Salmonellosis epidemiology and demographics

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Editor-In-Chief: C. Michael Gibson, M.S., M.D. [1]; Associate Editor(s)-in-Chief:

Overview

Salmonellosis is a global health issue and is estimated to cause approximately 93.8 million cases of gastroenteritis each year. There are major limitations preventing assessment of the global burden of salmonellosis. Many regions of the world, especially those with a large proportion of the global population such as South/Southeast Asia and South America, do not have publicly available data regarding salmonellosis surveillance. In the U.S., the incidence rate was approximately 2.8 cases per 100,000 persons in 2008. In Europe, the overall reported incidence rate was 39.01 per 100,000 persons in 2005.[1] Children and the elderly have a higher rate of incidence.[2]

Incidence

Worlwide, salmonellosis is estimated to cause approximately 93.8 million cases of gastroenteritis each year. In 2005, the estimated overall incidence rate for Europe was 39.01 per 100,000 persons. The countries with highest reported incidence were the Czech Republic and Slovakia. In 2007, the notification rate of salmonellosis by EU and EEA/EFTA countries was 34.26 per 100,000 persons. In the U.S., Salmonella causes approximately 1 million foodborne infections annually. The incidence of salmonellosis in the U.S., was approximately 2.8 cases per 100,000 persons in 2008. Incidence was highest in the youngest age groups(≤ 4 years) at approximately 4.7 - 6.9 cases per 100,000 population. [2][1]

Adapted from Center for Disease Control and Prevention(CDC)[3]

2017 Outbreak updates

Country Date Cases (confirmed and suspected) Deaths More details
The Democratic Republic of Congo (DRC) May 12th, 2017 9 1 (11.1%)
  • In May 11th, 2017, WHO declared a lab confirmed case in Bas-Uele region in the northeast Congo. Nine cases were hospitalized for hemorrhagic fever and three of them died. Only one case was confirmed to have Ebola virus.
  • Despite being a serious situation, it's considered a good sign that the outbreak struck in a remote and forested region
May 14th, 2017 11 3 (27%)[4]
  • The extent of the outbreak is not yet fully estimated but WHO recommends restriction of trade and travel with DRC.[4]
  • WHO's general director in Africa has met governmental representatives in Kinshasa to discuss measures to contain the outbreak.
May 17th, 2017 11 3 (27%)
  • About 125 people of the contacts of the infected people are being monitored for possible development of the symptoms.
  • Isolation facilities are being set up in case the outbreak involves wider areas.
May 18th, 2017 18 3 (17%)
  • The number of contacts of infected people that are being followed and monitored for development of symptoms rises to 400.
  • Personal Protective Equipment (PPE) for healthcare workers has been shipped to DR Congo.
  • UNICEF workers have arrived and began aiding in setting up mobile laboratory sites in nearby regions.
  • The Congolese government is in talks with the WHO in regards to "ring vaccination" of patient contacts with an experimental vaccine developed by an American company.
May 19th, 2017 29 3 (10%)
  • 416 contacts of infected patients are being followed.
May 21st, 2017 32 4 (13%)
  • The reported cases are from five health areas: Nambwa, Muma, Ngayi, Azande, and Ngabatala
May 22nd, 2017 34 4 (12%)
  • 54 contacts completed daily contact monitoring and 362 remain under follow up with daily monitoring
May 22nd, 2017 37 4 (11%)
  • Institut National de Recherche Biomedicale (INRB)) mobile laboratory began processing samples with 22 testing negative by PCR
May 22nd, 2017 38 4 (11%)
  • 33 samples have tested negative by PCR thus far
  • 3 additional contacts were identified. 365 contacts remain under daily follow up for signs and symptoms of ebola.
May 25th, 2017 43 4 (9%)
  • Experts estimate  that the 1400 Km isolation around Kinshasa has limited the spread of the disease.[5]
  • However, refugee flow across the borders towards the afflicted Bas-Uele region escaping the recent attacks of fighting militias puts the refugees at increased risk of infection and undermines the efforts to contain the outbreak.
May 28th, 2017 43 4 (9%)
  • No new reported cases nor deaths
  • 357 contacts are being monitored for symptoms and signs of ebola
  • Based on the limited number of new confirmed cases, the risk is declared to be low with simulated scenarios predict no further cases in the following 30 days.[6]
May 30th, 2017 52 4 (7%)
  • Authorities in DRC approves the new  rVSV-ZEBOV vaccine.
June 3rd, 2017 52 4 (7%)
  • No new confirmed cases .. with the last confirmed case was on May 22nd 2017
  • All the contacts of confirmed cases completed the follow up period of 21 days and none of them developed the symptoms of ebola.
  • The risk remains low but not negligible.
July 2nd, 2017 8 (confirmed cases) 4 (50%)
  • On July 2nd 2017, WHO declared that the recent outbreak has come to an end. This comes after 42 days of follow up of the contacts of the last diagnosed case (representing 2 incubation cycles of the virus).[7]
  • In total, 8 cases were confirmed to have ebola, 4 of them died. Only 5 of the 8 cases were laboratory confirmed.
  • For these 8 cases, there were 583 contacts that have been closely monitored. None of the contacts developed the symptoms of ebola.
  • The DRC government success to control the outbreak is thought to be due to:
  • Reporting the cases by local authorities in the proper time before further spread of the disease.
  • Testing blood samples and confirming the disease in a timely fashion (due to augmented lab facilities after the last outbreak)
  • Announcing the outbreak early by the government, which allowed early response by the WHO.
  • Survivors of the outbreak still have access to medical facilities allowing screening for persistent virus.

Age

The highest incidence of salmonellosis occurs in the age group 0-4. Older age groups also have a greater incidence.

Gender

The incidence of salmonellosis does not vary by gender.

References

  1. 1.0 1.1 Chai SJ, White PL, Lathrop SL, Solghan SM, Medus C, McGlinchey BM; et al. (2012). "Salmonella enterica serotype Enteritidis: increasing incidence of domestically acquired infections". Clin Infect Dis. 54 Suppl 5: S488–97. doi:10.1093/cid/cis231. PMID 22572674.
  2. 2.0 2.1 Majowicz SE, Musto J, Scallan E, Angulo FJ, Kirk M, O'Brien SJ; et al. (2010). "The global burden of nontyphoidal Salmonella gastroenteritis". Clin Infect Dis. 50 (6): 882–9. doi:10.1086/650733. PMID 20158401.
  3. "Center for Disease Control and Prevention (CDC)" (PDF).
  4. 4.0 4.1 "Ebola kills 3 in Democratic Republic of Congo, WHO says - CNN.com".
  5. "Congo's Ebola outbreak threatens CAR – WHO - Vanguard News".
  6. "apps.who.int" (PDF).
  7. "WHO declares an end to the Ebola outbreak in the Democratic Republic of the Congo - WHO | Regional Office for Africa".


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