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Zoonoses Public Health. 2018 Aug;65(5):560-568. doi: 10.1111/zph.12466. Epub 2018 Mar 25.

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

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Epidemic Intelligence Service, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Louisiana Department of Agriculture & Forestry, Office of Animal Health & Food Safety, Baton Rouge, LA, USA.
Service Center 4, USDA, APHIS, Veterinary Services, Oklahoma City, OK, USA.
Diagnostic Bacteriology Laboratory, National Veterinary Services Laboratories, Ames, IA, USA.
California Department of Public Health, Richmond, CA, USA.
Los Angeles County Department of Public Health, Los Angeles, CA, USA.
New York City Department of Health & Mental Hygiene, Long Island City, NY, USA.
USDA, APHIS, Veterinary Services Liaison to CDC, Centers for Disease Control and Prevention, Atlanta, GA, USA.
Instituto de Salud Pública de Chile, Santiago-Chile, Chile.
Laboratoire National de Santé, Dudelange, Luxembourg.


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.


Salmonella ; children; international; outbreak; turtles; zoonoses

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