Be Aware of Turtles as Pet Due to Risk of Salmonella Bacteria

Be Aware of Turtles as Pet Due to Risk of Salmonella Bacteria

Many people don't realize that reptiles (such as turtles, snakes, lizards, and iguanas) transmit salmonella, a kind of bacteria, through their feces. The salmonella bacteria are transmitted through direct contact with reptiles or by touching surfaces and people who have had contact with reptiles. Pet reptiles are an especially bad idea if anyone in your house, such as infants and elderly people, faces greater health risks from a salmonella infection.

These little turtles were very popular with children, until it was found out that these trendy pets shed salmonella. Children were becoming infected when they touched the turtles and put their fingers in their mouths or when they put the whole turtles in their mouths. Every year, there were about 100,000 cases of salmonella sickness due to baby turtles or other pet reptiles.

FDA is reminding the public that contact with baby turtles can pose a serious health risk. Although anyone can acquire this infection, the risk is highest in infants, young children, elderly people, and others with lowered natural resistance to disease due to pregnancy, cancer, chemotherapy, organ transplant, diabetes, liver problems, and other diseases. Children have a propensity to put their fingers in their mouth, and so Salmonella is rather easily transmitted. Moreover, turtles are kept in water that is contaminated, and the children touch the water and become infected

Many readers will remember the very small turtles, some with colorfully painted shells, sold years ago throughout California as the "perfect pet" for young children. Today, the sale of turtles with shells less than four inches in length is outlawed for your protection. Virtually all reptiles carry Salmonella bacteria, and while these germs may not pose a threat to the turtles, humans, especially children, are susceptible to illness from such exposure, as are other animals. But touching contaminated reptiles, including iguanas, turtles or snakes about 90 percent of reptiles carry salmonella. Pet chicks, ducklings, kittens and hedgehogs also have been linked to human outbreaks.

Salmonella is most commonly a food borne illness. Salmonella carried by healthy reptiles and livestock can infect people and cause severe abdominal cramps, nausea, diarrhea and vomiting. The condition is rarely fatal in adults, but in young children it can require hospitalization.

Turtles are natural carriers of Salmonella (part of their normal bacterial load in their intestines; they do not get sick from it). Although they often carry Salmonella, turtles do not constantly shed the bacteria in their feces, so even a turtle carrying Salmonella can give a false negative test depending on the timing of the testing. And, because Salmonella is survives pretty well in the environment and turtles are natural carriers, a Salmonella-free turtle can easily become re-infected, especially around other turtles.

The US Centers for Disease Control and Prevention said last week it is still investigating a 9 month multistate outbreak of gastroenteritis that has infected over 100 people who most likely caught Salmonella from small pet turtles.

The CDC announced the results of their ongoing epidemiologic and laboratory investigation into the outbreak in the 25th January issue of Morbidity and Mortality Weekly Report (MMWR). The first reported case occurred in May 2007 and the investigation started in October 2007.

The investigation links 103 cases of gastroenteritis in 33 states to Salmonella Paratyphi B var. Java believed to have been caught by being exposed to small turtles. Most of the patients who were asked, confirmed they had been in contact with a turtle in the seven days leading up to the onset of their symptoms.

Bacterial gastroenteritis is a very common problem in primary care and emergency department settings, especially for children younger than 5 years in the USA. Diarrhea accounts for as many as 5% of pediatric office visits and 10% of hospitalizations in this age group. Very often, gastroenteritis is underreported in the adult population. Each year, gastroenteritis affects every adult and accounts for 8 million doctor visits and 250,000 hospitalizations.

Many different types of bacteria can produce the symptoms associated with bacterial gastroenteritis including salmonella (responsible for 94%), shigella, staphylococcus, Campylobacter jejuni, clostridium (fewer than 1% of the cases), E. coli, yersinia, and others. Persistence of bowel symptoms commonly occurs after bacterial gastroenteritis and is responsible for considerable morbidity and health care costs.

A study shown that the risk of irritable bowel syndrome (IBS) in community individuals after having bacterial gastroenteritis was two fold greater in the general population. Pre-existing psychological and gastrointestinal co-morbidities independently increase this risk of developing IBS. Another study by British Medical Journal found that the risk is up to 10 times greater for people who have had bacterial gastroenteritis, caused by infections such as Salmonella and Campylobacter.

Transmission of disease from unfiltered/untreated swimming pool and spa water which may have become contaminated by germs from infected swimmers, incoming water from an unsanitary source, contaminated food--conditions, airborne contamination from rainfall, and droppings from birds, turtles, snakes, lizards, and iguanas may possible and may speed up multiplication and increase the bacterial load ingested.

Transmission occurs by contact with another person with gastro. This is through personal contact, contact with the faeces (poo) of an infected person, or by touching contaminated surfaces such as taps, toilet flush handles, children's toys and nappies.

Health authorities first noticed the outbreak when they investigated two cases of severe gastroenteritis in teenage girls who had both swum in the same family owned unchlorinated pool at the same time as two small pet turtles.

One of the girls, aged 13, visited a South Carolina hospital emergency department on the 31st August 2007, after experiencing 5 days of bloody diarrhea, abdominal cramps, fever, and vomiting. She was treated but not hospitalized and she recovered 7 days later. A stool specimen was analyzed and shown to contain Salmonella Paratyphi B var. Java.

The other girl, aged 15, was admitted to a hospital in North Carolina with a similar symptom history but she also had acute kidney failure. She spent 8 days in hospital and made a full recovery. A joint investigation by the two state health departments found that the girls has swum with pet turtles with shells smaller than 4 inches that had been sold illegally in a pet shop in South Carolina. Tests of the where the turtles were being kept at the pet shop confirmed the same strain of Salmonella Paratyphi B var. Java as that isolated from the younger girl.

Turtles and other reptiles are a well known cause of human Salmonella infection. A study spanning 1967 to 1997 found that 6 per cent of all human laboratory-confirmed, sporadic cases of Salmonella infections in the United States were caused by exposure to reptiles and amphibians. For those under the age of 21 the figure is nearly double, at 11 per cent. A study in New Jersey in 1972 found that small pet turtles accounted for approximately 23 per cent of Salmonella infections in children.

For this reason, the sale and distribution of small turtles with a shell length under 4 inches has been banned in the US since 1975. But in spite of this ban, the public is able to get hold of small turtles from pet shops, flea markets, street vendors, and through the internet, said the CDC.

The North Carolina Department of Public Health (NCDPH) conducted a wider database search of other reports of salmonella infections and found three other people had been infected with Salmonella Paratyphi B var. Java identical to the strain found in the pet shop turtles. And then, following a nationwide request from the NCDPH, other states started reporting the same strain linked to gastroenteritis outbreaks.

This led to a multistate investigation by the CDC and state and local health departments to find out how big this outbreak was nationwide and where the infections were coming from. The MMWR report from the CDC last week said that as of 18th January 2008, by searching reportable disease databases they have identified 103 cases of human Salmonella infections from this same outbreak strain, in 33 states.

Over half the patients are under 10 years of age and the first patient fell ill in May last year. Of the 80 patients who were asked about contact with turtles, 47 of them said they had been exposed to them in the 7 days leading up to onset of symptoms. No deaths have been reported.

In order to confirm the link with small turtles, the agency carried out a case-control telephone based study during November 15 to December 5 where they asked 70 patients and 45 neighborhood-matched controls about their exposure to turtles, other reptiles, or aquariums containing tropical fish.

Patients who said they had been exposed to turtles answered detailed questions about the type of exposure, for example whether and how they had handled their pets and their habitats. They were also asked about the size, type and source of their pets, and about their awareness of the link between exposure to reptiles and Salmonella infection.

The study revealed that 44 of the 70 patients had reported exposure to a pet turtle before they fell ill, compared with only 2 of the 45 controls. The patients had come by their turtle in a variety of ways: from pet shops, flea markets, street vendors, as gifts, and one or two said they had either got it through the Internet, from the wild, hatched from an egg given by a relative, or bought it at a conference. The CDC is still trying to find out if there is one common distributor or farm of origin for the turtles.

Like other reptiles, the majority of turtles carry Salmonella. Small turtles sold as pets are often bred in crowded ponds and nesting areas, which encourages Salmonella. Using antibiotics to try and stop the Salmonella just makes things worse because the bacteria become resistant. Turtles tend to shed Salmonella when they are stressed, and this makes it very difficult to tell when an animal is free of the bacteria, said the CDC.

"Multistate Outbreak of Human Salmonella Infections Associated with Exposure to Turtles --- United States, 2007--2008." published by the CDC on January 25, 2008.

Because of the risks, the CDC advises, “Turtles should not be allowed in childcare centers or nursing homes.” More advice: Households with young children should not have pet reptiles or amphibians at all. These pets should not roam households, and should be kept away from food preparation areas. In addition, kitchen sinks should not be used to bathe these pets or wash their cages or bowls, the CDC advises.


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