and this is followed by both humoral and cellular immune responses although Salmonella can survive in macrophages. Immunoglobulins are produced and it is these which may eventually aid the clearance of the bacterium. It should be borne in mind that the clearance is often not complete and stress situations can elicit a recrudescence of the bacterium suggesting that it has adapted to maintaining an intracellular presence despite the immune responses.
Best approach to immunostimulation, vaccine routes,combination approaches, adjuvants
A number of serological tests are available for the diagnosis of Salmonellosis. Whole blood tests and serum agglutination tests have been used for long periods and ELISA’s are now in routine use. Dependant on the antigen and tests used serological cross reactions between different serovars and even with some non-Salmonella organisms can occur so bacterial isolation must be used for confirmatory diagnosis.
GAP:Differential test for infected v. vaccinated animals, Tool to assess cellular and local response.
Feed, food and water should be treated prior to consumption. Manure, should be composted or effectively treated prior to being spread on the ground. Disinfection of the environment where animals are kept and of items coming into contact with either the animals or their excreta should be practised. Rigorous adherence to sanitation will minimise the risk but not prevent it completely. General biosecurity measures remained a good mean to avoid entrance of salmonella into buildings.
GAP:Potential for applying competitive exclusion principles to overcome environmental contamination
The isolation or elimination of carriers and the prevention of cross contamination together with adequate disinfection permits a good degree of control but is equally not foolproof.
Best way to identify latent carriers
Whole blood tests and serum agglutination tests are still used along with ELISA tests which have been validated. Cross reactivity among the serovars often occurs and therefore a definitive diagnosis of the serovar concerned involves isolation of the organism using bacterial culture methods. Antimicrobial susceptibility testing also should be performed.
GAP:Better biomic methods to simultaneously and rapidly detect, type and characterise organisms
Many inactivated vaccines are used against salmonellosis which are often multivalent. Live vaccines have also been used in some countries. Mutant vaccines attenuated rationally by molecular biological gene deletion techniques have also been developed. EU legislation dictates that live vaccines shall not be used unless an appropriate method is provided to distinguish
bacteriologically wild type strains of salmonella from vaccine strains. Vaccination programmes shall be used during rearing to all laying hens in EU countries with more than 20% SE+ST prevalence in laying hens flocks (EU baseline study 2004).
As above – plus potential for vaccination via spray
Generally speaking nowadays the use of antibiotics for the treatment of animals and humans with salmonellosis in many countries is very limited because of the risk of further developing the incidence of resistance in the bacterium. Antibiotic treatment is normally restricted to those cases where the disease is serious and potentially life threatening. EU legislation states that antimicrobials shall not be used as a specific method for the control of salmonellosis in poultry, but this is often interpreted to mean regulated serovars only.
Role of probiotics (which?) and painkillers/anti-inflammatory for therapy
The checking of feed for the presence of salmonella and the provision of dedicated protective clothing, hygiene barriers, and disinfection together with appropriate handling of excreta is appropriate. Where possible avoiding the movement of animals or birds onto the farm and, where this cannot be avoided the isolation and monitoring of bought in animals or pre-movement testing at source is advisable.
Motivation of farm staff to ensure full compliance
The general prevalence of salmonella organisms would negate any reason to prevent cross border trade but the current surveillance on poultry would suggest that any infected poultry would not be acceptable for trade and similarly animals known to be infected would not be accepted. There is still room for improvement as there are frequent breaches in control involving animals from within and outside the EU.
GAP:Design of reliable testing for International trade and detection of masking by antibiotic treatment
Biosecurity, the use of disinfection and normal sanitary measures can be used but no method is 100% effective at actually preventing salmonellosis occurring because of the common occurrence of the organism and the high cost of intensive control programmes.
GAP:Cost-effective priorities for control
The EU has a specific surveillance procedure in place for monitoring the level of Salmonella enteriditis and Salmonella typhimurium infection in poultry with specific targets in terms of the percentage reduction to be achieved for breeding chickens, laying hens, broilers and turkeys.
Verification of improved prevalence across MS
Surveillance and slaughter techniques with poultry have reduced the number of human infections from eggs or poultry meat considerably since the inception of this method of control but there is no means of eradicating the disease and a varying level of infection still persists in MS. Sweden, Norway and Finland have achieved a very high level of control by means of stamping out and restrictions as well as intense feed controls, but as the size of farms increases such measures become increasingly unaffordable.
GAP:How to create and maintain Salmonella-free niches in mainstream production.
The cost of the ‘Salmonella in eggs scare’ in the UK in the early 1990’s which increased the level of surveillance and slaughter of birds is estimated to have cost £70 million. Whilst the current annual cost will be lower since there are fewer flocks of infected poultry slaughtered the cost of the continued surveillance will still be considerable and since this is now EU wide may be even higher than the figure quoted above. The ongoing costs for EU, producers and competent authorities of control programmes is very large, but is necessary to maintain market confidence. Public Health gains are not translated into benefits for industry.
How to reward producers for effective control of Salmonella without encouraging ‘cheating’
No, except for S. abortus ovis
for sheep only:
Salmonellosis is a worldwide disease and therefore there is no specific geographical impact although the disease may be more prevalent in those countries with a less sophisticated method of dealing with animal and human excreta.
Generally speaking the impact on human individuals is merely a case of dealing with diarrhoea for a few days. Where the disease progresses beyond this antibiotic treatment may be required and ultimately a potential stay in hospital. Occasionally the disease may be severe enough in the very young or elderly to be the cause of death.
Economic assessment by country
Impact of reduced spending, food consumption by affected people
In 2000 it has been estimated that the total public health losses assuming one death per year in Finland would be 1.7 million Euros, however, in the case of Finland a more sophisticated monitoring system is in place and the losses are estimated to be in the region of 61,000 Euros. There are EFSA opinions that give more detail on this.
A 2011 report from the University of Florida stated Salmonella at the first rank with a cost of illness of $ 3,309 in US
A detailed breakdown of the treatment cost by Member States (MS) , and differential use of antimicrobials. Treatment failure rates in MS where AMR (Anti-microbial resistance) is high.Cost benefit analysis of EU measures against SE ST must be evaluated to convinced member states of the interest of their investment in salmonella prophylaxis
There is no specific geographical impact for salmonellosis in animals except that the disease is considered to be more prevalent among intensively reared animals and in countries with less strict control programmes or in hotter countries.
The cost of production is associated with the cost to the farm of replacing animals or birds slaughtered because they are found to be positive for salmonella together with the cost of disinfectants and vaccination. The cost therefore may be high. Deaths and clinical disease resulting is large costs are also common in cattle, but also occur in sheep, pigs and very occasionally poultry.
GAP:True cost of low level disease and wet litter
There are a number of estimates of the cost of surveillance depending on which country is recording the cost but generally it is thought the cost of surveillance alone is in the region of £3.4 million per annum.
GAP:More detail needs to be gathered from EC claims for reimbursement
The total cost of the ‘salmonella in eggs scare’ in the UK in 1993 has been estimated at £70 million based on the cost of slaughtering infected birds and the 90% drop in consumption of eggs. Other reports of Salmonella (e.g. in pigs) appear to not have disrupted the market in the same way.
GAP:No overall cost benefit analysis of Salmonella prophylaxis have been done at an EU level.
Other than the obvious restriction on infected animals there are no further restrictions on the international trade for this disease. Imports into the EU must conform with EU control legislation and countries must be approved for such imports. Certain third countries have additional requirements in relation to testing of breeding stock, companion animals and horses.
GAP:Role of international trade in spreading infection – e.g. in pigs
Should more effective prevention and control be available the surveillance regime in the EU may be scaled down thus saving several million Euro per year.
GAP:Design of a validation procedure for randomised testing to confirm continued high levels of control in the absence of a harmonised monitoring programme
Salmonellosis in animals can lead to increased environmental contamination together with infected produce (eggs or meat) which can then cause outbreaks in the human population. Whilst these are generally self limiting they can occasionally lead to hospitalisation and ultimately to death. Epidemics have occurred in countries and have caused major reductions in the consumption of the offending produce thus risking the livelihood of the farmers as well. Salmonella can be transferred from meat to plant materials during food preparation so avoidance of meat may not rule out the risk of contracting the disease. There has been considerable build up of resistance among the bacteria and therefore it is perceived to be a greater risk should the disease develop into one requiring hospitalisation.
Relative risk and attribution re sources and routes
Antimicrobial resistance gene transfer
Salmonellae are widespread in the environment and salmonellosis is most prevalent in areas of intensive animal husbandry. Many animals may be infected but show no clinical illness and are therefore important in relation to the spread of the disease. Whilst strain identification has traditionally relied on biochemical and serological methods, phage typing of some serovars and antibiograms, genotypic analysis by molecular fingerprinting of DNA has been used in recent years. Legislation is in place in the EU for surveillance of farm animals, particularly poultry, and this is to be extended over the coming years in order to minimise the chances of contaminated farm produce causing disease in the human population but also to prevent food scares which could jeopardise the livelihood of farmers.
Expert group members are included where permission has been given
Dr. Gilles Salvat, ANSES, France - [Leader]
Anne Brisabois, ANSES, France