Picking up chicks may be bad for your health. That's Rick's quip in this week's PodMed and my intro for the YouTube. We're both talking not about sexually transmitted infections or other risks of what many of us likely conjure up when we think 'picking up chicks,' rather, we're talking about live young poultry and the risk of salmonella infection, as reported in this week's New England Journal of Medicine.
Yes, indeed, turns out that a very lengthy and exhaustive sleuthing process described in this study identified mail order poultry as the cause of an outbreak of Salmonella Montevideo taking place in the United States between 2004 and 2011. During this time period there were 316 cases in 43 states, with cases peaking in the spring. About a quarter of those who developed the infection were hospitalized, but no deaths were reported.
The mean age of those who developed salmonella infection was 4 years. When investigators asked caregivers of these children whether they were aware that salmonella infection could be acquired through contact with an infected bird, only 21% of those interviewed said yes. Only 7% reported that when they purchased the bird they were informed, either in writing or orally, about the risk of salmonella infection from the animal.
So outside of the wow value of the impressive investigation necessary to identify the hatchery the infected birds came from, what are the public health implications of such a study? Turns out that standards for reducing the likelihood of salmonella infection relative to live birds shipped elsewhere are not the same as those for commercial hen or egg production, and are also voluntary. As the study authors point out, this investigation also reveals the difficulties inherent in trying to effectively interrupt salmonella infection in poultry.
So while we're waiting for some law-level interventions, what's a responsible parent or consumer to do? Obviously, one effective intervention is simply NOT to order chicks for Easter, which likely is why at least some of these birds were purchased. A look at the picture of dyed chicks, above, clearly demonstrates their almost irresistible cuteness, but like puppies, they do grow up and need to be taken care of. Can't overcome desire? A few hygiene measures can be employed: keep the birds out of the house and don't keep them near food or places where food is prepared. WASH YOUR HANDS (btw, the single most important infection control measure you can perform anywhere, anytime) after handling the chicks, and don't allow your young children to handle them at all. Having had young children, I would say it's a very good reason not to even buy the birds in the first place.
Older people and those with compromised immune systems are also at risk for acquring this infection, and may additionally experience more dire consequences, so once again, avoidance is prudent. It's worth keeping in mind that the birds infected with salmonella do not themselves appear sick, so that's no metric for reducing infection risk.
Other topics this week include a look at hormone replacement therapy guidelines in Annals of Internal Medicine, and three studies in Archives of Internal Medicine: the cardiovascular impact of both hypo- and hyperthyroid, and intensive glucose control and kidney disease. Until next week, y'all live well.