Editor’s note: This article summarizes key points from a Centers for Disease Control and Prevention (CDC) report published in Morbidity and Mortality Weekly Report (MMWR). The Introduction and Comment sections may include information that did not appear in the original publication. To subscribe to MMWR, visit www.cdc.gov/MMWR.
- “Notes from the Field: Four Multistate Outbreaks of Human Salmonella Infections Linked to Small Turtle Exposure – United States, 2015.” MMWR. 2016;65(25):655-656, https://www.cdc.gov/mmwr/volumes/65/wr/mm6525a3.htm?s_cid=mm6525a3_w.
Nontyphoidal Salmonella organisms cause a spectrum of illness, including acute gastroenteritis, bacteremia, meningitis, brain abscess and osteomyelitis. In the U.S., the rates of invasive Salmonella infection are highest among infants.
Over the last 10 years, a large number of Salmonella outbreaks have been attributed to contaminated food, live poultry and reptiles, including small turtles with a shell length of less than 4 inches. The Food and Drug Administration banned the sale and distribution of small turtles in 1975, but flea markets and discount stores throughout the U.S. continue to sell these animals.
In 2015, four separate multistate outbreaks of Salmonella were linked to small turtle exposure, and 124 people in 22 states were infected. The median patient age was 7 years (range less than 1 year to 82 years), and 41% were younger than 5 years of age. Thirty-three percent of people with available information were hospitalized, and 70% with ethnicity information were Hispanic.
The serovars implicated in these outbreaks were Salmonella Sandiego and Poona, as determined by Pulse Net, the national molecular subtyping network (http://www.cdc.gov/pulsenet/index.html).
The AAP Red Book advises pet owners to practice thorough hand hygiene after handling turtles or anything in their pets’ environment and limiting exposure of children younger than 5 years of age and immunocompromised people to animals that may carry Salmonella.
The CDC further advises pet owners and vendors to avoid illegal transactions involving small turtles at discount stores and flea markets. Advice is available in English and Spanish at http://www.cdc.gov/salmonella/small-turtles-10-15/advice.html.
When you see a turtle, think Salmonella.
