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
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.
21 Code of Federal Regulations. 1240.62.
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.
D'Aoust JY, H Lior. Pet turtle regulations and abatement of
human
salmonellosis. Can J Pub Health 1978;69:107-8.
Michael-Marler S, Brown ML, Siebling RJ. Eradication of
Arizona
hinshawii from artificially infected turtle eggs. Appl and Env
Microb 1983;45:748-54.
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.
Fujita K, Murono K, Yoshioka H. Pet-linked salmonellosis.
Lancet
1981;II:525.
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