2017 Salmonella Agbeni Infections Linked to Pet Turtles, 2017 (Final Update)

Posted March 13, 2018 2:00 PM ET

This outbreak investigation is over. Illnesses could continue because people may not know they could get a Salmonella infection from contact with pet turtles. Read the Advice for Pet Owners.

Outbreak Advisory

76
Cases

19
States

30
Hospitalizations

0
Deaths

CDC and multiple states investigated a multistate outbreak of human Salmonella infections linked to contact with pet turtles.
A total of 76 people infected with the outbreak strain of Salmonella Agbeni were reported from 19 states.
- Illnesses started on dates ranging from March 1, 2017 to December 1, 2017.
- Of 63 people with available information, 30 were hospitalized. No deaths were reported.
- 24 (32%) ill people were children younger than 5.
Epidemiologic and laboratory findings linked this outbreak of human Salmonella Agbeni infections to contact with turtles or their environments, such as water from a turtle habitat.
- In interviews, ill people answered questions about contact with animals during the week before becoming ill. Twenty-three (38%) of the 60 people interviewed reported contact with turtles or their environments, such as water from a turtle habitat, before getting sick.
- Of the 23 ill people who had contact with turtles, 14 (61%) reported contact with small turtles that had a shell length of less than four inches. They reported purchasing the turtle from a street vendor or receiving the turtle as a gift.
- In 2015, state and local health officials collected samples from turtles at a street vendor. Whole genome sequencing showed that the Salmonella Agbeni isolated from ill people in this outbreak was closely related genetically to the Salmonella Agbeni isolates from the turtles at the street vendor. This close genetic relationship means that illnesses in this outbreak were likely linked to turtles.
Whole genome sequencing did not identify predicted antibiotic resistance in 43 of 44 isolates from ill people
- One isolate from an ill person had predicted resistance to nalidixic acid and ciprofloxacin. The resistance in this isolate is unlikely to affect treatment for most outbreak-associated cases.
Testing of four outbreak isolates using standard antibiotic susceptibility testing methods by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory did not show any resistance.
Do not buy small turtles as pets or give them as gifts.
- Since 1975, the U.S. Food and Drug Administration has banned selling and distributing turtles with shells less than four inches long as pets because they are often linked to Salmonella infections, especially in young children.
All turtles, regardless of size, can carry Salmonella bacteria even if they look healthy and clean. These outbreaks are a reminder to follow simple steps to enjoy pet reptiles and keep your family healthy.
This outbreak investigation is over. Illnesses could continue because people may not know they could get a Salmonella infection from contact with pet turtles.

Previous Outbreak Advisories

66
Cases

18
States

23
Hospitalizations

0
Deaths

Since the last update on August 29, 2017, 29 more ill people have been reported from 14 states.
CDC and multiple states are investigating a multistate outbreak of human Salmonella infections linked to contact with pet turtles.
A total of 66 people infected with the outbreak strain of Salmonella Agbeni have been reported from 18 states.
- Illnesses started on dates ranging from March 1, 2017 to October 14, 2017
- Of 53 people with available information, 23 have been hospitalized. No deaths have been reported.
- Twenty-three (35%) ill people are children younger than 5.
Epidemiologic and laboratory findings link the outbreak of human Salmonella Agbeni infections to contact with turtles or their environments, such as water from a turtle habitat.
- In interviews, ill people answered questions about contact with animals during the week before becoming ill. Twenty (40%) of the 50 people interviewed reported contact with turtles or their environments, such as water from a turtle habitat, before getting sick.
- Of the 20 ill people who had contact with turtles, 12 (60%) reported contact with small turtles that had a shell length of less than 4 inches. They reported purchasing the turtle from a street vendor or receiving the turtle as a gift.
- In 2015, state and local health officials collected samples from turtles at a street vendor. Whole genome sequencing showed that the Salmonella Agbeni isolated from ill people in this outbreak is closely related genetically to the Salmonella Agbeni isolates from the turtles at the street vendor. This close genetic relationship means that human infections in this outbreak are likely linked to turtles.
Do not buy small turtles as pets or give them as gifts.
- Since 1975, the FDA has banned selling and distributing turtles with shells less than 4 inches long as pets because they are often linked to Salmonella infections, especially in young children.
All turtles, regardless of size, can carry Salmonella bacteria even if they look healthy and clean. These outbreaks are a reminder to follow simple steps to enjoy pet reptiles and keep your family healthy.
This outbreak is expected to continue since consumers might be unaware of the risk of Salmonella infection from small turtles. If properly cared for, turtles have a long life expectancy.

37
Cases

13
States

16
Hospitalizations

0
Deaths

CDC and multiple states are investigating a multistate outbreak of human Salmonella infections linked to contact with pet turtles.
Thirty-seven people infected with the outbreak strain of Salmonella Agbeni have been reported from 13 states.
- Illnesses started on dates ranging from March 1, 2017 to August 3, 2017
- Of 33 people with available information, 16 have been hospitalized. No deaths have been reported.
- Twelve (32%) ill people are children 5 years of age or younger.
Epidemiologic and laboratory findings link the outbreak of human Salmonella Agbeni infections to contact with turtles or their environments, such as water from a turtle habitat.
- In interviews, ill people answered questions about contact with animals during the week before becoming ill. Fifteen (45%) of the 33 people interviewed reported contact with turtles or their environments, such as water from a turtle habitat, before getting sick.
- In interviews with 9 ill people about where their turtles came from, 6 reported buying a turtle from a flea market or street vendor, or receiving the turtle as a gift.
- In 2015, state and local health officials collected samples from turtles at a street vendor. Whole genome sequencing showed that the Salmonella Agbeni isolated from ill people in this outbreak is closely related genetically to the Salmonella Agbeni isolates from turtles. This close genetic relationship means that people in this outbreak are more likely to share a common source of infection.
Do not buy small turtles as pets or give them as gifts.
- Since 1975, the FDA has banned selling and distributing turtles with shells less than 4 inches long as pets because they are often linked to Salmonella infections, especially in young children.
All turtles, regardless of size, can carry Salmonella bacteria even if they look healthy and clean. These outbreaks are a reminder to follow simple steps to enjoy pet reptiles and keep your family healthy.
This outbreak is expected to continue since consumers might be unaware of the risk of Salmonella infection from small turtles. If properly cared for, turtles have a long life expectancy.

Do not purchase, or give as a gift, turtles with a shell length of less than 4 inches in size.
Wash hands thoroughly with soap and water immediately after handling turtles or anything in the area where they live or roam, or after contact with pet feces. Do not touch your face, other people or any surface until hands have been washed.
Keep turtles out of homes with children younger than 5 years, adults older than 65 years, or people with weakened immune systems.
- Do not handle a turtle and an infant (such as feed, change diaper, or bathe) at the same time.
Turtles and other reptiles should not be kept in child care centers, schools, or other facilities with children younger than 5 years.
Do not allow turtles to roam freely in the home or living area, especially in food preparation areas.
Thoroughly clean and disinfect bathtubs that are used to bathe turtles or wash their dishes, cages, or aquariums. Kitchen sinks should not be used for these purposes.
Learn more about reducing the risk of illness from turtles and follow these simple steps to enjoy pet turtles and keep your family healthy.

Options for Unwanted Turtles

Releasing unwanted turtles into the wild is not recommended. Many pet retailers, pet stores, local animal shelters, zoos, or turtle rescues accept unwanted turtles. Talk to your veterinarian about other options.

Pet stores, street vendors, and others should not sell or distribute turtles with shell lengths less than 4 inches. Be aware that federal law prohibits the distribution of these small turtles.
- Distribution of pet turtles includes offering them for adoption or for free with or without the purchase of pet supplies such as turtle tanks or food.
Pet stores, street vendors, and others who sell or display turtles should provide health information to owners and potential purchasers of turtles near the turtle display and not at the cash register.
- This should include information about the risk of acquiring a Salmonella infection from turtles or from water in their habitats (tanks or aquariums), and instructions for proper cleaning of the turtle habitat.
- Posters containing this information are available in English, Spanish, French, and Chinese.
More information on displaying animals in public settings can be found in the 2013 Compendium of Measures to Prevent Diseases Associated with Animals in Public Settings. [PDF – 19 pages]

Advice to Health Care Providers

Health care providers should ask patients and patient caregivers about pet and animal ownership and should provide education about the risks of acquiring salmonellosis from pet reptiles.
Health care providers should teach patients and patient caregivers about proper hand washing practices.

Advice to Veterinarians

Veterinarians should provide education to reptile owners about the risks of acquiring salmonellosis from these animals and how to safely clean the animal habitat.

Table showing a list of outbreaks related to turtles and other reptiles
Outbreak	Cases	States	Hospitalizations
2015: Small Turtles —Salmonella Sandiego and Salmonella Poona More information (MMWR)>>	133	26	38
2015: Pet Crested Geckos – Salmonella Muenchen	22	17	3
2014: Pet Bearded Dragons – Salmonella Cotham	166	36	61
2013: Small Turtles – Salmonella Sandiego, Salmonella Pomona, and Salmonella Poona More information (MMWR)>>	473	43	78
2011: Water Frogs – Salmonella Typhimurium More information (MMWR)>>	241	42	72

CLICK TO VIEW CASE COUNT MAPS

People infected with the outbreak strain of Salmonella Agbeni by state of residence.

Photo of a small turtle resting on a person's finger.

Tips to Stay Healthy while Caring for Turtles

CDC recommends that households with young children do not keep turtles or other reptiles as pets.
Handwashing is the best way to prevent illness. Wash your hands with soap and water right after handling or caring for small turtles or their tanks.

Read our infographic [PDF – 1 page] for information about outbreaks of human illness linked to turtles, and more tips on how to stay healthy.

Trouble with Tiny Turtles

Audio Description Low Resolution Video

More Information

Poster available in English, French, and Chinese

Information for Veterinarians and Health Professionals