What is salmonellosis?

Salmonellosis is a foodborne infection caused by non-typhoidal Salmonella bacteria — distinct from typhoid fever (which is caused by S. Typhi and is covered in a separate hub). Non-typhoidal Salmonella causes approximately 93 million cases of diarrhoea per year globally. It typically causes acute gastroenteritis: sudden onset of nausea, vomiting, abdominal cramps, watery diarrhoea and fever, starting 6-72 hours after ingesting contaminated food and lasting 4-7 days. Most cases resolve without specific treatment.

What foods most commonly cause salmonellosis?

The highest-risk foods: eggs and egg products (raw eggs, runny yolks, homemade mayonnaise, tiramisu, raw cookie dough); poultry (undercooked chicken — particularly important to cook thoroughly to 75°C); pork and pig products; raw milk and unpasteurised dairy; fresh produce (sprouts, leafy greens, melons, tomatoes). Direct animal contact: reptiles (turtles, lizards, snakes — natural asymptomatic carriers), baby chicks and ducklings, farm animals. Prevention: cook poultry to ≥75°C; refrigerate food properly; wash hands after animal contact; avoid raw eggs.

Should antibiotics be used for salmonellosis?

For uncomplicated gastroenteritis in immunocompetent adults and children over 12 months: NO — antibiotics do not shorten illness duration, may prolong Salmonella faecal carriage, and accelerate AMR development. Management: oral rehydration (ORS), rest, adequate fluid intake. Antibiotics are indicated for: severe illness (high fever, systemic toxicity, bloody diarrhoea); invasive disease (bacteraemia, meningitis); immunocompromised patients (HIV, transplant, malignancy); infants under 3 months; adults over 65. First-line: fluoroquinolones (ciprofloxacin) or azithromycin — depending on local resistance patterns.

What is invasive NTS and why is it important in Africa?

Invasive non-typhoidal Salmonella (iNTS) is a distinct clinical syndrome — Salmonella entering the bloodstream to cause bacteraemia, meningitis or focal infections — occurring predominantly in immunocompromised individuals. In sub-Saharan Africa, iNTS disproportionately affects young children with malaria (Plasmodium falciparum malaria impairs splenic clearance of Salmonella), severe anaemia, malnutrition or sickle cell disease. iNTS causes a case fatality rate of 20-25% and is the most common bacterial cause of bloodstream infection in African children. This is why NTS — usually a self-limiting GI illness in HICs — is a major killer in LMICs.

How is Salmonella AMR a global threat?

Salmonella has developed resistance to every major antibiotic class used for treatment: Ampicillin, chloramphenicol, tetracyclines (widespread). Fluoroquinolones (ciprofloxacin): rising resistance globally — >50% in some Asian settings. ESBLs and AmpC beta-lactamases: cephalosporin resistance in NTS is increasingly documented. MDR-DT104 (Salmonella Typhimurium DT104): a multiresistant clone now present globally. The consequence: treatment of invasive NTS disease becomes increasingly difficult, particularly in resource-limited settings where affordable options are limited. WHO considers fluoroquinolone-resistant and ESBL-producing Salmonella high-priority AMR organisms.

How does GMJ News cover salmonellosis?

GMJ News covers WHO and ECDC-EFSA Salmonella data, EU One Health surveillance, iNTS burden in Africa, AMR resistance escalation, egg/poultry safety, reptile transmission, and antibiotic stewardship (no antibiotics in uncomplicated cases). Salmonella — the most common zoonotic foodborne pathogen in Europe — is directly relevant to PHIG's One Health and food safety programme.

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Salmonellosis

GMJ News knowledge hub · last reviewed September 2026 · Georgian Medical Journal

Summary Statistics Glossary GMJ news FAQ Documents Organizations Research

Salmonellosis — caused by non-typhoidal Salmonella (NTS) serovars such as S. Typhimurium and S. Enteritidis — is the most common foodborne zoonotic disease in the European Union and causes an estimated 93 million diarrhoeal episodes and 155,000 deaths per year globally, with the dominant exposure routes through eggs and poultry products, pig meat, reptile contact and contaminated fresh produce (WHO). Salmonella topped the EFSA-ECDC EU One Health 2024 Zoonoses Report as the most common cause of multi-country food-borne outbreaks in the EU — and antimicrobial resistance in Salmonella (MDR-DT104, ESBLs, fluoroquinolone resistance) is an escalating global threat that critically compromises treatment of invasive NTS disease, which kills approximately one quarter of children in sub-Saharan Africa who develop it in the context of malaria and sickle cell disease.

Key messages

#1 EU foodborne zoonotic — 93M cases/year

Salmonella topped the EFSA-ECDC EU One Health 2024 Zoonoses Report as the most common cause of multi-country foodborne outbreaks in the EU. Globally: 93 million diarrhoeal episodes and 155,000 deaths per year (WHO).

No antibiotics for uncomplicated cases

Non-typhoidal Salmonella gastroenteritis in immunocompetent patients is self-limiting (3-7 days). Antibiotics are NOT recommended for uncomplicated cases — they prolong carriage, increase AMR and do not shorten illness. They are reserved for severe/invasive disease, immunocompromised and infants <3 months.

Eggs, poultry and reptiles — the main sources

S. Enteritidis in eggs and poultry, S. Typhimurium in pigs and cattle, fresh produce, and direct reptile contact (turtles, lizards, snakes naturally carry Salmonella) are the dominant exposure routes. Raw eggs in homemade mayonnaise, tiramisu and sauces are a classic outbreak vehicle.

AMR — a growing crisis

Multidrug-resistant Salmonella (MDR-DT104 — resistant to ampicillin, chloramphenicol, streptomycin, sulfonamides, tetracyclines) and ESBL-producing strains resistant to cephalosporins are rising globally. Fluoroquinolone resistance compromises treatment of invasive NTS disease.

Invasive NTS — kills children in Africa

Invasive non-typhoidal Salmonella (iNTS) bacteraemia — occurring predominantly in sub-Saharan African children with malaria, severe malnutrition or sickle cell disease — has a case fatality rate of 20-25%, making NTS a leading cause of childhood bacterial meningitis and septicaemia in the region.

Georgia context — food safety and animal husbandry

Georgia has active Salmonella surveillance in poultry, cattle and pigs aligned with EU and international standards. Food safety management in Georgian poultry and egg production is a PHIG and food safety agency priority, given the One Health burden.

Key statistics

93M

non-typhoidal Salmonella diarrhoeal episodes/year globally

WHO

155K

deaths/year from non-typhoidal Salmonella globally

WHO

most common zoonotic foodborne pathogen in EU (EFSA-ECDC One Health 2024)

ECDC/EFSA 2024

20-25%

CFR of invasive NTS bacteraemia in sub-Saharan African children

WHO/Lancet

Rising

fluoroquinolone and ESBL resistance in Salmonella globally

WHO/ECDC

antibiotics recommended for uncomplicated NTS gastroenteritis

WHO

Salmonella EU foodborne outbreaks by food vehicle — EFSA-ECDC 2024 One Health Report

Source: EFSA-ECDC. Eggs and egg products consistently rank as the highest-risk vehicle for Salmonella outbreaks in the EU.

Glossary of key terms

Non-typhoidal Salmonella (NTS)
WHOSalmonella serovars other than S. Typhi and S. Paratyphi — the agents of typhoid/paratyphoid fever. Over 2,500 NTS serovars exist; the most epidemiologically important are S. Typhimurium and S. Enteritidis. NTS causes self-limiting gastroenteritis in immunocompetent hosts, and invasive disease (bacteraemia, meningitis) in vulnerable populations.

S. Enteritidis in eggs
WHO/EFSAThe most common NTS serovar globally — uniquely able to infect the ovary and oviduct of laying hens, causing internal contamination of intact eggs before the shell is laid. EU targets for reducing S. Enteritidis in laying flocks have reduced the egg-associated outbreak burden but have not eliminated it.

MDR-DT104
WHO/LancetSalmonella Typhimurium phage type 104 — a multidrug-resistant clone (resistant to ACSSuT: ampicillin, chloramphenicol, streptomycin, sulfonamides, tetracyclines) that emerged in cattle in the UK in the 1990s and spread globally. MDR-DT104 with additional fluoroquinolone resistance is increasingly reported.

iNTS (invasive NTS)
WHO/LancetA distinct clinical syndrome — Salmonella bacteraemia/meningitis/osteomyelitis — predominantly affecting immunocompromised individuals. In sub-Saharan Africa, iNTS overwhelmingly affects children under 5 with malaria (disrupts splenic NTS clearance), severe malnutrition or sickle cell disease. iNTS is the leading bacterial cause of bloodstream infection in African children.

Reptile-associated salmonellosis
CDC/WHOReptiles (turtles, lizards, snakes, frogs, iguanas) are natural asymptomatic Salmonella carriers — shedding bacteria in their faeces. Contact with reptiles or their environment (tanks, water) is a major risk, particularly for young children. CDC banned sale of small turtles in the US in 1975 for this reason.

EU zoonoses directive (2003/99/EC)
EFSA/ECDCMandates EU Member States to monitor and report eight priority zoonotic pathogens including Salmonella. EU-level reduction targets for Salmonella in poultry breeding and laying flocks have reduced the egg-associated outbreak burden in recent decades.