Reptile‐Associated Salmonellosis in Minnesota, 1996–2011

Abstract

Reptile-associated salmonellosis (RAS) occurs when Salmonella is transmitted from a reptile to a human. This study describes the epidemiology of RAS in Minnesota during 1996-2011. All Minnesotans with confirmed Salmonella infections are reported to the Minnesota Department of Health (MDH). Case patients are interviewed about illness characteristics and risk factors, including foods eaten, drinking and recreational water exposures, contact with ill people, and animal contact. Willing RAS case patients can submit stool from the reptile for culture. Serotype and pulsed-field gel electrophoresis (PFGE) subtype of Salmonella isolates from reptiles and case patients are compared. Of 8389 sporadic (not associated with an outbreak) non-typhoidal salmonellosis case patients in Minnesotans during 1996-2011, 290 (3.5%) reported reptile exposure. The median age of case patients with reptile exposure was 11 years, 31% were under the age of 5 years and 67% were under the age of 20 years; 50% were female. The median illness duration was 8 days; 23% required hospitalization. The most commonly reported reptile exposures were lizard (47%), snake (20%), turtle (19%) and a combination of reptile types (14%). Eighty-four per cent of isolates from case patients who reported reptile exposure were Salmonella enterica subspecies I. The three most common serotypes were Typhimurium (15%), Enteritidis (7%) and subspecies IV serotypes (7%). Of 60 reptiles testing positive for Salmonella, 36 (60%) yielded the same Salmonella serotype as the human isolate. Twenty-six of 27 reptile isolates that were subtyped by PFGE were indistinguishable from the human isolate. Of these, 88% were subspecies I; the most common serotypes were Enteritidis (12%), Typhimurium (8%), and Bareilly (8%). RAS accounts for approximately 3.5% of salmonellosis cases in Minnesota, primarily affecting children. The majority of isolates from case patients and reptiles belonged to Salmonella subspecies I, suggesting that reptiles are a source of human infection with serotypes not traditionally considered to be reptile-associated.

Flea market finds and global exports: Four multistate outbreaks of human Salmonella infections linked to small turtles, United States—2015

“…Almost half (45%) of the ill people in these outbreaks were children aged <5 years; this high percentage of young children infected with Salmonella is consistent with other published literature on reptile‐associated salmonellosis (Meyer Sauteur, Relly, Hug, Wittenbrink, & Berger, ; Murphy & Oshin, ; Whitten, Bender, Smith, Leano, & Scheftel, ), including recent outbreaks (Harris et al., ; Walters et al., ). This high percentage might be explained by challenges in this age group to enforcing good hygiene practices or preventing the appeal of playing with small turtles or contact with the turtle's habitat, where bacteria grow (Mann & Bjotvedt, ).…”

Plasmid‐mediated quinolone resistance in human non‐typhoidal Salmonella infections: An emerging public health problem in the United States

“…Year TA B L E 1 Ciprofloxacin non-susceptibility a among non-typhoidal Salmonella surveillance isolates and plasmid-mediated quinolone resistance (PMQR) genes detected among isolates with the study phenotype b , by serotype, (Mermin et al, 2004). All patients in our study who reported reptile or amphibian exposure had isolates with PMQR genes and most of these isolates had serotypes that are reptile associated (Ackman, Drabkin, Birkhead, & Cieslak, 1995;Editorial Team et al, 2008;Guerra et al, 2010;Whitten, Bender, Smith, Leano, & Scheftel, 2015); these included several serotypes (e.g., Apapa, Telelkebir, IV 44:z4,z23:-) that are uncommon in humans (Centers for Disease Control & Prevention, 2017). Three Salmonella Litchfield isolates from these patients were ciprofloxacin resistant and were the only study isolates tested with >1 PMQR gene detected, consistent with reports of higher-level quinolone resistance in strains carrying two or more unrelated PMQR genes (Jacoby et al, 2014;Lin et al, 2015;Rodríguez-Martínez et al, 2016).…”

Reducing the risk of pet-associated zoonotic infections

“…Yet, pet contact has been identified as a risk factor for many diseases, with case-control studies and molecular typing data strongly supporting pet sources for bacterial (e.g., Campylobacter, Salmonella), fungal (e.g., dermatophytes), parasitic (e.g., Toxoplasma gondii) and viral pathogens (e.g., lymphocytic choriomeningitis virus). 6,[9][10][11][12] Although pets do not typically directly transmit arthropod-borne diseases to people (e.g., Lyme borreliosis, ehrlichiosis, anaplasmosis), they do bring the zoonotic disease vectors -ticks and fleas -in close proximity to people, potentially increasing disease risk.…”

“…In one study, 31% of reptile-associated salmonellosis cases occurred in children less Review than 5 years of age and 17% occurred in children aged 1 year or younger; these findings highlight the heightened risk in children and the potential for reptile-associated Salmonella to be transmitted without direct contact with the animal or its enclosure. 12 Outbreaks of pet-associated salmonellosis involving hedgehogs, rodents, young poultry, frogs and turtles have recently been reported, in which children accounted for a high proportion of cases (35%-70%). 23 In addition, various animal foods (e.g., raw meat, raw eggs and raw treats such as pig's ears) are commonly contaminated with Salmonella species.…”