By now, most of the estimated 94 victims of the On the Border Salmonella outbreak in Vancouver, Washington, have at least begun their recoveries.  It is likely that more will be added to the number 94.  Will it top 100 victims? 

Salmonella illnesses many times do not carry the same long term health risks that a person who suffers from HUS after an E. coli illness has.  It is typically a self-limited, though severe, gastrointestinal illness that resolves with time.  But a certain percentage of Salmonella victims–and certainly a certain percentage of On the Border Salmonella outbreak victims–will go on to develop either post infectious irritable bowel syndrome or reactive arthritis.

Post Infectious Irritable Bowel Syndrome:

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 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.

Reactive Arthritis:

The terminology used to describe this type of complication has changed over time. The term “Reiter’s Syndrome” was used for many years, but has now fallen into disfavor. The precise proportion of persons that develop reactive arthritis following a Salmonella infection is unknown, with estimates ranging from 2 to 15%. [11] Symptoms of reactive arthritis include inflammation (swelling, redness, heat, and pain) of the joints, the genitourinary tract (reproductive and urinary organs), or the eyes.

More specifically, symptoms of reactive arthritis include pain and swelling in the knees, ankles, feet and heels. It may also affect wrists, fingers, other joints, or the lower back. Tendonitis (inflammation of the tendons) or enthesitis (inflammation where tendons attach to the bone) can occur. Other symptoms may include prostatitis, cervicitis, urethritis (inflammation of the prostate gland, cervix or urethra), conjunctivitis (inflammation of the membrane lining the eyelid) or uveitis (inflammation of the inner eye). Ulcers and skin rashes are less common. [12] Symptoms can range from mild to severe.