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BACKGROUND: Ownership of backyard poultry flocks has increased in popularity concurrent with the increase in live poultry-associated salmonellosis in humans. These increases highlight the need to better understand practices that contribute to this emerging public health issue. We reviewed outbreak reports to describe the epidemiology of live poultry-associated salmonellosis in the USA, examine changes in trends, and inform prevention campaigns.
METHODS: Live poultry-associated salmonellosis outbreaks were defined by having ≥2 culture-confirmed human Salmonella infections with a combination of epidemiologic, laboratory, or trace-back evidence linking illnesses to live poultry contact. Outbreak data was obtained through CDC’s outbreak database, CDC’s National Outbreak Reporting System, and literature review. Additionally, standardized poultry exposure questionnaires administered during 21 multi-state outbreak investigations between 2008−2013 were analyzed to identify high-risk practices.
RESULTS: During 1990−2013, 51 live poultry-associated salmonellosis outbreaks were documented, involving 2,188 illnesses, 306 hospitalizations, and 5 deaths. The median outbreak size was 25 case-patients (range: 4−356). Outbreak onsets ranged from January to July; 79% of outbreaks began during February to April. Montevideo was the most common Salmonella serotype and represented 39% (20/51) of live poultry-associated outbreaks. Additionally, 3 outbreaks consisted of multiple Salmonella serotypes. The median patient age was 9 years (range <1 to 92). Sixty percent (374/619) of case-patients reported exposure to chicks and 27% (170/619) of case-patients reported exposure to ducklings. The median time between obtaining poultry and illness onset was 17 days. Since 2007, outbreak trends shifted toward larger, year-round, multistate outbreaks linked to backyard flock ownership. Seventy four percent of respondents reported that baby poultry exposure occurred in the home. High-risk practices included keeping poultry inside households [51% (194/381)] and kissing poultry [14% (52/373)].
CONCLUSIONS: Live poultry contact remains an important source of human salmonellosis in the USA, particularly among children. These recurring live poultry-associated salmonellosis outbreaks highlight the need to focus efforts on strategies to prevent human illnesses associated with live poultry contact through a comprehensive One Health approach involving public and animal health officials, industry, backyard poultry flock owners, as well as human and animal health practitioners.