Article on Salmonellosis in Infants Resulting in Increased Health Risks

An article in the journal Pediatrics titled "Epidemiology of Salmonellosis Among Infants in the United States: 1968–2015 " looks at nontyphoidal Salmonella infection in infants which results in high rates of hospitalization and death due to the increased risk of invasive infection.

The study did not provide information regarding the source of the contamination. 

 "These data do not provide information to assess sources of Salmonella or risk factors for invasive disease; demographic characteristics are described as risk indicators. Reported risk factors for infant salmonellosis include exposure to animals, exposure to a household member or attending day care with a child with recent diarrhea, international travel, riding in a shopping cart with raw meat or poultry, and other indoor and outdoor environmental exposures.15,–18 Use of infant formula and lack of breastfeeding are correlated risk markers.15,19,Salmonella has only rarely been identified in commercial formula.20,21 Breastfeeding might be protective because of immunity (eg, maternal antibodies from breastmilk) or to lack of exposure to bottles contaminated by household members."

Pediatrics

https://publications.aap.org/pediatrics/article/doi/10.1542/peds.2021-056140/191251/Epidemiology-of-Salmonellosis-Among-Infants-in-the

ARTICLE| MAY 10 2023

Epidemiology of Salmonellosis Among Infants in the United States: 1968–2015 

Julie L. Self, PhD, MPH; Michael C. Judd, MPH; Jennifer Huang, MPH; Patricia I. Fields, PhD; Patricia M. Griffin, MD; Karen K. Wong, MD, MPH

OBJECTIVES:
Describe characteristics of gastroenteritis, bacteremia, and meningitis caused by nontyphoidal Salmonella among US infants.


METHODS:
We analyze national surveillance data during 1968–2015 and active, sentinel surveillance data during 1996–2015 for culture-confirmed Salmonella infections by syndrome, year, serotype, age, and race.


RESULTS:

During 1968–2015, 190 627 culture-confirmed Salmonella infections among infants were reported, including 165 236 (86.7%) cases of gastroenteritis, 6767 (3.5%) bacteremia, 371 (0.2%) meningitis, and 18 253 (9.7%) with other or unknown specimen sources. Incidence increased during the late 1970s–1980s, declined during the 1990s–early 2000s, and has gradually increased since the mid-2000s. Infants’ median age was 4 months for gastroenteritis and bacteremia and 2 months for meningitis. The most frequently reported serotypes were Typhimurium (35 468; 22%) for gastroenteritis and Heidelberg for bacteremia (1954; 29%) and meningitis (65; 18%). During 1996–2015 in sentinel site surveillance, median annual incidence of gastroenteritis was 120, bacteremia 6.2, and meningitis 0.25 per 100 000 infants. Boys had a higher incidence of each syndrome than girls in both surveillance systems, but most differences were not statistically significant. Overall, hospitalization and fatality rates were 26% and 0.1% for gastroenteritis, 70% and 1.6% for bacteremia, and 96% and 4% for meningitis. During 2004–2015, invasive salmonellosis incidence was higher for Black (incident rate ratio, 2.7; 95% confidence interval, 2.6–2.8) and Asian (incident rate ratio, 1.8; 95% confidence interval, 1.7–1.8) than white infants.

CONCLUSIONS:

Salmonellosis causes substantial infant morbidity and mortality; serotype heidelberg caused the most invasive infections. Infants with meningitis were younger than those with bacteremia or gastroenteritis. Research into risk factors for infection and invasive illness could inform prevention efforts.