A strain of salmonella carried by small pet turtles has sickened more than 100 people and hospitalized at least 24 nationwide in the largest recorded outbreak of its kind, the Centers for Disease Control and Prevention reported Thursday.
Cases have been reported in 33 states, but mostly in California, Texas, Pennsylvania and Illinois. Most of the patients have been children.
No one has died in the latest outbreak, which began in August. But some patients have experienced severe symptoms, including acute kidney failure.
The most common symptoms reported to the CDC included bloody diarrhea, abdominal cramping, fever and vomiting. The median age of patients was 7 1/2 .
"With over 100 cases reported, that's fairly substantial," said Mark Sotir, a CDC epidemiologist in Atlanta. "For every case that's reported to the CDC, we estimate 30 or 40 sick people that haven't been reported."
Dr. Jonathan Fielding, Los Angeles County's public health director, said he had a simple piece of advice for parents thinking about buying a pet turtle -- don't.
"If you have them, make sure you're washing your hands a lot after you're touching them," he said.
Salmonella bacteria are most often associated with food poisoning, but about 6% of infections come from contact with turtles. Turtles can carry a variety of salmonella without symptoms and shed them in their feces.
Small turtles have been particularly problematic because they are often bred in crowded conditions and are more likely to be given to children as pets. A 3-week-old girl in Florida died in March from a different strain of salmonella carried by a small turtle.
Since 1975, federal law has prohibited the sale of pet turtles with shells shorter than 4 inches. But public health officials say enforcement is spotty.
The new outbreak was detected after two teenagers were taken to different hospitals in North Carolina and South Carolina on the same day. The girls had swum together in an unchlorinated pool that two pet turtles had also swum in.
A salmonella strain known as Paratyphi B variant Java was isolated from one of the girls and in the water of the turtles' habitat.
Of the 103 reported cases, nearly half of the patients remembered being exposed to a turtle; many others were friends or relatives of turtle owners.
Many of the patients reported feeding, kissing or playing with a turtle. In one case, a baby was bathed in a sink where turtle waste had been disposed of, the CDC said.
The turtles most often came from pet shops, but they were also bought at flea markets or from street vendors. The CDC is investigating whether the outbreak can be traced to a common turtle distributor or farm.
Of the 12 cases reported in California, 11 were from Southern California, mostly Los Angeles County.