2021 Salmonella Outbreaks Linked to Small Turtles – Investigation Details
Posted September 29, 2021
This outbreak investigation is over. However, turtles of any size can still carry Salmonella germs that can make you sick. Do not buy turtles with shells less than 4 inches long, and always take steps to stay healthy around your pet turtle.
In December 2020, CDC and public health officials in several states began collecting different types of data to investigate a multistate outbreak of Salmonella Typhimurium infections. In April 2021, CDC and state officials began investigating a multistate outbreak of Salmonella Poona infections.
Epidemiologic, laboratory, and traceback data show that contact with small turtles made people in both outbreaks sick.
As of September 29, 2021, both outbreaks are over.
Epidemiologic Data
A total of 87 people infected with the outbreak strains of Salmonella Typhimurium (43 people) or Salmonella Poona (44 people) were reported from 20 states and the District of Columbia (see map). Illnesses started on dates ranging from August 27, 2020, to July 30, 2021 (see timeline).
Sick people ranged in age from less than 1 to 85 years, with a median age of 6, and 39 (45%) people were children under the age of 5. Of all sick people, 44 (52%) were female. Of 74 people with information available, 32 (43%) were hospitalized. One death was reported from Pennsylvania.
State and local public health officials interviewed people about the animals they came into contact with the week before they got sick. Of the 63 people who provided this information, 48 (76%) reported contact with pet turtles. Of the 33 people who reported the size of their pet turtle, 27 (82%) reported contact with pet turtles with shells less than 4 inches long.
Laboratory Data
Public health investigators used the PulseNet system to identify illnesses that were 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).
For each outbreak, WGS showed that bacteria from sick people’s samples were closely related genetically. This means that people in each outbreak likely got sick from the same type of animal.
On January 29, the Pennsylvania Department of Health collected samples from a turtle habitat in a sick person’s home for testing and found the outbreak strain of Salmonella Typhimurium. On May 4 and May 6, the Los Angeles County Department of Public Health and Orange County Health Care Agency in California collected samples from sick people’s turtles and turtle habitats for testing and found the outbreak strain of Salmonella Poona. These testing results mean that people likely got sick from touching small turtles or things in their habitat.
WGS of bacteria from both outbreaks, including 85 samples from sick people, 3 samples from turtles, and 6 samples from turtle habitats, did not predict any antibiotic resistance. CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory also conducted standard antibiotic susceptibility testing on bacteria from 7 people’s samples and found no resistance.
Traceback Data
Sick people in both outbreaks reported getting their turtles from various places, including pet stores, roadside vendors, flea markets, and online stores. However, collecting purchase records is often difficult in outbreaks linked to small turtles because selling and distributing small turtles domestically is illegal. Sellers often move around and do not release information on where turtles were purchased.
For the Salmonella Typhimurium outbreak, some people reported purchasing turtles smaller than 4 inches from pet stores. Two pet stores reported their turtles were supplied by Turtles & Tortoises Inc., a turtle farm in Florida. This turtle farm may not explain all of the illnesses in that outbreak. For the Salmonella Poona outbreak, a source of turtles was not identified.
Public Health Actions
CDC and state officials notified pet stores that were reported by sick people and turtle farms, including Turtles & Tortoises Inc., that they should not sell turtles with shell lengths under 4 inches as pets. Pet stores and turtle farms were also encouraged to educate customers about Salmonella risks from pet turtles.
Epidemiologic, laboratory, and traceback data show that contact with small turtles is making people sick.
Epidemiologic Data
Since the last update on April 15, a total of 11 more illnesses have been reported in the Salmonella Typhimurium outbreak linked to small turtles. In addition, CDC has identified a second, separate outbreak of Salmonella Poona infections also linked to small turtles. CDC will provide combined updates on these two outbreaks because they are linked to the same type of animal and the advice for the public and for businesses is the same.
As of June 11, a total of 64 people infected with the outbreak strains of Salmonella Typhimurium (42 ill people) or Salmonella Poona (22 ill people) have been reported from 17 states and the District of Columbia (see map). Illnesses started on dates ranging from August 27, 2020, to May 23, 2021 (see timeline).
Sick people range in age from less than 1 to 59 years, with a median age of 6. In these outbreaks, 29 (45%) people are children under the age of 5, and 27 (43%) are female. Of 53 people with information available, 26 were hospitalized. One death has been reported from Pennsylvania.
The true number of sick people in an outbreak is likely 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 3 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 the week before they got sick. Of the 48 people who provided this information, 37 (77%) reported contact with pet turtles. Of the 25 people who reported the size of their pet turtle, 21 (84%) reported contact with pet turtles with shells less than 4 inches in length.
Laboratory and Traceback Data
Sick people in both outbreaks reported getting their turtles from various places, including pet stores, roadside vendors, flea markets, and online stores. Collecting purchase records is often difficult in outbreaks linked to small turtles because selling and distributing small turtles domestically is illegal. Sellers often move around and do not release information on where turtles were purchased. CDC is working with state officials to try to collect purchase records from pet stores to identify suppliers of turtles.
For the Salmonella Typhimurium outbreak, some ill people reported contact with turtles smaller than 4 inches that were purchased from pet stores. Two pet stores reported their turtles were supplied by Turtles and Tortoises Inc., a turtle farm in Florida. This farm may not explain all of the illnesses in that outbreak. Local and state health officials in Pennsylvania collected samples from ill people’s turtles and turtle habitats for testing and identified the outbreak strain of Salmonella Typhimurium.
For the Salmonella Poona outbreak, CDC and partners are working to determine the source or sources of the turtles causing illness. The Los Angeles County Department of Public Health and Orange County Health Care Agency in California collected samples from ill people’s turtles and turtle habitats for testing. Testing identified the outbreak strain of Salmonella Poona.
Whole genome sequencing (WGS) of bacteria from both outbreaks, including 50 samples from sick people, 2 animal samples, and 6 samples from turtle habitats, did not predict any antibiotic resistance. CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory also conducted standard antibiotic susceptibility testing on bacteria from three people’s samples and found no resistance.
Public Health Actions
CDC and state and local officials are working to identify locations where these small turtles were sold illegally during these outbreaks and inform them of the ban. Pet stores have been notified that they should not be selling turtles with shell lengths under 4 inches as pets. Officials in Florida are working with CDC to provide information to Turtles and Tortoises Inc. about the Salmonella Typhimurium illness outbreak and the ban on selling small turtles.
Don’t buy small turtles with shells less than 4 inches as pets. Pet stores and other vendors should not sell small turtles as pets. Turtle farms should not sell small turtles domestically as pets or sell to pet stores.
Epidemiologic, laboratory, and traceback data show that contact with small turtles is making people sick.
Epidemiologic Data
Since the last update on February 23, nine more illnesses have been reported. As of April 15, a total of 31 people infected with the outbreak strain of Salmonella Typhimurium have been reported from 10 states (see map). Illnesses started on dates ranging from August 27, 2020, to March 20, 2021 (see timeline).
Sick people range in age from less than 1 to 59 years, with a median age of 6. In this outbreak, 13 (41%) people are children under the age of 5, and 12 (39%) are female. Of 28 people with information available, 9 were hospitalized. One death has been reported from Pennsylvania.
The true number of sick people in an outbreak is likely 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 the 23 people who provided this information, 19 (83%) reported contact with pet turtles. Of the 12 people who reported the size of their pet turtle, 11 (92%) reported contact with pet turtles with shells less than 4 inches in length.
Laboratory and Traceback Data
Sick people reported getting their turtles from various places, including roadside vendors, flea markets, and pet stores. CDC is working with state officials to collect purchase records from pet stores to try to identify a common supplier of small turtles.
State officials are also collecting samples from turtles and turtle habitats for testing.
Whole genome sequencing (WGS) of bacteria from 31 people’s samples and 3 samples from a turtle habitat did not predict any antibiotic resistance. CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory also conducted standard antibiotic susceptibility testing on bacteria from three people’s samples and found no resistance.
CDC and public health officials in several states are investigating a multistate outbreak of Salmonella Typhimurium infections linked to small turtles.
Epidemiologic, laboratory, and traceback evidence show that contact with small turtles is making people sick.
Epidemiologic Data
As of February 20, 2021, a total of 22 people infected with the outbreak strain of Salmonella Typhimurium have been reported from seven states (see map). Illnesses started on dates ranging from August 27, 2020, to January 16, 2021 (see timeline).
The true number of sick people in an outbreak is likely 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.
Sick people range in age from less than 1 to 59 years, with a median age of 6. Thirty-six percent are female. Of 19 people with information available, 8 were hospitalized. One death has been reported from Pennslyvania.
State and local public health officials interviewed people about the animals they came into contact with in the week before they got sick. Of the 18 people who provided this information, 15 (83%) reported contact with pet turtles. Of the nine people who reported the size of their pet turtle, nine (100%) reported contact with pet turtles with shells less than 4 inches in length. People reported getting their turtles from various places, including flea markets, roadside vendors, and a pet store.
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 foodborne 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 source.
On January 29, 2021, the Pennsylvania Department of Health collected samples from a turtle habitat in a sick person’s home for testing. WGS showed that the Salmonella in the turtle’s environment is closely related to bacteria from sick people. This means that people likely got sick from touching small turtles or something in their habitat.
WGS of bacteria isolated from nine people’s samples and two environmental samples from a turtle habitat did not predict any antibiotic resistance. CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory also conducted standard antibiotic susceptibility testing on bacteria isolated from three outbreak samples and found no resistance.
A common supplier of small turtles has not yet been identified. It is often difficult to determine a common farm or supplier of small turtles due to the illegal practice of sales of small turtles by mobile vendors who do not stay in a single location.
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. The U.S. Food and Drug Administration bans the sale and distribution of these turtles.
