Salmonella in the Caribbean: Public Health Response and Measures

This report provides a comprehensive overview of Salmonella in the Caribbean, addressing its significance as a public health concern. It delves into the microorganism's characteristics, the diseases it causes (enteric and systemic salmonellosis), and the factors contributing to its spread, with a particular focus on outbreaks linked to contaminated eggs. The report highlights the historical context of Salmonella in the Caribbean, including the challenges in early detection and the subsequent development of control measures. It discusses the global incidence of salmonellosis, preventive measures, and the importance of early detection and intervention. The study also examines the role of public health departments and clinical laboratories in monitoring and controlling the disease. The report emphasizes the importance of hygiene, proper food handling, and early detection and intervention to prevent the spread of Salmonella. Overall, the report aims to provide insights into the root causes, symptoms, and preventive measures related to Salmonella in the Caribbean and globally.

Report on Salmonella in the Caribbean 1
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Report on Salmonella in the Caribbean 2
Salmonella Enteric is a class of microorganisms, a significant cause of foodborne illness
worldwide (Devi Nelluri & Thota, 2018). The microorganism is generally known to cause
enteric and systemic salmonellosis, a prevalent nutrient-borne disease, and to infect the intestinal
tract (Issenhuth-Jeanjean et al., 2014). Its infection is a major concern in the developing and
underdeveloped countries. Salmonella enteric is a gram-negative rod-shaped flagellated
facultative anaerobe of about 2 μm in size (Pui et al., 2011).
Virtually all salmonella strains are pathogenic because they may attack, replicate and cause life-
threatening illness in the human host cells. The disorder has a sudden onset of headache,
abdominal pain, (bloody) diarrhoea, nausea and vibration. Fever is almost always there. The
disease generally lasts between 5 and 7 days and normally requires no therapy unless the patient
is seriously dehydrated or the infection is transmitted from the gut (Salmonella in the Caribbean
2004).
The global incidence of Salmonellosis has risen quickly since 1985, and Salmonella enteritidis
(SE) has been responsible for a large part of this rise. SE outbreak investigations and sporadic
cases have identified shell eggs as a primary SE source and raw or understood egg consumption
as a major risk factor for infection. SE type 4 phage (PT4) has also been discovered to be viral in
comparison to other SE phage kinds, causing significant disease rises. The global emergence of
SE appears to be caused by the SE's ability to infect hen's ovary without any visible evidence and
contaminate the intact egg ("Outbreaks of Salmonella Serotype Enteritidis Infection Associated
with Eating Shell Eggs --- United States, 1999--2001", 2019).
A study involved longitudinal and point-in-time surveys of Salmonella carriage and
environmental contamination on two commercial cage layer farms positive for “Salmonella
enterica subsp. enterica serovar Typhimurium” (flock A age, 32 weeks; flock B age, 34 weeks).
Salmonella-positive fecal, egg belt, and dust samples were all unconditionally associated with
eggshells testing positive for Salmonella. The odds of an eggshell testing positive for Salmonella
were 91.8, 61.5, and 18.2 times higher when fecal, egg belt, and dust samples, respectively,
tested positive for Salmonella (Gole, Torok, Sexton, Caraguel & Chousalkar, 2014).
Salmonella was a disease of public health concern in the Caribbean since the mid-1980s as it led
to a growing amount of diarrhoea instances and outbreaks affecting local and tourist populations.
The communicable disease monitoring scheme at that time did not, however, promote the timely
detection of those outbreaks or the study of infection-related risk variables.
This led to growth in the spread of Salmonella. The reportable disease scheme in the area was
poor and consequently Central Asia Regional Economic co-operation (CAREC) suggested a
revision of the regional reporting of communicable disease ("Health Reporting") following
comprehensive consultations with health ministries from the various Caribbean countries, health
care providers, professional medical organizations, and clinical laboratories ("Salmonella in the
Caribbean", 2004). In addition to healthcare suppliers (i.e., clinician-oriented monitoring), the
detection of reportable laboratory-confirmed illnesses (i.e. laboratory-based monitoring) was
enrolled by clinical laboratories. Casino eggs, homemade eggs, home ice cream, punch a crème
(e.g. a comparable drink to egg) and stout and eggs were all part of the particular ingredients
containing raw egg. Following the release of the outcomes of the study of the Salmonella case-
control, the Ministries of Health and Agriculture of the Ministries of Trinidad and Tobago
launched farm-to-table approaches to Salmonella prevention and controls in the shell egg

Report on Salmonella in the Caribbean 3
microbiology and environmental health assessment of the egg-producing farms. The Agriculture
Minister has created a protocol to identify and remove infected flocks from the supply of the egg
and to boost measures for the quality assurance and sanitation of egg-producing farms by means
of government and private partnerships and networks (Salmonella in the Caribbean, 2004).
Salmonella is a common disease in human beings. Globally, the causes of non-typhoidal
Salmonella spp are estimated at around 93.8 million and 155,000 fatalities annually
("Salmonellosis" 2014). In the United States, the incidence of salmonellosis in recent years has
stayed quite stable. In 2012, approximately 16 cases per 100,000 individuals were reported, but
an estimated 29 cases were not diagnosed for each reported case. There have been decreases in
reported instances of salmonellosis in the EU. In 2011, approximately 20 cases per 100,000
people were reported ("Salmonellosis" 2014).
Monitoring data in developing countries are often not available. In Southeast Asia, 22.8
salmonella cases are estimated annually. In individuals who are immunocompromised, including
the kids and older individuals, salmonellosis happens most often. The majority of instances in
kids under 10 and individuals who are immunocompromised with reptile-associated
salmonellosis occur. Invasive disease associated with reptiles ("Salmonellose," 2014), children
under the age of six months appear particularly at risk.
Salmonella transmission can be restricted by applying preventive measures including: hand
washing after contact with reptiles, chickens or other birds; correctly washing food; avoiding the
use of milk and its derivatives; preventing the consumption of raw eggs and meat. For the
preparation, washing and cooking of foods food managers should retain hygiene levels at a high
level. Whenever fever, diarrhea and vomiting occur, food managers should report instantly to
their employers. Fruit and vegetable producers should also use good hand hygiene, fecal
contamination protection, water quality evaluation and storage hygiene equipment ("Salmonella
Homepage | CDC", 2019). In order to determine and compare particular types of bacteria
associated with Salmonella, the public health department should be notified of all instances of
salmonellosis, and therefore clinical laboratories should send their isolates of Salmonella to town
or counties or to state public health laboratories ("Salmonella Homepage | CDC", 2019).
The aim of secondary prevention is to detect and intervene early on new infectious disease cases
in a way that prevents or reduces the risk of further infection spreading to the population ('
Salmonella Homepage CDC', 2019). Tertiary prevention concentrates on individuals who are
already ill. The aim is to enhance the quality of life through the reduction of disability,
complication reduction or delay and restoration of functions. The treatment and rehabilitation of
the illness (“Tertiary Prevention”, 2019).
In conclusion it can be stated that the study focused on root cause of the Salmonella in the
Caribbean islands as well as other parts of the world. The report has given insight of the
preventive measures and how can be controlled from spreading. It also touches upon signs and
symptoms and what are the risk elements associated with this diseases.

Report on Salmonella in the Caribbean 4
References
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Safety And Preservation, 231-268. doi: 10.1016/b978-0-12-814956-0.00009-3
Gole, V., Torok, V., Sexton, M., Caraguel, C., & Chousalkar, K. (2014). Association between
Indoor Environmental Contamination by Salmonella enterica and Contamination of Eggs
on Layer Farms. Journal Of Clinical Microbiology, 52(9), 3250-3258. doi:
10.1128/jcm.00816-14
Issenhuth-Jeanjean, S., Roggentin, P., Mikoleit, M., Guibourdenche, M., de Pinna, E., & Nair, S.
et al. (2014). Supplement 2008–2010 (no. 48) to the White–Kauffmann–Le Minor
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Pui, C., Wong, W., Chai, L., Nillian, E., Ghazali, F., & Cheah, Y. et al. (2011). Simultaneous
detection of Salmonella spp., Salmonella Typhi and Salmonella Typhimurium in sliced
fruits using multiplex PCR. Food Control, 22(2), 337-342. doi:
10.1016/j.foodcont.2010.05.021
Salmonella Homepage | CDC. (2019). Retrieved 22 August 2019, from
https://www.cdc.gov/salmonella/index.html
Salmonella in the Caribbean. (2004). Retrieved 16 August 2019, from
https://www.cdc.gov/epicasestudies/downloads/salm_i.pdf
Salmonellosis. (2014). Retrieved 22 August 2019, from
http://www.cfsph.iastate.edu/Factsheets/pdfs/nontyphoidal_salmonellosis.pdf
Tertiary Prevention. (2019). Retrieved 22 August 2019, from
https://www.healthlinkbc.ca/physical-activity/tertiary-prevention