Small Turtles Linked to Multistate Salmonella Outbreak
According to an article in this week’s issue of the Morbidity and Mortality Weekly Report (MMWR), a CDC investigation into a multistate Salmonella outbreak determined the source of the outbreak to be pet turtles. Due to past Salmonella outbreaks linked to pet turtles, the sale and distribution of small turtles (those with a shell less than 4 inches long) has been prohibited in the United States since 1975. Despite this, small turtles are still available.
The CDC was first notified of this Salmonella outbreak in October of 2007, when the North Carolina Division of Public Health (NCDPH) notified CDC of human infections caused by Salmonella serotype Paratyphi B L (+) tartrate (+) (Salmonella Paratyphi B var. Java) in several states.
The outbreak began in May of 2007, but two cases in August were pivotal in determining the source of the outbreak:
On August 31, 2007, a girl aged 13 years visited a South Carolina hospital emergency department, where she reported a 5-day history of bloody diarrhea, abdominal cramps, fever, and vomiting. She was treated with trimethoprim-sulfamethoxazole and intravenous fluids but was not hospitalized. Her illness resolved in 7 days. A stool specimen yielded Salmonella Paratyphi B var. Java. Also on August 31, a girl aged 15 years was admitted to a North Carolina hospital with acute renal failure and a 4-day history of bloody diarrhea, abdominal cramps, fever, and vomiting. She was hospitalized for 8 days and recovered fully.
A joint investigation by NCDPH and the South Carolina Department of Health and Environmental Control revealed that, on August 24, the two girls had swum in an unchlorinated, in-ground swimming pool belonging to the family of the older girl. Two pet turtles belonging to the family also were permitted to swim in the pool. The turtles, both of which had carapace lengths of less than 4 inches, had been purchased recently from a pet shop in South Carolina. A water sample collected from the turtle habitat yielded Salmonella Paratyphi B var. Java with an XbaI pattern indistinguishable by pulsed-field gel electrophoresis (PFGE) from the isolates of the younger girl. Stool specimens were not collected from the older girl.
On October 5, NCDPH informed PulseNet† that tests of isolates from three other persons revealed Salmonella Paratyphi B var. Java with an XbaI pattern indistinguishable from the isolates of the younger girl and the turtle habitat (defined as the outbreak strain). On October 5, in response to a request issued by NCDPH through PulseNet, several other state health departments reported human Salmonella Paratyphi B var. Java isolates with an XbaI pattern indistinguishable from the outbreak strain.
The Ohio Department of Health provided further evidence of a turtle associated outbreak by reporting that isolates indistinguishable from the outbreak strain had been obtained from a patient with exposure to a small turtle during the week before illness onset, from that patient’s pet turtle, and from water collected from the turtle’s habitat.
As of January 18, 2008, a total of 103 Salmonella (salmonellosis) cases with isolates indistinguishable from the outbreak strain had been reported to CDC from 33 states.
The strain of Salmonella was particularly virulent, and at least 80 of these people were hospitalized. No deaths were reported.
Most of the exposure to the turtles occurred at the person’s home. Some were exposed at the home of a friend or relative.
According to the CDC report, exposure to a turtle included the following:
- holding or touching the turtle
- feeding the turtle
- contact with the turtle’s habitat
- kissing the turtle
- putting the turtle in one’s mouth
The sources of the turtles included the following:
- a pet shop
- a flea market
- a street vendor
- on an Internet website
- acquired from thewild
- hatched from an egg given by a relative
- purchased at a conference center event.
The CDC report provides insight into the sale turtles:
In 1980, the 1975 prohibition was estimated to have prevented 100,000 Salmonella infections in U.S. children each year since going into effect. However, this prohibition has an exception: small turtles may be sold legally for scientific, educational or exhibition purposes. During 2001–2006, the number of turtles kept as pets in the United States increased 86% to nearly 2 million turtles (6), suggesting that this exception might provide a mechanism by which small turtles become household pets.
We agree with the CDC in that “because of the particular hazard associated with small turtles, prohibiting the sale and distribution of small turtles likely remains the most effective public health action to prevent turtle-associated salmonellosis.”
No matter where or how exposure occurred, those sickened (or their parents) should contact our law office for a free consultation regarding liability for injuries. To contact Pritzker | Ruohonen, please call toll-free at 1-888-377-8900 or submit the firm’s free case consultation form.
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