Salmonellosis

Salmonella sp. is a rod shaped Gran negative bacteria frequently found in reptiles and amphibians and in many cases may be considered part of the normal flora. Salmonella enterica is the type species and is further divided in to six subspecies with over 2500 serovars. This bacteria is able to induce disease in humans and animals and is not only transmitted by reptiles, but may also be transmitted by farm animals through eggs or meat. Every year there are millions of infections worldwide resulting in thousands of deaths. In the United States (US) the Center of Disease Control (CDC) estimates that 7% of he 93.000 human cases are the result of a reptile or amphibian encounter or contact. The same center estimates that 3% of homes have a reptile in the household.

It seems there were many cases of children putting small turtles in their mouths. In the US in 1975 the sale of turtles (aquatic terrapins in the UK) under 4 inches (10cm) was prohibited. High numbers were imported from the US to Europe and came from farms as well as wild caught. Over a three year period (2002-2005) 3.8 million turtles were exported from the US. in 1975 the Food and drug administration (FDA) banned interstate shipments of turtles under 4 inches due there being over 280000 cases per year. In 1997 the European Union banned the import of Trachemys scripta elegans but following this ban imports of other species continued including Trachemys scripta scripta and other North American species.

In humans salmonellosis in humans causes fever, abdominal cramps and diarrhoea; this may progress to a more severe form affecting blood, bone marrow and nervous system. Salmonella sp. may be excreted through faeces of reptiles that appear to be healthy. People are infected upon ingestion of Salmonella sp. after close contact with a reptile or contaminated objects. 

Due to the high incidence of Salmonella sp. in reptiles some authorities consider them as asymptomatic carriers, whereas estimates vary between 36-90%. Vets have an important task of warning owners and general public about precautions that shoud be taken to prevent infection.

False negatives are a problem in reptiles making asymptomatic carrier detection difficult. Treatment of asymptomatic carriers with antibiotics has proved to be inecffective and in sick reptiles with salmonellosis euthanasia should be considered.

In 2011 an article published in Clinicians Brief authored by an American and European specialist in Herpetology stated that you are more likely to become infected with Salmonella sp. through ingestion of pork meat, eggs or peanut butter than reptiles.

In exotics veterinary medicine the use of fluoroquinolones is widely criticised and should be seriously considered before treating and exotic pet, as these drugs are used to treat salmonellosis in humans and may cause resistances. Enrofloxacin is a commonly used drug and perhaps should be used as in canine and feline medicine, as a second line antibiotic after culture and sensitivity tests have been performed. 

The CDC also recommends that reptiles are not kept in households with children under five years of age. The elderly or immunosuppresed people should also avoid exposure to reptiles.

The CDC recommends the following:

  • DO
    • Wash your hands thoroughly with soap and warm water immediately after touching a reptile or amphibian, or anything in the area where they live and roam. Use hand sanitizer if soap and water are not readily available.
      • Adults should always supervise hand washing for young children.
    • Keep reptiles and amphibians out of homes with children younger than 5 years old or people with weakened immune systems.
    • Habitats and their contents should be carefully cleaned outside of the home. Use disposable gloves when cleaning and do not dispose of water in sinks used for food preparation or for obtaining drinking water.
    • Wash any clothing the reptile or amphibian might have touched.
    • Use soap or a disinfectant to thoroughly clean any surfaces that have been in contact with reptiles or amphibians.
  • DON'T
    • Don't let children younger than 5 years of age, older adults, or people with weak immune systems handle or touch amphibians or reptiles, or anything in the area where they live and roam, including water from containers or aquariums.
    • Don't keep reptiles and amphibians in child care centers, nursery schools, or other facilities with children younger than 5 years old.
    • Don't touch your mouth after handling reptiles or amphibians and do not eat or drink around these animals.
    • Don't let reptiles or amphibians roam freely throughout the house or in areas where food or drink is prepared, served, or stored, such as kitchens, pantries, or outdoor patios.
    • Don't bathe animals or clean their habitats in your kitchen sink, bathroom sink, or bathtub. To prevent cross-contamination, animals should be bathed in a small plastic tub or bin that is dedicated for animal use only.
      • If bathtubs must be used for these purposes, they should be thoroughly cleaned afterward. Use bleach to disinfect a sink, bathtub, or other place where reptile or amphibian habitats are cleaned.

 

References and Further Reading

Association of Reptile and Avian Veterinarians (ARAV) http://www.arav.org

Centers for Disease Control and Prevention (CDC) http://www.cdc.gov/salmonella/

CDC Special Advice for People at Extra Risk for Zoonoses http://www.cdc.gov/healthypets/extra_risk.htm

Food and Drug Administration: Pet Turtles Cute But Contaminated With Salmonella http://www.fda.gov/ForConsumers/ConsumerUpdates/ ucm048151.htm

Pathogen Safety Data Sheets and Risk Assessment– Public Health Agency of Canada http://www.phac-aspc.gc.ca/lab-bio/res/psds-ftss/index- eng.php#s

Medical Microbiology http://www.ncbi.nlm.nih.gov/books/NBK7627/

The Merck Manual http://www.merck.com/pubs/mmanual/ 

Acha PN, Szyfres B (Pan American Health Organization [PAHO]). Zoonoses and communicable diseases common to man and animals. Volume 1. Bacterioses and mycoses. 3rd ed. Washington DC: PAHO; 2003. Scientific and Technical Publication No. 580. Salmonellosis; p. 233-251.

Austin CC, Wilkins MJ. Reptile-associated salmonellosis. JAVMA. 1998 Mar 15;212(6):866-867.

Beers MH, Porter RS, editors. The Merck manual. 18th ed. Whitehouse Station, NJ: Merck and Co.; 2006. Reactive arthritis; p. 292-294.

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Bradley T, Angulo FJ. Salmonella and reptiles: veterinary guidelines. J Herp Med Surg. 2009; 19:36-37.

Bradley T, Angulo F, Mitchell M. Public health education on Salmonella spp and reptiles. JAVMA. 2001;219(6):754-755.

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Centers for Disease Control and Prevention [CDC]. Iguana- associated salmonellosis -- Indiana, 1990. MMWR Morb Mortal Wkly Rep. 1992;41(03):38-39.

Centers for Disease Control and Prevention [CDC]. Is a turtle the right pet for your family? [online]. CDC;29 Apr 2005. Available at: http://www.cdc.gov/healthypets/spotlight_an_turtles.htm. 

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Centers for Disease Control and Prevention [CDC]. Reptile- associated salmonellosis--selected states, 1996-1998. MMWR Morb Mortal Wkly Rep. 1999;48(44):1009-1012; Errata 1999;48(45):1051.

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