By Dr. Becker
The Centers for Disease Control and Prevention (CDC) is investigating an outbreak of salmonella linked to small turtles.
As of mid-May, 124 people in 27 states had been infected by 3 different strains of salmonella bacteria.
Of the 124 reported cases, 19 individuals have been hospitalized. Fortunately, no deaths have been reported. Young children are at higher risk for salmonella infection from turtles than older children and adults, with 67 percent of reported cases affecting kids 10 years of age or younger.
The number of ill persons identified in each state is as follows: Alaska (2), Alabama (1), Arizona (3), California (21), Colorado (5), Delaware (3), Georgia (3), Illinois (1), Indiana (1), Kentucky (1), Massachusetts (3), Maryland (6), Michigan (2), Minnesota (1), Nevada (4), New Jersey (7), New Mexico (3), New York (24), North Carolina (1), Ohio (2), Oregon (1), Pennsylvania (9), South Carolina (3), Texas (12), Virginia (3), Vermont (1), and West Virginia (1).
Five Multistate Outbreaks
In what the CDC is referring to as Outbreak 1, the culprit is Salmonella Sandiego, strain A. Infections from this strain of bacteria have been reported in 55 people and 13 states. Median age of patients is 7, and about 25 percent required hospitalization.
Turtles with a shell length of less than 4 inches purchased from street vendors were reported as harboring the bacteria. (It is actually illegal to sell these turtles.) The majority were identified as red-eared slider turtles.
In CDC Outbreak 2, both Salmonella Sandiego, strain A, and Salmonella Pomona, strain A were identified, indicating the turtles may have come from the same source as those in outbreak 1. Of the 9 cases reported in 8 states, 3 sufferers were hospitalized. As in outbreak 1, the turtles were identified as having a shell length of less than 4 inches.
Outbreak 3 involves 15 individuals in 8 states and the bacteria strain has been identified as Salmonella Poona, strain A. Median age of patients is 3 and over 25 percent required hospitalization.
The majority of people infected in this outbreak reported contact with turtles in the week before they became ill. Red-eared sliders purchased from street vendors were again identified.
Outbreak 4 currently involves 6 reported infections from 3 states, and the bacteria has been identified as Salmonella Sandiego, strain B. Sickened individuals have a median age of 17 and only 1 person has been hospitalized.
Red-eared slider turtles were again identified. Purchases were made from pet stores, a street vendor and a flea market.
In Outbreak 5, 39 individuals in 16 states are reported as infected with Salmonella Pomona, strain B. Median age is 1 year and 2 people have been hospitalized. Once again, small turtles purchased from street vendors were identified.
The investigation into this outbreak suggests a common source for the turtles in outbreak 1 and outbreak 5.
Because so many of the turtles linked to illness were purchased from street vendors, it makes it very difficult for CDC investigators to identify the original source of contamination. Because of the known risk of salmonella infections from small turtles, the FDA has banned the sale and distribution of these turtles (smaller than four inches in diameter) as pets since 1975.
Signs of Salmonella Infection
Contact with turtles and other reptiles and amphibians, and their habitats, is a common source of human salmonella infection.
These animals carry salmonella bacteria that are shed in their feces and then contaminate their bodies and habitats. Humans pick up the bacteria by handling the animals and their living environment.
If you or another family member becomes infected with salmonella from a turtle, illness usually develops within 12 to 72 hours after contact. Symptoms of infection include abdominal cramping, vomiting, diarrhea and fever.
A salmonella infection usually runs its course in 4 to 7 days. More serious infections can require hospitalization, and if the infection moves from the intestines into the bloodstream and other organs, death can result without immediate treatment.
Not only are young children more susceptible to infection, so are the elderly and people with compromised immune systems.
People who keep reptiles and amphibians should be aware that bacteria normal to the species can cause infection in humans. Many of these animals can make wonderful pets as long as you recognize the risks associated with potential bacterial contamination.
The following handling tips will help keep everyone in the family safe from infection:
- Wash your hands thoroughly with soap and water after handling any amphibian or reptile, or anything your pet has come in contact with.
- Closely supervise any children who handle amphibians, reptiles or their habitats, and help the little ones wash their hands properly.
- Children five and under should not handle these pets or any components of their habitats.
- Elderly members of the household or anyone with a compromised immune system should also avoid contact with these pets and their habitats.
- If anyone in your household develops the symptoms of salmonella infection, contact a health care provider and advise them of any contact with reptiles or amphibians.
- Amphibians and reptiles should not be kept in child-care centers where hands-on activities are encouraged, nor should they be housed in children's bedrooms.
- Don't allow these pets to roam around your house, and especially not in food and drink preparation areas.
- When cleaning a reptile or amphibian habitat, wear disposable gloves and if possible, do the cleaning outdoors. Don't clean the habitat near any food or drink preparation areas, sources of food or drinking water, or the kitchen sink. Discard the gloves after cleaning the habitat, and wash your hands and any exposed areas of your arms thoroughly.
- Don't bathe these pets in the kitchen sink or near any food or drink preparation areas. If you bathe your reptiles or amphibians in the bathtub or use it for habitat cleaning, thoroughly clean and disinfect it afterward to kill any bacteria that may have transferred to tub surfaces.
- Reduce the shedding of salmonella bacteria by reducing environmental stress. House turtles and other reptile or amphibian pets in an optimal environment, with appropriate water quality and filtration, cage size, temperature, UV light and feed species-appropriate nutrition.
- Avoid purchasing juvenile turtles (smaller than four inches) or supporting street vendors participating in the exploitation of exotic animals.