Don’t kiss turtle or frogs; additional Salmonella risk

Some federal food safety thingy decided he just had to tell me how disappointed he was because I ran the don’t-kiss-frogs-and-salmonella story and the U.K. version that linked it to a Disney movie, The Frog and the Prince.

“Your non-apology for your role is (sic) amplifying the ‘far-fetched, but sorta fun’ story makes me wonder how serious you are about your posts and your role in our public health community.”

Who is ‘our?’ Writing 101 mistake.

And dude, join the end of the line. Lots of people are disappointed with me.

The headline of the blog post was, Don’t kiss frogs or turtles, whether it’s in a Disney film or not. And with a new report from CDC, let me reiterate, don’t kiss turtles.

On September 4, 2008, the Philadelphia Department of Public Health (PDPH) and the Pennsylvania Department of Health (PADOH) notified CDC of an outbreak of possible turtle-associated human Salmonella Typhimurium infections detected by identifying strains with similar pulsed-field gel electrophoresis (PFGE) patterns in PulseNet. Turtles and other reptiles have long been recognized as sources of human Salmonella infections (1), and the sale or distribution of small turtles (those with carapace lengths <4 inches) has been prohibited in the United States since 1975 (2,3). CDC and state and local health departments conducted a multistate investigation during September–November 2008. This report summarizes the results of that investigation, which identified 135 cases in 25 states and the District of Columbia; 45% were in children aged ≤5 years. Among 70 patients with primary infection, 37% reported turtle exposure, of which 81% was to small turtles most commonly purchased from street vendors. A matched case-control study showed a significant association between illness and exposure to turtles (matched odds ratio [mOR] = 16.5). Increasing enforcement of existing local, state, and federal regulations against the sale of small turtles, increasing penalties for illegal sales, and enacting more state and local laws regulating the sale of small turtles (e.g., requiring Salmonella awareness education at the point-of-sale), could augment federal prevention efforts. …

This S. Typhimurium outbreak is the third multistate, turtle-associated Salmonella outbreak in the United States since 2006. Before 2006, no large multistate turtle-associated Salmonella outbreaks were identified. One reason for this apparent increase might be PulseNet, which has improved the ability to detect multistate outbreaks. Increased pet turtle ownership in the United States also might contribute to the recurrent outbreaks: the proportion of households in the United States owning pet turtles doubled during 1996–2006, from 0.5% to 1.0% (4). Together, the three recent Salmonella outbreaks account for 258 laboratory-confirmed cases of salmonellosis (5–7) and many more unreported illnesses likely occurred. As with past outbreaks, most ill persons reporting turtle exposure were exposed to turtles with shell lengths <4 inches; these turtles were mainly acquired from flea markets, street vendors, and souvenir shops. The case-control study found a significant association of Salmonella infection with turtle exposure; however, 63% of primary cases in the outbreak had no knownturtle exposure, and 60% had no reptile exposure. This might have resulted, in part, from failure to recall a turtle exposure. Parents or guardians were interviewed as proxies for young children and they might have been unaware of their child’s turtle exposure outside of the home. In addition, certain patients might have had unknown indirect turtle exposure through environmental cross-contamination or unrecognized person-to-person transmission or have been sporadic or background cases.