Investigation Details
Posted August 18, 2023
CDC and public health officials in several states are investigating a multistate outbreak of Salmonella Stanley and Salmonella Pomona infections.
Epidemiologic, laboratory, and traceback data showed that contact with small turtles made people sick.
Epidemiologic Data
A total of 26 people infected with the outbreak strain of Salmonella Stanley (24 people) or Salmonella Pomona (2 people) were reported from 11 states (see map). Illnesses started on dates ranging from October 27, 2022, to July 16, 2023 (see timeline).
The true number of sick people in an outbreak is likely much higher than the number reported, and this outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.
Public health officials collect many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provides clues to help investigators identify the source of the outbreak. The table below has information about sick people in this outbreak (“n” is the number of people with information available for each demographic).
| Demographics | Information |
|---|---|
| Age (n=26) |
Range from <1 to 64 years Median age of 14 31% under 5 years |
| Sex (n=26) |
42% female 58% male |
| Race (n=22) |
68% White 27% African American/Black 5% Asian 0% Native American or Alaska Native 0% Native Hawaiian or other Pacific Islander 0% reported more than one race |
| Ethnicity (n=24) |
88% non-Hispanic 13% Hispanic |
State and local public health officials interviewed people about the animals they had contact with in the week before they got sick. Of the 20 people who provided this information, 16 (80%) reported contact with pet turtles. Of the 13 people who reported the size of the pet turtle, 12 (92%) reported contact with pet turtles with shells less than 4 inches long.
Laboratory and Traceback Data
Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause gastrointestinal illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).
WGS showed that bacteria from sick people’s samples are closely related genetically. This means that people in this outbreak likely got sick from the same type of animal.
In July 2023, the Tennessee Department of Health collected samples from two turtles and their tank in a sick person’s home for testing. These turtles were purchased from a pet store. WGS showed that the Salmonella on the turtles and their environment are closely related to bacteria from sick people.
WGS analysis of bacteria from 26 people’s samples, 3 animal samples, and 1 environmental sample did not predict resistance to any antibiotics. Standard antibiotic susceptibility testing of five people’s samples by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory also found no resistance.
Thirteen people were interviewed about where they purchased their pet turtle: 6 (46%) people reported purchasing their pet turtles from online retailers, 5 (38%) people reported buying their turtle from stores, and 1 (8%) person reported buying their turtle from a reptile show. Investigators are working to determine if there is a common source of turtles.
Public Health Actions
CDC advises that you always take steps to stay healthy around your pet turtle: wash your hands, play safely, and keep supplies and the pet area clean. Do not buy small turtles with shells less than 4 inches long.
CDC and public health officials in several states are collecting different types of data to investigate a multistate outbreak of Salmonella Stanley infections.
Epidemiologic, laboratory, and traceback data show that contact with small turtles purchased from a website called myturtlestore.com is a source of illnesses in this multistate outbreak.
Epidemiologic Data
Six more illnesses have been reported since the last update on July 21, 2022. As of August 29, 2022, a total of 21 people infected with the outbreak strain of Salmonella Stanley have been reported from 14 states (see map). Illnesses started on dates ranging from January 3, 2022, to July 15, 2022 (see timeline).
Sick people range in age from less than one year to 75 years, with a median of 14 years, and 60% of people are female. Of 18 people with information available, 8 (44%) have been hospitalized. No deaths have been reported.
The true number of sick people in an outbreak is likely much higher than the number reported, and the outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 2 to 4 weeks to determine if a sick person is part of an outbreak.
State and local public health officials are interviewing people about the animals they came into contact with in the week before they got sick. Of 14 people interviewed, 10 (71%) reported touching turtles. Of the 9 people interviewed about the size of their turtle, all 9 (100%) reported contact with a pet turtle with a shell less than 4 inches long.
Laboratory and Traceback Data
Eight people were interviewed about where they purchased their small pet turtles, and all 8 (100%) reported purchasing their small pet turtles from online retailers. Five (63%) of these 8 people purchased their small pet turtles from a website called myturtlestore.com.
On July 20, 2022 the Florida Department of Health collected samples from turtles and their environments from the myturtlestore.com facility. WGS shows that Salmonella found on the turtles are closely related to bacteria from sick people.
WGS analysis of bacteria from 20 people’s samples, 4 turtle samples, and 3 environmental samples did not predict resistance to any antibiotics. Standard antibiotic susceptibility testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory of bacteria from one person’s sample and one environmental sample also found no resistance.
Public Health Actions
CDC advises that you always take steps to stay healthy around your pet turtle: wash your hands, play safely, and keep supplies and the pet area clean. Do not buy small turtles with shells less than 4 inches long, including from online retailers such as myturtlestore.com.
