37 Individuals Infected in Multistate Salmonella Agbeni Outbreak Linked to Pet Turtles

An ongoing investigation is being conducted by the Centers for Disease Control and Prevention (CDC) regarding a multistate outbreak of Salmonella Agbeni, a rare strain of the bacteria that doesn't typically infect humans. The culprits behind these infections? Pet turtles.

In a recent outbreak update, the CDC shared that this outbreak, which spans a total of 13 states, includes 37 infected individuals, 16 of which have required hospitalization. Thirty-two percent of those infected are children aged 5 or younger. As of the last available update, there are no associated deaths.

The CDC reports that epidemiologic and laboratory findings matched the outbreak of Salmonella Agbeni infections to contact with turtles or elements from their habitat, such as water. Per part of their investigation, the CDC questioned those who were infected, asking them if they had any contact with animals in the week previous to them falling ill. They found that almost half—45% of the 33 individuals interviewed—had contact with turtles and/or their habitats. Furthermore, 6 of the infected individuals reported purchasing their turtles from either a flea market, a street vendor, or having received their turtle as a gift.

State and local health departments collected samples from turtles sold by a street vendor in 2015 and found, through the use of whole genome sequencing, that the Salmonella Agbeni isolates taken from the turtles were a close genetic match to the isolates taken from infected individuals, which suggests that the individuals in this outbreak “share a common source of infection.”

The CDC is imploring the public to cease purchasing small turtles as pets and to avoid giving them as gifts. In fact, in 1975, the US Food and Drug Administration (FDA) banned the selling and distribution of turtles with shells that are “less than 4 inches long.” However, regardless of the size of the turtle, these animals have the potential to carry Salmonella bacteria.

In an infographic, the CDC shared that over the course of a 2-year period, from 2011 to 2013, 8 multistate outbreaks were traced back to tiny turtles. A total of 473 individuals were infected in 41 states. Furthermore, 70% of the infections occurred in children aged 10 or below, and 31% occurred in infants less than 1-year-old.

However, turtles aren’t the only reptiles responsible for outbreaks of Salmonella. In 2015, a Salmonella Muenchen outbreak that consisted of 22 infected individuals spanning 17 states was traced back to pet crested geckos; 3 of the cases required hospitalization. And, in 2016, an outbreak of Salmonella Cotham that impacted a staggering 166 individuals spanning 36 states was linked to pet bearded dragons. A total of 37% of those infected required hospitalizations.

To this end, the CDC stresses that, “these outbreaks are a reminder to follow simple steps to enjoy pet reptiles and keep your family healthy.”

Some of the safety tips provided by the CDC for handling pet turtles include the following:

• Always wash your hands after touching your pet turtle and/or it’s habitat.
• Bathe your turtles outside as opposed to a kitchen or a bathroom; use a tub or a bin that is dedicated solely to bathing your turtle if it must be done inside.
• Do not kiss your turtle as this increases risk of infection.

“The outbreak is expected to continue since consumers might be unaware of the risk of Salmonella infection from small turtles,” according to the outbreak update.

The CDC recommends that health care providers ask patients about pet ownership and educate their patients, especially those younger in age, on the risks of salmonellosis infection from pet reptiles. Additionally, providers should also encourage their patients to perform proper hand hygiene.