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Pet-Turtle-Associated Salmonellosis -- Puerto Rico

In January 1984, a 4-month-old girl was reported to the Division of Epidemiology, Puerto Rico Department of Health, to have been hospitalized with enteritis due to Salmonella serogroup F. Shortly before becoming ill, the infant had had contact with a pet turtle imported from the mainland United States and purchased in a local store. Because of this patient, a case-control study of salmonellosis among children under 1 year of age reported in 1983 in Puerto Rico was undertaken. The study showed that seven of 61 patients either had pet turtles in the home or had known, direct contact with pet turtles in the 2 weeks before becoming ill. An additional three patients had possible contact with pet turtles outside the home. None of the matched neighborhood controls reported any contact with pet turtles (p

0.05). Isolates from the 10 turtle-associated infants with salmonellosis were serogrouped as groups B, C1, C2, and F. Isolates were not available for serotyping.

Health inspectors visited 40 pet shops broadly distributed around the island and impounded 1,242 turtles, all of which had been purchased through five distributors from two turtle farms in Louisiana. An estimated 32,000 turtles were shipped from these farms to Puerto Rico in 1983. Further shipment of turtles from the Louisiana farms to Puerto Rico has been halted by the U.S. Food and Drug Administration (FDA). Residents of Puerto Rico have been warned of the danger these animals pose to the health of children and have been advised to bring their turtles to the health department for disposal. Reported by JG Rigau-Perez, MD, Puerto Rico Dept of Health; Emergency and Epidemiology Operations Br, U.S. Food and Drug Administration; Enteric Diseases Br, Div of Bacterial Diseases, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: The interstate and intrastate commercial distribution of turtles less than 4 inches long was banned by FDA in 1975 after epidemiologic studies demonstrated that 14% of reported salmonellosis in the United States was attributable to pet turtles (1,2). Since then, the efficacy of the ban on the distribution of small turtles has been documented by nationwide surveillance in the United States (3) and Canada (4), although sporadic cases of salmonellosis in Florida, Georgia, and Iowa have been attributed to illegally distributed pet turtles. An estimated 3-4 million turtles continue to be raised and marketed in this country for export (5). The study in Puerto Rico shows that these turtles may have accounted for 12%-17% of reported infant salmonellosis there. If the areas surveyed are representative of the rest of the island in this respect, then approximately 30 cases of infant salmonellosis reported in 1983 in Puerto Rico could be attributed to contact with pet turtles, for an attack rate of approximately one reported case per 1,000 imported turtles. Since only hospitalized salmonellosis patients are reported in Puerto Rico, and the vast majority of cases are probably not cultured and diagnosed, the actual number of infections caused by turtles is likely to be much higher.

Recent reports have linked turtles exported from the United States to S. typhimurium and S. muenchen infections in Japan (6,7), and to S. java infections in the United Kingdom (8). Pet turtles raised in the United States continue to be associated with human disease, and these animals remain inappropriate pets for children. The importation of pet turtles may result in a substantial public health problem that could be prevented by appropriate regulations.

References

  1. Lamm SH, Taylor A Jr, Gangarosa EJ, et al. Turtle-associated salmonellosis: I. An estimation of the magnitude of the problem in the United States, 1970-1971. Am J Epidemiol 1972;95:511-7.

  2. 21 Code of Federal Regulations. 1240.62.

  3. Cohen ML, Potter M, Pollard R, RA Feldman. Turtle-associated salmonellosis in the United States. Effect of public health action 1970 to 1976. JAMA 1980;243:1247-9.

  4. D'Aoust JY, H Lior. Pet turtle regulations and abatement of human salmonellosis. Can J Pub Health 1978;69:107-8.

  5. Michael-Marler S, Brown ML, Siebling RJ. Eradication of Arizona hinshawii from artificially infected turtle eggs. Appl and Env Microb 1983;45:748-54.

  6. Nakamori J, Miyazaki K, Nishio T, et al. Pet terrapin-linked salmonellosis; first proved cases in Japan and its epidemiology. Rinsho-to-Saikin 1976;3:88-94.

  7. Fujita K, Murono K, Yoshioka H. Pet-linked salmonellosis. Lancet 1981;II:525.

  8. Anonymous. Reptilian salmonellosis. Lancet 1981;II:130-1.



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