Salmonella from Small Pet Turtles: The 2017 Agbeni Outbreak

Selling small turtles — those with shells under 4 inches — has been illegal in the United States since 1975, because they spread Salmonella. Outbreaks keep happening anyway. In 2017, one strain of Salmonella Agbeni sickened 76 people in 19 states, and nearly half of those with information ended up in the hospital.

How the outbreak was found

In June 2017, PulseNet, the national network that matches the DNA fingerprints of foodborne bacteria, found 17 Salmonella Agbeni isolates with the same pattern. That pattern had turned up before: in a turtle in 2015, and in a 2016 illness cluster in which 63 percent of patients reported contact with turtles. CDC and state and local health departments investigated, interviewing patients about turtle contact, the species and where they got them.

The patients

Of 12 patients who said how they got their turtles, six bought them from a street or roadside vendor, three from a store, two at festivals, and one received them as a gift. Tracing did not find a single turtle farm supplying the sellers.

What linked it to turtles

Whole-genome sequencing showed that the 2017 patient isolates, the 2016 cluster and the 2015 turtle isolate were closely related, differing by 0 to 18 genetic changes — supporting turtles as the likely source.

Why it stood out

• More hospitalizations: 48 percent, against 27 percent in multistate foodborne outbreaks and 28–33 percent in recent turtle-linked Salmonella outbreaks.
• A different map: earlier turtle outbreaks of Salmonella Poona and Pomona were concentrated in the Southwest, while turtles are mostly bred in the Southeast. This one centered on the East Coast, suggesting more needs to be learned about turtle breeding and sales.

The authors called for educating shoppers and store staff about the ban on selling small turtles, and teaching pet owners how to keep Salmonella from spreading from pets to people.

Sources

Based on "Notes from the Field: An Outbreak of Salmonella Agbeni Infections Linked to Turtle Exposure — United States, 2017," by Lia Koski and colleagues (CDC; New York State Department of Health; New York City Department of Health and Mental Hygiene; Pennsylvania Department of Health), Morbidity and Mortality Weekly Report, Centers for Disease Control and Prevention; a work of the United States government in the public domain.