Salmonella Gastroenteritis (Child)
Salmonella is a kind of bacteria that is carried by some animals. This includes chickens, turkeys, and other birds, cows, pigs, turtles, lizards, iguanas, dogs, and cats. People can get it by eating food that comes from an infected animal. This includes raw eggs and raw or undercooked meat. It can also be passed by food or water that has come in contact with the feces of an infected animal or person.
This infection occurs most often in children under 5. Children with immune system problems are at higher risk for more severe illness.
A salmonella infection can cause symptoms, such as:
Symptoms appear within 2 days of exposure. They usually go away after 3 to 7 days.
Antibiotics are sometimes given to treat this illness. Mild symptoms will get better without any antibiotic treatment. More severe illness or those at high risk will need antibiotics.
The main danger from this illness is dehydration. This is the loss of too much water and minerals from the body. When this occurs, body fluids must be replaced. This can be done with oral rehydration solution. Oral rehydration solution is available at drugstores and most grocery stores.
Home care
Follow all directions given by your child’s healthcare provider.
If giving medicines to your child:
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Don’t give over-the-counter diarrhea medicines unless your child’s provider tells you to. These can make the illness last longer.
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If antibiotics were prescribed, make sure your child takes them every day until they are finished. Don’t stop giving them if your child feels better. Antibiotics must be taken as a full course.
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You can use acetaminophen or ibuprofen to control pain and fever. Or you can use other medicine as prescribed.
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Never give aspirin to a child or teen. It could cause a rare but serious condition called Reye syndrome.
To prevent the spread of illness:
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Remember that washing with soap and water and using alcohol-based sanitizer is the best way to prevent the spread of infection. Wash your hands before and after caring for your sick child.
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Clean the toilet after each use.
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Keep your child out of daycare until they are cleared by the healthcare provider.
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Teach your child to wash their hands after using the toilet and before meals. This is very important if your child is in day care.
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Make sure your child doesn't have contact with the feces of reptiles (turtles, lizards, and iguanas), birds, dogs, and cats. Wash hands with soap after handling reptiles, birds, or baby chicks, and after contact with pet feces.
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Wash your hands before and after preparing food. Keep in mind that people with diarrhea or vomiting should not prepare food for others.
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Wash your hands after using cutting boards, counter tops, and knives that have been in contact with raw foods.
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Wash and then peel fruits and vegetables.
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Keep uncooked meats away from cooked and ready-to-eat foods.
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Wash all cooking utensils, including cutting boards, after they touch raw food
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Use a food thermometer when cooking. Cook poultry to at least 165°F (74°C). Cook ground meat (beef, veal, pork, lamb) to at least 160°F (71°C). Cook fresh beef, veal, lamb, and pork to at least 145°F (63°C).
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Don’t serve raw or undercooked eggs (poached or sunny side up), poultry, meat, or unpasteurized milk and juices to your child.
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Don't eat foods made with unpasteurized milk
Giving liquids and food
The main goal while treating vomiting or diarrhea is to prevent dehydration. This is done by giving small amounts of liquids often.
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Keep in mind that liquids are more important than food right now. Give small amounts of liquids at a time, especially if your child is having stomach cramps or vomiting.
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For diarrhea: If you are giving milk to your child and the diarrhea is not going away, stop the milk. In some cases, milk can make diarrhea worse. If that happens, use oral rehydration solution instead. Don't give apple juice, soda, or other sweetened drinks. Drinks with sugar can make diarrhea worse.
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For vomiting: Start with oral rehydration solution (ORS) at room temperature. Give 1 teaspoon (5 ml) every 5 minutes. Even if your child vomits, continue to give ORS. Much of the liquid will be absorbed, in spite of the vomiting. After 2 hours with no vomiting, start with small amounts of milk or formula and other fluids. Increase the amount as tolerated. Don't give your child plain water, milk, formula, or other liquids until vomiting stops. As vomiting decreases, try giving larger amounts of ORS. Space this out with more time in between. Continue this until your child is making urine and is no longer thirsty (has no interest in drinking). After 4 hours with no vomiting, restart solid foods. After 24 hours with no vomiting, resume a normal diet.
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You can resume your child's normal diet over time as they feel better. Don’t force your child to eat, especially if they are having stomach pain or cramping. Don’t feed your child large amounts at a time, even if they are hungry. This can make your child feel worse. You can give your child more food over time if they can tolerate it. Foods you can give include cereal, mashed potatoes, applesauce, mashed bananas, crackers, dry toast, rice, oatmeal, bread, noodles, pretzels, soups with rice or noodles, and cooked vegetables.
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If the symptoms come back, go back to a simple diet or clear liquids.
Follow-up care
Follow up with your child’s healthcare provider, or as advised. If a stool sample was taken or cultures were done, call the healthcare provider for the results as instructed.
Call 911
Call 911right away if any of these symptoms occur:
When to get medical advice
Call your child’s healthcare provider right away if any of the following occur:
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Belly pain that gets worse
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Constant lower right belly pain
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Repeated vomiting after the first 2 hours on liquids
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Occasional vomiting for more than 24 hours
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More than 8 diarrhea stools in 8 hours
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Severe diarrhea for more than 24 hours
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Blood in vomit or stool
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Reduced oral intake
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Dark urine or no urine for 4 to 6 hours in a baby or younger child, or 6 to 8 hours in an older child, no tears when crying, sunken eyes, or dry mouth
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Fussiness or crying that can't be soothed
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Abnormal drowsiness
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New rash
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Diarrhea lasts more than 1 week
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Fever is to be expected with Salmonella infection. But call for ongoing fevers beyond what your child's provider has explained to be normal. (see "Fever and children" below)
Fever and children
Use a digital thermometer to check your child’s temperature. Don’t use a mercury thermometer. There are different kinds and uses of digital thermometers. They include:
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Rectal. For children younger than 3 years, a rectal temperature is the most accurate.
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Forehead (temporal). This works for children age 3 months and older. If a child under 3 months old has signs of illness, this can be used for a first pass. The provider may want to confirm with a rectal temperature.
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Ear (tympanic). Ear temperatures are accurate after 6 months of age, but not before.
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Armpit (axillary). This is the least reliable but may be used for a first pass to check a child of any age with signs of illness. The provider may want to confirm with a rectal temperature.
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Mouth (oral). Don’t use a thermometer in your child’s mouth until they are at least 4 years old.
Use a rectal thermometer with care. Follow the product maker’s directions for correct use. Insert it gently. Label it and make sure it’s not used in the mouth. It may pass on germs from the stool. If you don’t feel OK using a rectal thermometer, ask the healthcare provider what type to use instead. When you talk with any healthcare provider about your child’s fever, tell them which type you used.
Below is when to call the healthcare provider if your child has a fever. Your child’s healthcare provider may give you different numbers. Follow their instructions.
When to call a healthcare provider about your child’s fever
For a baby under 3 months old:
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First, ask your child’s healthcare provider how you should take the temperature.
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Rectal or forehead: 100.4°F (38°C) or higher
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Armpit: 99°F (37.2°C) or higher
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A fever of ___________as advised by the provider
For a child age 3 months to 36 months (3 years):
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Rectal or forehead: 102°F (38.9°C) or higher
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Ear (only for use over age 6 months): 102°F (38.9°C) or higher
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A fever of ___________ as advised by the provider
In these cases:
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Armpit temperature of 103°F (39.4°C) or higher in a child of any age
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Temperature of 104°F (40°C) or higher in a child of any age
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A fever of ___________ as advised by the provider