Multistate outbreak of human Salmonella infections associated with exposure to turtles–United States, 2007-2008

Turtles and other reptiles have long been recognized as a source of human Salmonella infections. To prevent turtle-associated Salmonella infections in humans, the sale and distribution of small turtles (i.e., those with a carapace length of less than 4 inches) has been prohibited in the United States since 1975. Despite this prohibition, small turtles remain available to the public from various sources, including pet shops, flea markets, street vendors, and Internet websites. In October 2007, the North Carolina Division of Public Health (NCDPH) notified CDC of human infections caused by Salmonella serotype Paratyphi B L (+) tartrate (+) (Salmonella Paratyphi B var. Java) in several states. Salmonella Paratyphi B var. Java is a nontyphoidal strain of Salmonella that causes gastroenteritis. This report describes the results of the epidemiologic and laboratory investigation conducted by CDC and state and local health departments during October 2007-January 2008. The findings document an ongoing, multistate outbreak of Salmonella Paratyphi B var. Java infections, with the first reported illness onset occurring on May 4, 2007. Many of these infections have occurred in young children and have been associated with exposure to small turtles. Prohibiting the sale and distribution of small turtles likely remains the most effective public health action to prevent turtle-associated salmonellosis.