Outbreak of human infections with uncommon Salmonella serotypes linked to pet bearded dragons, 2012–2014

Abstract

Reptiles are one of the fastest growing sectors in the United States pet industry. Reptile‐associated salmonellosis (RAS) continues to be an important public health problem, especially among children. We investigated an outbreak of human Salmonella infections resulting from serotypes Cotham and Kisarawe, predominately occurring among children. An outbreak of illnesses was identified in persons with exposure to pet bearded dragon lizards. Human and animal health officials, in cooperation with the pet industry, conducted epidemiologic, traceback and laboratory investigations. Onsite sampling was conducted at two US breeding facilities, one foreign breeding facility, and a large pet retail chain. A total of 166 patients in 36 states were identified with illness onset dates from 02/2012–06/2014. The median patient age was 3 years (range, <1–79 years), 57% were aged ≤5 years, and 37% were aged ≤1 year. Forty‐four patients (37%) were hospitalized, predominantly children. Sampling at breeding facilities and a national pet store chain resulted in isolation of outbreak serotypes at each facility; isolation proportions ranged from 2%–24% of samples collected at each facility.Epidemiologic, microbiologic and traceback evidence linked an outbreak of uncommon Salmonella serotypes to contact with pet bearded dragons. The high proportion of infants involved in this outbreak highlights the need to educate owners about the risk of RAS in children and the potential for household contamination by pet reptiles or their habitats. Strategies should be developed to improve breeding practices, biosecurity and monitoring protocols to reduce Salmonella in the pet reptile trade.

Pet Reptiles: A Potential Source of Transmission of Multidrug-Resistant Salmonella

“…Reptiles have been known to be important carriers of Salmonella spp. worldwide, which may pose a health hazard as a source of human infection, particularly in children (4,16,(41)(42)(43). However, there is a lack of consensus regarding the role of reptile shops on MDR Salmonella strains spreading.…”

Turning Negatives into Positives for Pet Trading and Keeping: A Review of Positive Lists

“…The criteria used to formulate the Flemish list is described on the government's website as those species that are easy to keep; do not pose a risk to people; that have sufficient husbandry guidance available [187]. However, the established scientific consensus is that reptile husbandry is highly complex [188][189][190][191] and carries significant risks to public health [89,[192][193][194], thus the scientific rationale founding the Flemish positive list for reptiles is highly questionable.…”

Bacteriophage as an alternative to prevent reptile‐associated Salmonella transmission

“…Because RAS transmissions are related to direct contact with contaminated reptile skin and cage environments, bacteriophages were administered onto biofilms developed on both skin surfaces and polystyrene plates (Kiebler et al., 2020; Mermin et al., 2004). The ability to form a biofilm was confirmed before the biofilm degradation tests.…”

“…Additionally, many different serovars have been observed, including Pomona, Java, Stanley, Poona, Muenchen, Marina, Newport, Abaetetuba, Anatum, Cerro, Chameleon and Tilene (Pedersen et al, 2009;Woodward et al, 1997). Young patients (under 5 years of age) are hospitalized more frequently than older patients, and infants (under 1 year of age) comprise the largest proportion of patients (Aiken et al, 2010;Kiebler et al, 2020;Pedersen et al, 2009). Bacteriophages are viruses that infect and lyse specific target bacteria (Harper et al, 2014;Jassim & Limoges, 2014;Letchumanan et al, 2016) and are commonly isolated from the natural environment.…”