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African Pygmy Hedgehog-Associated Salmonellosis -- Washington, 1994

During 1994, the Washington Department of Health Public Health Laboratory reported the isolation from a human of a rare Salmonella serotype, Salmonella serotype Tilene. This report summarizes the epidemiologic investigation of the case by the Seattle-King County Department of Public Health, which suggested the infection was related to exposure to African pygmy hedgehogs.

On April 9, 1994, a 10-month old girl was evaluated in a hospital emergency department in King County for an acute febrile, nonbloody diarrheal illness; the fever resolved without treatment but the diarrhea persisted for 3 weeks. On April 28, she was evaluated in an outpatient clinic; a stool sample yielded Salmonella Tilene. The infant had been breast-fed and received supplemental solid foods; she did not attend a child care center. Her parents were asymptomatic, and cultures of stool samples from both were negative. The family owned a dog and a breeding herd of 80 apparently healthy African pygmy hedgehogs; a stool sample from one of three hedgehogs cultured yielded Salmonella Tilene. Although the infant had not had direct contact with the hedgehogs, the hedgehogs were handled frequently by one member of the family. The infant's illness resolved after treatment for an upper respiratory infection with trimethoprim-sulfamethoxazole. Reported by: S Lipsky, Epidemiology Unit, T Tanino, Laboratory Section, Seattle-King County Dept of Public Health; JH Lewis, Public Health Laboratories, Washington Dept of Health. Foodborne and Diarrheal Diseases Br, Div of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: Salmonella Tilene is an uncommon cause of human illness; the organism was first isolated in 1960 from a child in Senegal (1). Although the patient in Washington had the first documented human infection with this serotype in the United States, * since January 1991 the U.S. Department of Agriculture (USDA) has identified two isolates from animals at the National Veterinary Services Laboratory -- both were from African pygmy hedgehogs (K. Ferris, USDA, personal communication, April 1995). Although the African pygmy hedgehog is an unusual pet, ownership of these animals is reportedly increasing in the United States (2). African pygmy hedgehogs are bred domestically in the United States; importation from Africa has been prohibited since 1991 because they can carry foot-and-mouth disease, a disease of livestock that is not found in the United States (R. Perkins, USDA, personal communication, May 1995).

Salmonella spp. are found worldwide in domestic and wild animals, including mammals, reptiles, and birds. Although ingestion of contaminated food is the most important source of salmonellosis in humans (3), pets are another potential source of infection (4,5). The overall risk for acquiring salmonellosis from pets is low; however, the risk is increased with exposure to animals with high fecal carriage rates of Salmonella. In general, carriage rates are higher in animals that are young, have diarrhea, or live in overcrowded conditions (4). Reported carriage rates are highest in reptiles (as high as 90%), and lowest in dogs and cats (4). Carriage rates have not been reported for African pygmy hedgehogs.

The investigation of this case and a recent report involving reptile-associated transmission of Salmonella (5) underscore the potential risk for transmission of Salmonella from an infected pet to members of the household who do not have direct contact with the pet. This risk can be reduced by handwashing after handling of pets, especially before eating or handling food, and by avoiding contact with pets' feces (6).

References

  1. Le Minor L, Pinhede N, Kerrest J, Armengaud M, Baylet R, Drean D. A new serotype of Salmonella, S. tilene (1,40:e,h:1,2) {French}. Bull Soc Path Exot 1960;53:777-8.

  2. Lermayer RM. African pygmy hedgehogs: latest pet sensation. Live Animal Trade and Transport Magazine 1992;Dec:45-8.

  3. Tauxe RV. Salmonella: a postmodern pathogen. J Food Protect 1991:54:563-8.

  4. Glaser CA, Angulo FJ, Rooney J. Animal associated opportunistic infections in HIV-infected persons. Clin Infect Dis 1994;18:14-24.

  5. CDC. Reptile-associated salmonellosis -- selected states, 1994-1995. MMWR 1995;44:347-50.

  6. Angulo FJ, Glaser CA, Juranek DD, Lappin MR, Reginery RL. Caring for pets of immunocompromised persons. J Am Vet Med Assoc 1994; 205:1711-8.

    • On June 21, the Texas Department of Health reported to CDC the second human infection with Salmonella Tilene in the United States; the patient's family owned a hedgehog.





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