Public health priority: High if a cluster. Routine for all others.
PHU response time: Respond to confirmed cases on the same day of notification if:
Enter confirmed cases on NCIMS within 3 working days.
Case management: Advise cases who are food handlers or who care for children, the elderly or patients to stay away from work until 48 hours have elapsed after symptoms have completely resolved. Identify likely source.
Contact management: Close contacts should be encouraged to seek medical attention early if symptoms develop.
Only confirmed cases should be notified
A confirmed case requires laboratory definitive evidence only.
Salmonella infection is to be notified by:
There are many different serotypes of Salmonella that cause human disease.
The typical incubation period can vary from 6 hours to 3 days, (and occasionally longer), but is commonly 12 to 36 hours. Salmonellosis is infectious while the case's stools are positive, which can vary from several days to several weeks after infection. A temporary carrier state occasionally continues for months, particularly in infants, the elderly and immunocompromised people. Long term permanent carriage occurs in <1% of the population.
Salmonella infection usually presents as acute gastroenteritis, with sudden onset of headache, abdominal pain, diarrhoea, nausea and sometimes vomiting. In rare cases, Salmonella can cause septicaemia or focal infections such as abscesses or arthritis.
Begin follow-up investigation on same day of notification for
Notify the Communicable Disease Branch on the day a cluster of cases of any Salmonella serotype or MLVA type is identified. Local clusters should be investigated by the Public Health Unit in whose area the cases reside, using the hypothesis generating questionnaire on the NSW Health website.
Investigations of state wide outbreaks will be centrally coordinated in close collaboration with the PHUs.
Within 3 working days of notification enter confirmed cases on NCIMS. Serotype and MVLA type will be automatically uploaded into NCIMS by the enterics team.
The response to a notification will normally be carried out in collaboration with the case's health carers. Where the PHU undertakes follow up, it should ensure that action has been taken to:
For case treatment, refer to Therapeutic Guidelines: Antibiotic. For non-invasive and uncomplicated cases, treatment is usually supportive only. Antibiotics given in the acute stage may prolong the carrier state, but may be indicated in the very young, the elderly or debilitated.
The case or relevant care-giver should be informed about the nature of the infection and the mode of transmission. Emphasise the importance of correct food handling and hygienic practices, particularly hand washing before eating and preparing food and after going to the toilet.
Where a food source is suspected on epidemiological grounds, immediately notify the NSW Food Authority to conduct an environmental assessment and consider control measures.