Relationship between non-typhoidal Salmonella dose and food poisoning in humans: A systematic review

Food safety is a major public health concern. The zoonotic pathogen non-typhoidal Salmonella, responsible for salmonellosis, is a leading cause of bacterial food poisoning globally, making its detection and control essential. Understanding the infectious dose of Salmonella is crucial for identifying appropriate risk management strategies; however, significant uncertainties remain, warranting a systematic review. Following PRISMA guidelines, we conducted a comprehensive search across multiple databases (Web of Science, PubMed, and CAB Abstracts) to identify relevant studies examining the relationship between Salmonella dose and foodborne illness in humans. Four main types of studies were identified: experimental trials, case reports, case series, and mathematical modelling. An analysis of these studies revealed their respective strengths and limitations. The data showed considerable variability, with the dose required to cause illness depending on factors such as Salmonella serovar, food type, and the health status of the exposed population. A key challenge identified was the lack of sufficient data on collective food poisoning incidents, which complicates the development of more reliable dose-response models. Despite these limitations, this review underscores the importance of targeted food safety interventions and risk assessments tailored to specific food products and population groups. The findings provide a foundation for enhanced food safety measures and support ongoing efforts to protect public health from foodborne illnesses.