Multistate Outbreaks of Human Salmonella Infections Linked to Small Turtles

Contact with reptiles (such as turtles, snakes, and lizards) and amphibians (such as frogs and toads) can be a source of human Salmonella infections. Salmonella germs are shed in the droppings of reptiles and amphibians and can easily contaminate their bodies and the water in tanks or aquariums where these animals live, which can spread to people. The Food and Drug Administration (FDA) has banned the sale and distribution of turtles with a shell length of less than 4 inches since 1975. However, small turtles continue to cause human Salmonella infections, especially among young children. CDC is collaborating with public health officials in multiple states and the FDA to investigate 6 overlapping, multistate outbreaks of human Salmonella infections linked to exposure to turtles or their environments (e.g., water from a turtle habitat). More than 160 illnesses have been reported from 30 states; 64 percent of ill persons are children age 10 or younger, and 27 percent of ill persons are children age one year or younger. Fifty-six percent of ill persons are Hispanic. A total of 168 persons infected with outbreak strains of Salmonella Sandiego, Salmonella Pomona, and Salmonella Poona have been reported from 30 states. The number of ill persons identified in each state is as follows: Alabama (2), Alaska (2), Arizona (5), California (28), Colorado (5), Delaware (3), Georgia (3), Illinois (3), Indiana (1), Kentucky (1), Louisiana (1), Maryland (6), Massachusetts (5), Michigan (2), Minnesota (1), Mississippi (1), New Jersey (7), North Carolina (1), New Mexico (6), Nevada (8), New York (25), Ohio (2), Oregon (1), Pennsylvania (16), South Carolina (4), Tennessee (4), Texas (19), Vermont (1), Virginia (4), and West Virginia (1). 34 ill persons have been hospitalized, and no deaths have been reported. 64% of ill persons are children 10 years of age or younger, and 27% of ill persons are children 1 year of age or younger. 56% of ill persons are of Hispanic ethnicity. Information about the association between reptiles and Salmonella is now available in Spanish. Results of the epidemiologic and environmental investigations indicate exposure to turtles or their environments (e.g., water from a turtle habitat) is the cause of these outbreaks. 72% of ill persons reported exposure to turtles prior to their illness. 94% of ill persons with turtle exposure specifically reported exposure to small turtles (shell length less than 4 inches). Thirty-nine percent of ill persons with small turtles reported purchasing the turtles from street vendors, and 15% reported purchasing small turtles from pet stores. Small turtles are a well-known source of human Salmonella infections, especially among young children. Because of this risk, the Food and Drug Administration has banned the sale and distribution of these turtles as pets since 1975. Turtles with a shell length of less than 4 inches in size should not be purchased as pets or given as gifts. Key Messages Dont buy small turtles from street vendors, websites, pet stores, or other sources. Keep reptiles out of homes with young children or people with weakened immune systems. Reptiles should not be kept in child care centers, nursery schools, or other facilities with young children. ALWAYS wash your hands thoroughly with soap and warm water immediately after touching a reptile or anything in the area where they live and roam. Use hand sanitizer if soap and water are not readily available. Adults should always supervise hand washing for young children.