Four multistate Salmonella outbreaks in US linked to small turtles

Four multistate Salmonella outbreaks in the United States have been linked to small turtles or their environments, according to WHO and the CDC.

Outbreak strains were detected in 133 patients from 26 states since January 2015, 38 of whom were hospitalized. Most cases occurred in infants and young children, WHO reported. Fifty-one cases (41%) occurred in those aged younger than 5 years. No deaths were reported.

An initial investigation led by the CDC linked the outbreaks to four turtle farms in Louisiana, which may have exported infected turtles internationally. Pond water testing at all four farms revealed additional nonoutbreak Salmonella isolates.

WHO is urging countries that import reptile or amphibian pets, including small turtles, to be aware of possibly infected pets and to inform local health authorities of potential outbreaks, especially in the pediatric population. The CDC warned that all turtles can carry Salmonella, despite appearing healthy and clean. The agency expects the outbreak to continue as consumers may be unaware of their risk for Salmonella and turtles, when cared for properly, have a long life expectancy.

Although the sale and distribution of small turtles has been banned in the U.S. since 1975, similar Salmonella outbreaks linked to the animals have been recorded, WHO said. From 2011 to 2013, 473 Salmonella infections were reported in 41 states, Washington, D.C., and Puerto Rico, according to Casey Barton Behravesh, MS, DVM, DrPH, captain in the U.S. Public Health Service and director of the CDC’s One Health Office, and colleagues. Populations most affected by these outbreaks included children aged younger than 5 years, who accounted for 55% of the infections, and Hispanics, who accounted for 45% of infections. Another outbreak that occurred between April 26 and Sept. 22, 2014, resulted in 40 infections in adults and children from 12 states, 40% of whom were aged younger than 1 year.

Casey Barton Behravesh

“Despite an ongoing federal ban against their sale as pets, small turtles are a significant source of human illness,” Behravesh and colleagues wrote. “To reduce the number of illicitly marketed small pet turtles, state and local jurisdictions should consider enacting regulations against the sale of small pet turtles to complement federal enforcement activities.” – by Stephanie Viguers

References:

Basler C, et al. MMWR Morb Mortal Wkly Rep. 2015;64:804.

Walters MS, et al. Pediatrics. 2016;doi:10.1542/peds.2015-1735.

Disclosure: The researchers report no relevant financial disclosures.

* This story was last updated on May 19 to reflect the number of patients and states affected by the Salmonella outbreak.