BACKGROUND: Zoonotic transmission of Salmonella causes an estimated 11% of salmonellosis in the United States. In August 2015, the U.S. Food and Drug Administration notified CDC of a consumer complaint involving transmission of Salmonella Sandiego to a child from a small turtle. PulseNet, the national molecular subtyping network for foodborne disease surveillance subsequently detected three additional multistate Salmonella clusters: one Salmonella Sandiego and two SalmonellaPoona. We aimed to characterize the extent of the outbreaks and prevent additional infections.
METHODS: Cases were defined as infection with one of the outbreak strains of Salmonella Sandiego or SalmonellaPoona from January 1, 2015 to December 28, 2015. Interviews were conducted using a standard questionnaire regarding turtle exposure. Environmental samples were taken from cases’ pet turtle habitats. Traceback was initiated for cases with purchase information. Water samples were collected from one turtle farm.
RESULTS: One hundred twenty-five cases from 22 states were identified; of these, 34 (27%) were <1 year old. Forty (75%) of 53 patients with ethnicity information were Hispanic. Of 74 patients interviewed, 41 (55%) had turtle exposure. Turtles were purchased from stores, street vendors, flea markets, or as carnival prizes or gifts. Seven environmental samples matched the outbreak strains of Salmonella Poona and Salmonella Sandiego. Traceback for one patient’s turtle identified a farm where water testing yielded Salmonella;however, the outbreak strains were not identified.
CONCLUSIONS: Epidemiologic, microbiologic and traceback evidence linked the outbreaks to contact with small turtles and their environment; however, transient turtle vendors hindered traceback to farms. Small turtles remain a source for human Salmonella infections, especially among young children. The high proportion of Hispanics and monolingual Spanish-speaking cases in this outbreak highlighted the need to ensure translation of outbreak and public health prevention messages to prevent salmonellosis.