Many are familiar with norovirus, the most common cause of foodborne illness in the U.S. (we covered norovirus in this blog post) – it made a lot of news headlines over the past several months due to a high number of illnesses. But you may be less familiar with Salmonella – the #1 cause of hospitalization and death from foodborne illness in the U.S., according to the CDC, and the second most common cause of foodborne illness (commonly called food poisoning). 1
For foodservice establishments, Salmonella is a significant risk, but one that can be prevented with comprehensive food safety policies, including a strong food safety culture. Salmonella caused 18.6% of foodborne illness outbreaks from 2017-2019, the second most common pathogen (behind norovirus), according to a recent report by the CDC.
We are covering Salmonella in June as it is more common to get sick from Salmonella in the summer months because warm weather and unrefrigerated foods (like at picnics) create ideal conditions for Salmonella to grow. Knowing about this pathogen is vital in helping protect ourselves and our loved ones from its potential risk.
What is Salmonella?
Salmonella is a group of bacteria that can make people sick. Salmonellosis is the most common illness caused by most types of Salmonella.
How common is Salmonella illness?
The CDC estimates that Salmonella causes about 1.35 million infections in the U.S. annually.1 Most cases are mild; however, severe cases lead to an average of 26,500 hospitalizations and 420 deaths per year.1 According to the CDC, sickness from Salmonella is highly underreported – estimating that for every laboratory-confirmed case of Salmonella illness, there are about 30 more that are not reported!2 So that estimated 1.35 million infections per year is likely more than 3 million!
How do I get infected with Salmonella?
You can get sick from Salmonella:
- by eating raw or undercooked food that was contaminated with Salmonella at the farm
- by drinking water that is contaminated with the bacteria
- from eating prepared or ready-to-eat food that has been contaminated with the bacteria from food handlers not following established hand and surface hygiene best practices, such as handwashing and surface hygiene measures that prevent cross-contamination from raw to cooked food
- from other people who are sick with Salmonella
- from touching animals – healthy animals, from pets to animals at petting zoos or fairs, can carry Salmonella or other germs that can make you sick
Who is most at risk for severe illness from a Salmonella infection?
Groups at the highest risk of severe disease from Salmonella infections include pregnant women, children under five years old, adults over 65, and immunocompromised individuals.
What are the symptoms of Salmonella infection?
The most common symptoms are diarrhea which can be bloody, fever, and stomach cramps. According to the CDC, sickness typically begins between 6 hours to 6 days after infection and lasts 4-7 days. In most cases, symptoms will resolve on their own, but some with severe diarrhea may need to take antibiotics or be hospitalized.
What foods are commonly associated with Salmonella contamination?
Salmonella can be found in a variety of foods, including chicken, beef, turkey, pork, eggs, fruits, vegetables like sprouts, and even processed foods like frozen pot pies and frozen chicken nuggets. Chicken is a big culprit of illnesses from Salmonella – you can get sick if it's not cooked thoroughly or its juices contaminate other surfaces that get onto food you eat raw, such as salad.3 Other recent Salmonella outbreaks have also included nut butters, onions, seafood, prepackaged salads, peaches, papayas, and many others. Food contaminated with Salmonella typically doesn't smell or taste off and still may look good. That is why prevention is critical.
What are some Salmonella prevention tips around home or picnics?
As with other foodborne illnesses, following good food safety practices is key to prevention. The CDC groups prevention guidelines into four basic steps:
- Clean: Hands and surfaces can become contaminated after handling raw, uncooked, or contaminated food. Once contaminated, hands and surfaces can spread germs to other food, surfaces, and even individuals, increasing the risk for foodborne illness. The solution? Make sure to clean your hands and surfaces often! If possible, use soap and water to clean your hands before, during, and after preparing food. If soap and water are not available, use a hand sanitizer containing at least 60% alcohol, and follow the label instructions. To clean surfaces, first, remove any soil or food debris that might be present, and then apply an EPA-approved surface sanitizer, preferably one that is effective against Salmonella and norovirus and does not require a rinse step after use on food-contact surfaces.
- Separate: It is important to keep raw meat, chicken, turkey, seafood, and eggs separate from other foods, especially foods that have been cooked or are ready to eat. Be sure to use different cutting boards, knives, and utensils for uncooked food to avoid transferring germs to cooked or prepared foods that are ready to serve. Not separating raw and uncooked foods from those that are cooked or ready to eat can lead to cross-contamination, which increases the risk of foodborne illness.
- Cook: Foods, especially raw meats and poultry, must be cooked to a safe internal temperature in order to kill germs that can make you sick. Always use a food thermometer to check the internal temperatures of the food after cooking – the color or appearance of food after cooking isn't a reliable indicator of temperature. The CDC recommends cooking food to the following internal temperatures to prevent Salmonella:
- 145°F for beef, pork, ham, veal, and lamb
- 145°F for fish with fins
- 160°F for ground beef, ground pork, ground veal, and ground lamb
- 160°F for egg dishes
- 165°F for poultry (chicken, turkey, duck), including ground chicken and ground turkey
- 165°F for casseroles
- Chill: After cooking and preparing food, it is important to properly store your food at cold temperatures to prevent the growth of germs that could cause illness. Within 2 hours of cooking food, be sure to refrigerate your leftovers at 40°F or less. Also, be sure not to overfill your refrigerator, as airflow is needed to maintain colder temperatures. A thermometer for use inside your refrigerator can help you ensure you're maintaining proper cold-holding temperatures. At picnics, keep cold food cold – place perishables in a cooler with ice packs, keep the lid closed as much as possible, and put drinks in a separate cooler to cut back on how often the lid is opened.
How can my foodservice establishment prevent Salmonella outbreaks?
Ensure staff are trained and follow your establishment's protocols and procedures to prevent foodborne illness outbreaks – this should include best practices to prevent cross-contamination (moving pathogens around from a surface, food item, or person to another object) like:
- Ensuring employees comply with hand hygiene policies, including thoroughly washing all surfaces of their hands for at least 20 seconds after using the restroom, after handling raw meat/poultry/eggs, and other key moments. Emphasize proper glove use to avoid bare-hand contact with food.
- Cleaning and sanitizing cooking utensils and food-contact surfaces when switching between types of food.
- Ensuring staff follow hot and cold food handling requirements and proper cooking instructions (like cooking foods to safe internal temperatures).
- Providing sick leave policies and employee wellness screenings to encourage staff not to show up to work sick.
- Purchase food from suppliers with food safety programs in place.
For more on preventing cross-contamination, read my blog co-authored with Hal King, Ph.D.: "Contaminated Surfaces – A Cross-Contamination Risk in Retail and Foodservice Establishments."
Do PURELL® products kill Salmonella?
The U.S. Food and Drug Administration (FDA) does not allow manufacturers of hand sanitizer or soap to make claims regarding the efficacy of these products against Salmonella or any specific bacteria. A claim around the efficacy of PURELL® Hand Sanitizer against any specific virus or bacteria would be an off-label claim and not permitted under the FDA rules.
PURELL® Surface Sanitizers, Disinfectants, and Wipes are EPA-registered, safe for most hard surfaces (spray is also safe on most soft surfaces), and quickly kill 99.9% of viruses and bacteria, including Salmonella and norovirus (spray kills in 30 seconds), the flu virus, and human coronavirus (COVID-19). They earned the EPA's lowest allowable toxicity rating (Category IV), so they don't contain harsh chemicals or fumes and don't require gloves, handwashing, or rinsing after use – even on food-contact surfaces. PURELL® surface sprays are certified for the EPA's Design for the Environment (DfE) as part of the EPA's Safer Choice program.
Businesses interested in PURELL® products should contact their GOJO distributor click here to schedule a meeting with our representatives, or find a distributor now.
For more on food safety at picnics and BBQs this summer, visit the FDA's page on "Handling Food Safely While Eating Outdoors." For additional information on Salmonella, visit the CDC's Salmonella homepage.
Later this month, I will post about E. coli – another foodborne pathogen common in summer months. Subscribe to the GOJO blog so you don't miss it.