Turtle-associated salmonellosis in Puerto Rico. Hazards of the global turtle trade

Tauxe, Robert V.

doi:10.1001/jama.254.2.237

Cited by 15 publications

(13 citation statements)

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“…Most case-patients in these outbreaks were infants and children <5 years, consistent with historical observations 11,25 and recent outbreaks 17,18,20 showing that TAS predominantly affects young children. Half of case-patients <5 years had direct contact with turtles in the week before they became ill; others likely became infected in the home through contact with surfaces contaminated by turtles and turtle habitats.…”

Section: Figuresupporting

confidence: 87%

Outbreaks of Salmonellosis From Small Turtles

et al. 2016

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OBJECTIVE: Turtle-associated salmonellosis (TAS), especially in children, is a reemerging public health issue. In 1975, small pet turtles (shell length <4 inches) sales were banned by federal law; reductions in pediatric TAS followed. Since 2006, the number of multistate TAS outbreaks has increased. We describe 8 multistate outbreaks with illness-onset dates occurring in 2011–2013. METHODS: We conducted epidemiologic, environmental, and traceback investigations. Cases were defined as infection with ≥1 of 10 molecular subtypes of Salmonella Sandiego, Pomona, Poona, Typhimurium, and I 4,[5],12:i:-. Water samples from turtle habitats linked to human illnesses were cultured for Salmonella. RESULTS: We identified 8 outbreaks totaling 473 cases from 41 states, Washington DC, and Puerto Rico with illness onsets during May 2011–September 2013. The median patient age was 4 years (range: 1 month–94 years); 45% percent were Hispanic; and 28% were hospitalized. In the week preceding illness, 68% (187 of 273) of case-patients reported turtle exposure; among these, 88% (124 of 141) described small turtles. Outbreak strains were isolated from turtle habitats linked to human illnesses in seven outbreaks. Traceback investigations identified 2 Louisiana turtle farms as the source of small turtles linked to 1 outbreak; 1 outbreak strain was isolated from turtle pond water from 1 turtle farm. CONCLUSIONS: Eight multistate outbreaks associated with small turtles were investigated during 2011–2013. Children <5 years and Hispanics were disproportionately affected. Prevention efforts should focus on patient education targeting families with young children and Hispanics and enactment of state and local regulations to complement federal sales restrictions.

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Section: Figuresupporting

confidence: 87%

Outbreaks of Salmonellosis From Small Turtles

et al. 2016

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“…All serotypes detected in this study were non‐typhoidal. Although non‐typhoidal Salmonellae may lack pathogenicity in reptiles, they can be responsible for severe invasive disease in infants, elderly and immunocompromised individuals often requiring hospitalization (Tauxe et al., 1985; Woodward et al., 1997; Van Meervenne et al., 2009).…”

Section: Discussionmentioning

confidence: 99%

SalmonellaInfection in Illegally Imported Spur‐Thighed Tortoises (Testudo graeca)

Percipalle

Giardina²,

Lipari

et al. 2011

Zoonoses and Public Health

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The prevalence of Salmonella infection was determined in a group of spur-thighed tortoises (Testudo graeca) seized during two smuggling attempts and in a population of captive Hermann's tortoises (Testudo hermanni) sheltered in a wildlife rescue centre. Salmonella spp. was isolated in 81 of 220 (36.8%) and in 17 of 67 (25.4%) cloacal swabs collected from the T. graeca and T. hermanni tortoises respectively. Overall, a total of 21 different Salmonella serotypes were found. Some of these serotypes are common to terrestrial chelonians while others have never been reported. All cultured serotypes were non-typhoidal but nonetheless many of these have been previously reported as source of human outbreaks of reptile-related salmonellosis. Eighty-two per cent and 5.3% of the isolates were resistant to two and three anti-microbial agents respectively. However, the isolates were highly susceptible to the anti-microbials of choice for the treatment of salmonellosis such as cephalosporins and fluoroquinolones. Our findings confirm that tortoises can be considered a reservoir for Salmonella and that care should be employed when handling and breeding these animals. Tight surveillance should be enforced to avoid illegal importation and prevent the trading of live tortoises, carriers of zoonotic pathogens.

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“…Since 2006, 15 multistate outbreaks of human Salmonella infections linked to small turtles were reported to the Centers for Disease Control and Prevention (CDC), including eight outbreaks in 2012 (Bosch, Tauxe, & Behravesh, ). Several Salmonella serotypes have been repeatedly linked to contact with small turtles, including Poona, Pomona and Sandiego (Basler et al., ; Bosch et al., ; Harris, Neil, Behravesh, Sotir, & Angulo, ; Tauxe, Rigau‐Perez, Wells, & Blake, ; Walters et al., ). In some of these outbreaks, turtle farms in Louisiana were identified as the source of turtles linked to illnesses (Bosch et al., ; Tauxe et al., ; Walters et al., ).…”

Section: Introductionmentioning

confidence: 99%

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

Gambino-Shirley

Stevenson

Concepción-Acevedo

et al. 2018

Zoonoses and Public Health

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Zoonotic transmission of Salmonella infections causes an estimated 11% of salmonellosis annually in the United States. This report describes the epidemiologic, traceback and laboratory investigations conducted in the United States as part of four multistate outbreaks of Salmonella infections linked to small turtles. Salmonella isolates indistinguishable from the outbreak strains were isolated from a total of 143 ill people in the United States, pet turtles, and pond water samples collected from turtle farm A, as well as ill people from Chile and Luxembourg. Almost half (45%) of infections occurred in children aged <5 years, underscoring the importance of the Centers for Disease Control and Prevention recommendation to keep pet turtles and other reptiles out of homes and childcare settings with young children. Although only 43% of the ill people who reported turtle exposure provided purchase information, most small turtles were purchased from flea markets or street vendors, which made it difficult to locate the vendor, trace the turtles to a farm of origin, provide education and enforce the United States federal ban on the sale and distribution of small turtles. These outbreaks highlight the importance of improving public awareness and education about the risk of Salmonella from small turtles not only in the United States but also worldwide.

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Turtle-associated salmonellosis in Puerto Rico. Hazards of the global turtle trade

Cited by 15 publications

References 0 publications

Outbreaks of Salmonellosis From Small Turtles

Outbreaks of Salmonellosis From Small Turtles

SalmonellaInfection in Illegally Imported Spur‐Thighed Tortoises (Testudo graeca)

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

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