Environmental Assessment Aids Investigation of Salmonella Outbreaks Associated with Exposure to Small Turtles in Souvenir Shops in Okaloosa and Walton Counties, Florida 2012

BACKGROUND:   Approximately 74,000 Salmonella infections each year in the United States are due to reptile and amphibian exposure. In March 2012, the Centers for Disease Control and Prevention (CDC), public health officials and the Food and Drug Administration (FDA) began investigating a series of multistate outbreaks of Salmonella infections associated with small turtles or their environment. A total of 248 persons from 34 states have been identified. Of the 248 persons identified, exposure to turtles prior to illness was reported in 72% of ill persons and 89% of those with turtle exposure specifically recalled exposure to small turtles with a shell length less than four inches.  In addition, 34% of ill persons with small turtles reported purchasing turtles from street vendors and 17% reported buying from pet stores.  As a result of four cases reporting exposure to small turtles at souvenir shops in Florida, the Florida Department of Health (FDOH) and the Florida Fish and Wildlife Conservation Commission (FWC) conducted an environmental assessment of these shops.  

METHODS:   FDOH and FWC collected water samples from turtle tanks at five different souvenir stores, including two that were named by the cases for a total of 25 environmental samples. The samples were analyzed by the Bureau of Public Health Laboratories in Jacksonville, FL. Pulsed-field gel electrophoresis (PFGE) was performed and the PFGE fingerprints were compared to clinical cases to identify matches.

RESULTS:   From the 25 samples obtained from the souvenir shops, all were positive for Salmonella. The laboratory isolated 30 Salmonella colonies for further testing. The lab identified six different serogroups and eight different serotypes. The four clinical isolates from Salmonella positive cases that visited Destin, FL matched four isolates of S. Poona from one of the turtle aquaria sampled. One isolate collected from a different souvenir shop also matched the Salmonella Sandiego cluster 1204COJLX-1.

CONCLUSIONS:   This investigation into Salmonella outbreaks related to turtle exposure in Florida linked environmental sampling results and five human cases. Conducting the environmental assessment aided the national investigation in identifying one source of turtles and human cases. The assessment also aided in identification of a turtle distributor in Louisiana. However, even if a definitive match had not been found, the fact that every environmental sample was positive for Salmonella highlights the potential risk of exposure to Salmonella when coming into contact with turtles and/or their environment.