Today, Del Monte recalled approximately 23,000 pounds of Guatemalan-grown canteloupe due to the product’s implication in a Salmonella outbreak that has sickened at least 12 people in 7 states. The recalled products were sold at Costco locations in affected states. This is the third time in the last three years that Del Monte cantaloupe products have been recalled, or implicated as the cause of a Salmonella outbreak.
Symptoms of Salmonella gastroenteritis include diarrhea, abdominal cramps, fever, nausea, and/or vomiting. In mild cases diarrhea may be non-bloody, occur several times per day, and not be very voluminous; in severe cases it may be frequent, bloody and/or mucoid, and of high volume. Complications of Salmonella infection can include sepsis, reactive arthritis, and post-infectious irritable bowel syndrome.
The arthritis that can be caused by Salmonella infection affects the knees, ankles, and feet, causing pain and swelling. Wrists, fingers and other joints can be affected, though with less frequency. Patients with reactive arthritis commonly develop inflammation where the tendon attaches to the bone, a condition called enthesopathy. Some patients with reactive arhtritis also develop heel spurs, bony growths in the heel that cause chronic or long-lasting foot pain. Reactive arthritis can also affect the joints of the back and cause spondylitis, inflammation of the vertebrae in the spinal column. The duration of reactive arthritis symptoms can vary greatly. Most of the literature suggests that the majority of patients recover within a year. The condition, can, however, be permanent. One study found nearly 50 percent of patients with post dysenteric reactive arthritis continued to have symptoms roughly one year after onset (Inman, et al., 1998).
Irritable bowel syndrome (IBS) is one disorder in a spectrum of common functional gastrointestinal disorders. Symptoms of IBS can include constipation, diarrhea, alternating diarrhea and constipation, abdominal pain, urgency, bloating, straining at stools, and a sense of incomplete evacuation. The Rome III definition for IBS, which is widely accepted in the medical community, is recurrent abdominal pain or discomfort at least three days per month for at least three months, with at least two of the following symptoms also present: improvement of the pain or discomfort with defecation, a change in frequency of stools, or a change also in the form or appearance of stool.
The observation that the onset of IBS symptoms can be precipitated by gastrointestinal infection dates to the 1950s. Different studies have shown that 7-31% of individuals who have experienced an episode of infectious gastroenteritis, whether bacterial or viral, may develop symptoms of IBS.
One recent meta-analysis (a study that combines results from previously published research studies and analyzes the larger number) of 8 studies published between 1950 and 2005 found a positive association between gastrointestinal infection and the onset of IBS in 6 of the studies. In this meta-analysis alone, the average occurrence of post-infectious IBS was 9.8%, compared to 1.2% in the control group. This equates to a sevenfold increase in the odds of developing IBS after gastrointestinal infection.
There appear to be several risk factors associated with the development of post-infectious IBS, including female sex, severity and duration of the acute infectious illness, whether the person suffered from bloody stools, and psychological profile. As with non-post-infectious IBS, the precise mechanism that produces the symptoms is not specifically known. The pathogens known to precipitate post-infectious IBS symptoms include specifically, though not necessarily exclusively, Enterotoxigenic E. coli strains, Shiga toxin-producing E. coli strains (including E. coli O157:H7), Campylobacter, Shigella, and Salmonella.