Salmonella From Rattlesnake Pills: Kansas and Texas, 2017

Rattlesnake pills — capsules of dried, powdered rattlesnake meat — are sold as remedies for everything from cancer to acne, sometimes labeled "natural," in alternative medicine and health food stores, at roadside markets and online. They are not approved by the FDA, which does not review them for safety or effectiveness. In 2017 they turned up in a Salmonella investigation, reported by Lyndsay Bottichio of CDC with the Kansas and Texas health departments.

A bottle in Texas

In November 2017, while investigating a Salmonella illness, the Texas Department of State Health Services took a bottle of rattlesnake pills from a patient's home. The pills grew Salmonella Oranienburg. But the bacteria from the Texas patient didn't match those from the pills by pulsed-field gel electrophoresis, so the cause of that patient's illness was never settled; the patient couldn't be re-interviewed and no more samples could be collected.

A match in Kansas

PulseNet, the national network that compares bacterial fingerprints from foodborne illness, found many isolates with the same pattern as the pill sample. Whole genome sequencing then showed the pill bacteria were closely related to those from a patient in Kansas — making it likely the Kansas patient was sickened by rattlesnake pills.

That patient hadn't mentioned the pills in a first, standard interview, which asked about vitamins and supplements. Re-interviewed on December 17, 2017, with specific questions about unusual supplements, the patient recalled a trip to Chihuahua, Mexico, and buying pastillas de víbora de cascabel — rattlesnake pills — that seemed homemade. The patient had taken five and had none left, so whether they came from the same source as the Texas pills couldn't be determined. No other related infections were found.

Who is at risk

Reptiles and their meat can carry Salmonella. Earlier outbreaks traced to rattlesnake pills mostly involved people with cancer taking them as medicine, and mostly S. arizonae. This was the first report linking rattlesnake pills to S. Oranienburg.

People more likely to get severely ill — even hospitalized or killed — by Salmonella from a contaminated food or supplement include:

• people with weakened immune systems, such as those with HIV or on chemotherapy;
• pregnant women;
• children under 5;
• adults over 60.

Anyone considering rattlesnake pills, especially people at higher risk, should know about the Salmonella risk, and should talk with a licensed health care provider about the risks and benefits of any supplement before taking it.

Sources

Based on Bottichio L, Webb LM, Leos G, Tolar B, Dowell N, Basler C, "Notes from the Field: Salmonella Oranienburg Infection Linked to Consumption of Rattlesnake Pills — Kansas and Texas, 2017," MMWR, Centers for Disease Control and Prevention; a work of the United States government in the public domain.