Recent Multistate Outbreaks of HumanSalmonellaInfections Acquired from Turtles: A Continuing Public Health Challenge

Abstract

The federal ban in the United States on the sale of turtles with shell lengths <4 inches that was established in 1975 has reduced the number of turtle-associated human Salmonella infections during subsequent years, especially among children. Although numerous sporadic turtle-associated Salmonella infections in humans have been reported since the ban went into effect, outbreaks were not reported until recently. Since 2006, 3 multistate outbreaks of turtle-associated Salmonella infections have been documented in the United States. This review examines the history of turtle-associated human Salmonella infections in the United States and discusses reasons why an increase in turtle-associated salmonellosis may be occurring and how challenges in enforcement of the ban affect disease control. Additional steps should be considered by the public health community, state governments, and enforcement agencies to prevent turtle-associated Salmonella infections in humans.

Household pets and zoonoses

“…The recall of rodents used as pet feed do not fall within the mandate of the CFIA, the agency responsible for food recalls in Canada. Numerous regulatory gaps exist in the enforcement of legislation pertaining to the sale and distribution of pets such as pet frogs and turtles as well (Harris et al 2010;CDC 2010).…”

“…Knowledge gaps have been identified with pet owners and pet distributors who do not understand the disease risks associated with these animals (CDC 2010; Harris et al 2010). Inadequate understanding among daycare staff, school teachers, and health care practitioners pertaining to the screening and safe handling of pets and the risks of disease transmission is also an identified knowledge gap (Croft et al 2007;Pickering et al 2008;Fritz 2009;Little 2010;Younus et al 2010).…”

Gastroenteritis por Salmonella spp. en tres lactantes asociada a contacto con tortugas acuáticas

“…En humanos, las infecciones por Salmonella no tífica se manifiestan generalmente como una gastroenteritis autolimitada. Sin embargo, en pacientes con factores de riesgo como niños bajo cinco años, inmunocomprometidos y adultos mayores, estas infecciones pueden producir meningitis, sepsis e incluso la muerte 2,3 . En Chile, durante el período de vigilancia 2008-2011, el Instituto de Salud Pública (ISP) confirmó 11.403 aislados provenientes de muestras clínicas, con una tasa de incidencia de 21 por 100.000 habitantes en 2011.…”

“…Aproximadamente 6% de las salmonelosis en E.U.A, son adquiridas por contacto directo o indirecto con reptiles 9 . Desde la década de los 50 en Europa y 60 en E.U.A, se han reportado casos de infecciones humanas asociadas a tortugas adquiridas como mascotas 3,12,13 . La especie más frecuentemente asociada a estas infecciones es Trachemys scripta elegans, conocida popularmente como tortuga acuática de orejas rojas 3 .…”

“…Desde la década de los 50 en Europa y 60 en E.U.A, se han reportado casos de infecciones humanas asociadas a tortugas adquiridas como mascotas 3,12,13 . La especie más frecuentemente asociada a estas infecciones es Trachemys scripta elegans, conocida popularmente como tortuga acuática de orejas rojas 3 . El aumento de casos llevó al gobierno estadounidense a establecer políticas de control, intentando certificar tortugas libres de Salmonella spp.…”