Keep reptile–human interactions safe

While the contribution of the main food-related sources to human salmonellosis is well documented, knowledge on the contribution of reptiles is limited.

reptile–human interactionsWe quantified and examined trends in reptile-associated salmonellosis in the Netherlands during a 30-year period, from 1985 to 2014. Using source attribution analysis, we estimated that 2% (95% confidence interval: 1.3–2.8) of all sporadic/domestic human salmonellosis cases reported in the Netherlands during the study period (n = 63,718) originated from reptiles.

The estimated annual fraction of reptile-associated salmonellosis cases ranged from a minimum of 0.3% (corresponding to 11 cases) in 1988 to a maximum of 9.3% (93 cases) in 2013. There was a significant increasing trend in reptile-associated salmonellosis cases (+ 19% annually) and a shift towards adulthood in the age groups at highest risk, while the proportion of reptile-associated salmonellosis cases among those up to four years-old decreased by 4% annually and the proportion of cases aged 45 to 74 years increased by 20% annually.

We hypothesise that these findings may be the effect of the increased number and variety of reptiles that are kept as pets, calling for further attention to the issue of safe reptile–human interaction and for reinforced hygiene recommendations for reptile owners.

Increase in reptile-associated human Salmonellosis and shift toward adulthood in the age groups at risk, The Netherlands, 1985 to 2014

Eurosurveillance, Volume 21, Issue 34, 25 August 2016, DOI:

L Mughini-Gras, M Heck, W van Pelt

It’s the kids that suffer; from the duh files: Pet reptiles pose Salmonella risk for infants

Owning exotic reptiles such as snakes, chameleons, iguanas and geckos could place infants at risk of salmonella infection, according to a British study.

HunterBreederMainWebResearchers in the southwestern English county of Cornwall found that out of 175 cases of salmonella in children under five over a three-year period, 27% occurred in homes which had reptile pets.

If the pet is allowed to run free in the home, this poses a risk, especially if the child is at an exploratory stage of crawling or licking surfaces.

The average age of children who fell ill with “reptile-associated salmonellosis” (RAS) was just six months, said the study, led by Dan Murphy of the Royal Cornwall Hospital in Truro.

The investigation is published in a specialised British journal, Archives of Disease in Childhood.

A U.S. study in 2004 estimated that RAS was behind 21% of all of laboratory-confirmed cases of Salmonella among people aged under 21.

Children suffer the most: Salmonellosis from reptiles in Minnesota, 1996-2011

I’ve told this tale before but it’s worth retelling in light of new stats from Minnesota.

turtle.kissTurtles in the 1960s and 1970s were inexpensive, popular, and low maintenance pets, with an array of groovy pre-molded plastic housing designs to choose from. Invariably they would escape, only to be found days later behind the couch along with the skeleton of the class bunny my younger sister brought home from kindergarten one weekend.

Maybe I got sick from my turtle.

Maybe I picked up my turtle, rolled around on the carpet with it, pet it a bit, and then stuck my finger in my mouth. Maybe in my emotionally vacant adolescence I kissed my turtle. Who can remember?

Reptile-associated salmonellosis (RAS) occurs when Salmonella is transmitted from a reptile to a human. This study describes the epidemiology of RAS in Minnesota during 1996-2011.

All Minnesotans with confirmed Salmonella infections are reported to the Minnesota Department of Health (MDH). Case patients are interviewed about illness characteristics and risk factors, including foods eaten, drinking and recreational water exposures, contact with ill people, and animal contact. Willing RAS case patients can submit stool from the reptile for culture. Serotype and pulsed-field gel electrophoresis (PFGE) subtype of Salmonella isolates from reptiles and case patients are compared.

Of 8389 sporadic (not associated with an outbreak) non-typhoidal salmonellosis case patients in Minnesotans during 1996-2011, 290 (3.5%) reported reptile exposure. The median age of case patients with reptile exposure was 11 years, 31% were under the age of 5 years and 67% were under the age of 20 years; 50% were female. The median illness duration was 8 days; 23% required hospitalization. The most commonly reported reptile exposures were lizard (47%), snake (20%), turtle (19%) and a combination of reptile types (14%).

Back CameraEighty-four per cent of isolates from case patients who reported reptile exposure were Salmonella enterica subspecies I. The three most common serotypes were Typhimurium (15%), Enteritidis (7%) and subspecies IV serotypes (7%). Of 60 reptiles testing positive for Salmonella, 36 (60%) yielded the same Salmonella serotype as the human isolate. Twenty-six of 27 reptile isolates that were subtyped by PFGE were indistinguishable from the human isolate. Of these, 88% were subspecies I; the most common serotypes were Enteritidis (12%), Typhimurium (8%), and Bareilly (8%). RAS accounts for approximately 3.5% of salmonellosis cases in Minnesota, primarily affecting children.

The majority of isolates from case patients and reptiles belonged to Salmonella subspecies I, suggesting that reptiles are a source of human infection with serotypes not traditionally considered to be reptile-associated.

Zoonoses Public Health. [ahead of print]

Whitten T1, Bender JB, Smith K, Leano F, Scheftel J.

You see a cute lizard, I see a Salmonella factory

We got two kittens from a rescue shelter. The 4-year-old and the 38-year-old are both enjoying the frantics of kittens. Even me.

And it allowed me to continue the discussion with Sorenne about bacteria and germs, and why sucking on her foot isn’t a great idea, and how kitties themselves.

But there will be no reptiles in this house, except for the occasional small skink that enters by accident.

Parents and schools see cute pets; I see Salmonella factories.

Scott Weese of the University of Guelph chimes in with his recent Worms and Germs blog post, excerpts below:

Reptiles can be good pets in some situations. The key is understanding and accepting the risk. That involves understanding the risks associated with reptiles, understanding types of households where the risk is high and knowing what to do to reduce the risk.

Denial isn’t an effective infection control measure.

An interview in Oregon Live with the founder of International Reptile Rescue highlights this issue.

“And while reptiles have been associated with spreading salmonella (the CDC reports about 70,000 such cases a year) people are more likely to black kittycontract it from a dog, Hart says”

Uh…no. Reptiles are clearly high risk when it comes to Salmonella. Reptile contact has been clearly and repeatedly shown to be a risk factor for human salmonellosis. Dogs and cats (and various other animals) are potential sources of salmonellosis but while many more people have contact with dogs and cats, reptile contact is much more likely to result in Salmonella transmission. It only makes sense. Reptiles are at very high risk for shedding the bacterium. Dogs and cats rarely do (especially when they’re not fed raw meat).

“She’s never seen a case in the 30-plus years she’s been working with reptiles.”

Ok. So, since I’ve never actually seen influenza virus, I’ll never get the flu?

I know a lot of infectious disease physicians that have different experiences. In fact, it’s rare for me to talk to an infectious diseases physician without them providing details of various reptile-associated salmonellosis cases.

Talking about the risk of Salmonella shouldn’t be taken as insulting or a threat to reptile enthusiasts. People should accept that the risk is present and try to minimize it. The article actually has some of that useful information. “Just use common sense – wash hands thoroughly after handling the animal or its cage. A good rule of thumb is to keep hand sanitizer nearby. While white kittychildren under age 5 should avoid any contact with reptiles, Hart doesn’t advise snakes for children under age 7 or 8 for fear they could unwittingly harm the creature.”

Reducing the risk is common sense…keeping reptiles out of high risk environments and using basic hygiene and infection control practices.

However, any semblance of common sense goes out the door when a rescue like this offers programs where you can pay them to bring reptiles to daycares, pre-schools and schools. So much for young kids avoiding contact with reptiles.

Reptiles aren’t bad, they’re just bad in certain situations. Common sense needs to be more common.

UK baby sick with Salmonella from pet lizard

A five-month-old baby was rushed to hospital after contracting Salmonella pomona from an exotic family pet.

Your Local Guardian reports a warning has now been issued to all reptile owners and further investigations by Sutton Council environmental health officers revealed the family’s Bearded Dragon lizard and tortoises to be the likely culprits that passed on the bacteria.

The five-month-old has since recovered and the council is using the incident to urge parents of young children to keep them away from reptiles.

It follows a similar incident in 2009 when a baby girl from Sutton was admitted to intensive care with a fever and high heart rate after contracting Salmonella Arizona from her family’s pet snake.

For salmonella sake, don’t touch lizards or cast members of Jersey Shore

Replace the term “amphibian and reptile” with “Jersey Shore cast member” and this advisory from the Jefferson Health Dept. in North Jersey is still accurate.

Contact with amphibians (such as frogs and toads) and reptiles (such as turtles, snakes, and lizards) can be a source of human salmonella infections.

• Small turtles, with a shell length of less than four inches, are a well-known source of human Salmonella infections, especially among young children. Because of this risk, the Food and Drug Administration has banned the sale of these turtles since 1975.

• Amphibians and reptiles can carry salmonella germs and still appear healthy and clean.

• To prevent contamination, keep amphibians and reptiles out of kitchens and other areas where food and drink is prepared, served, or consumed.

• Don’t let children younger than 5 years of age, older adults, or people with weak immune systems handle or touch amphibians or reptiles.

• Don’t let reptiles and amphibians roam free in your home.

Salmonella risk from reptiles, Australia version

In 2009, a four-month-old baby girl was taken to an Australian hospital emergency department after contracting salmonella through indirect contact with an eastern bearded dragon.

Testing revealed the girl had been infected with a type of salmonella known as rubislaw. A subsequent article published in the Medical Journal of Australia revealed that between nine and 19 cases of rubislaw had been detected in Australians between 2000 and 2009.

Reptile expert Robert Johnson said many pet owners were unaware of the risks posed by reptiles and needed to practice good hygiene to eliminate their chances of infection.

Dr Johnson said the risk of salmonella poisoning should not deter people from owning reptiles.

”They are great little pets. They don’t create a noise and you can keep them in reasonably small areas. But you have to maintain good hygiene.”

The risks of reptiles as pets will be on the agenda at the Australian Veterinary Association’s annual conference in Adelaide this week.

Salmonella city: over 60 reptiles abandoned in North Carolina

Investigators say more than 60 reptiles were left without water and heat in an abandoned warehouse in the Upstate.

It’s been more than three months since authorities made charges in the case, but the owner of the animals has still not been tracked down.

Nigel Platt says an alligator was laying in rotting food and his own filth when he found him.

Platt says, "I can only describe it as salmonella city, or it was a salmonella soup."

The tortoises, some of the non-venemous snakes, and the alligator can all be taken to schools and churches to educate kids, and all of the animals will stay at Safe Haven and Educational Adventures, a non-profit organization, where they will continue to receive care.

If the animals came from ‘salmonella city’ maybe taking them to a school isn’t the best idea.

Infant in Ireland stricken with botulism from pet turtle, reptiles not suitable as pets for under fives

An infant in Ireland is recovering after a bout with botulism type E, most likely due to exposure to a pet turtle or turtle feed.

Dr Paul McKeown, a specialist in public health medicine at the national Health Protection Surveillance Centre (HPSC) warned that reptiles are not appropriate pets for children under the age of five.

Reptiles such as snakes, lizards, tortoises, turtles and terrapins have become extremely popular as pets, he said, but they require careful handling as they carry a range of germs that can lead to illness. Washing hands after touching them is very important.

“Given the risks, reptiles should not be kept as pets in a house where there are children under the age of five,” he added.

There are a number of different types of botulism toxin but the type which the baby picked up – type E – is so rare it was only the seventh case ever reported in an infant worldwide, the centre said.

Texas proposes changes to salmonella warnings for handling reptiles (another of my favorite reads) reports the Texas Department of State Health Services has proposed changes to the wording reptile retailers in Texas use on signs warning customers about salmonella. The deadline for the public to submit comments is Sunday, Nov. 21, 2010.

Current law requires all retail stores that sell reptiles to post warning signs and distribute written warnings about reptile-associated salmonellosis. The signs are to include recommendations for preventing the transmission of salmonella. The proposed changes, according to the department, allow for consistency with the Centers for Disease Control and Prevention recommendations.

If approved, the warning signs would have to include the following recommendations, at minimum.

• Persons should always wash their hands thoroughly with soap and running water after handling reptiles or reptile cages or after contact with reptile feces or the water from reptile containers or aquariums. Wash your hands before you touch your mouth.

• Persons at increased risk for infection or serious complications of salmonellosis, such as children younger than 5 years of age, the elderly, and persons whose immune systems have been weakened by pregnancy, disease (for example, cancer) or certain medical treatments (for example, chemotherapy) should avoid contact with reptiles and any items that have been in contact with reptiles.

• Reptiles should be kept out of households or facilities that include children younger than 5 years of age, the elderly, or persons whose immune systems have been weakened by pregnancy, disease (for example, cancer) or certain medical treatments (for example, chemotherapy). Families expecting a new child should remove any reptile from the home before the infant arrives.

• Reptiles should not be allowed to roam freely throughout the home or living area. Wash and disinfect surfaces that the reptile or its cage has contacted.

• Reptiles should be kept out of kitchens and other areas where food or drink is prepared or consumed. Kitchen sinks should not be used to bathe reptiles or to wash their dishes, cages or aquariums. If bathtubs are used for these purposes, they should be cleaned thoroughly and disinfected with bleach. Wear disposable gloves when washing the dishes, cages or aquariums.

The signs would also have to include a statement notifying customers that even though reptiles may not appear sick at the time of purchase, they may carry salmonella bacteria, which can make people sick.

The entire proposal is available at: