{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,11,6]],"date-time":"2026-11-06T20:21:06Z","timestamp":1793996466743,"version":"4.8.0"},"reference-count":54,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T00:00:00Z","timestamp":1660089600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2022,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>Non\u2010typhoidal <jats:italic>Salmonella<\/jats:italic> cause an estimated 1.4 million human illnesses, 26,000 hospitalizations and 400 deaths annually in the United States. Approximately 11% of these infections are attributed to animal contact. Reptiles and amphibians are known sources of salmonellosis; young children (aged &lt;5\u2009years) are disproportionately affected by reptile\u2010 and amphibian\u2010associated salmonellosis (RAAS) outbreaks. We describe multistate RAAS outbreaks to characterize illnesses and inform prevention efforts. RAAS outbreaks were defined as \u22652 culture\u2010confirmed human <jats:italic>Salmonella<\/jats:italic> infections with similar pulsed\u2010field gel electrophoresis patterns and epidemiologic, laboratory or traceback evidence linking them to a common reptile\/amphibian exposure. Data sources included the Animal Contact Outbreak Surveillance System; CDC Outbreak Response and Prevention Branch's outbreak management database; PulseNet, the national molecular subtyping network for foodborne disease surveillance in the United States; and the National Antimicrobial Resistance Monitoring System. Twenty\u2010six RAAS outbreaks were reported during 2009\u20132018, resulting in 1465 illnesses and 306 hospitalizations. The outbreaks were associated with turtles (19), lizards (5), snakes (1) and frogs (1). Sixteen (61.5%) outbreaks were linked to small turtles (&lt;4 inches), resulting in 914 illnesses. Forty\u2010nine percent of outbreak\u2010associated patients were aged &lt;5\u2009years. Of 362 patients\/caregivers interviewed, 111 (30.7%) were aware that reptiles\/amphibians can carry <jats:italic>Salmonella<\/jats:italic>. Among 267 patient isolates with antimicrobial susceptibility information, 20 (7.5%) were non\u2010susceptible to \u22651 antibiotic used to treat human salmonellosis. RAAS outbreaks result in considerable morbidity, particularly among young children. Illnesses linked to small turtles are preventable through education, targeted outreach to caregivers and paediatricians, and when appropriate, enforcement. Historically, individual states and jurisdictions have enforced existing or promulgated new authorities to address outbreaks. Preventing future RAAS outbreaks requires addressing challenges related to the illegal sale\/distribution of small turtles; and for legal reptile sales, providing information on RAAS risk to consumers at point of sale to support informed pet ownership decisions.<\/jats:p>","DOI":"10.1111\/zph.12990","type":"journal-article","created":{"date-parts":[[2022,8,10]],"date-time":"2022-08-10T10:38:41Z","timestamp":1660127921000},"page":"925-937","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":39,"title":["Multistate reptile\u2010 and <scp>amphibian\u2010associated<\/scp> salmonellosis outbreaks in humans, United States, 2009\u20132018"],"prefix":"10.1111","volume":"69","author":[{"ORCID":"https:\/\/orcid.org\/0000-0002-8095-1433","authenticated-orcid":false,"given":"Michelle A.","family":"Waltenburg","sequence":"first","affiliation":[{"name":"Division of Foodborne, Waterborne and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ariana","family":"Perez","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"General Dynamics Information Technology  Atlanta Georgia USA"},{"name":"Division of Viral Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zainab","family":"Salah","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth E.","family":"Karp","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jean","family":"Whichard","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Tolar","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lauren","family":"Gollarza","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lia","family":"Koski","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"CAITTA, Inc.  Herndon Virginia USA"},{"name":"Maricopa County Department of Public Health  Phoenix Arizona USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna","family":"Blackstock","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"Division of Scientific Education and Professional Development Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Colin","family":"Basler","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"One Health Office Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0003-4856-4932","authenticated-orcid":false,"given":"Megin","family":"Nichols","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"311","published-online":{"date-parts":[[2022,8,10]]},"reference":[{"key":"e_1_2_11_2_1","volume-title":"Red book (2018): Report of the committee on infectious diseases","author":"American Academy of Pediatrics","year":"2018"},{"key":"e_1_2_11_3_1","volume-title":"Pet ownership and demographics sourcebook","author":"American Veterinary Medical Association","year":"2018"},{"key":"e_1_2_11_4_1","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/jiw415"},{"key":"e_1_2_11_5_1","unstructured":"Association of Reptile and Amphibian Veterinarians(2016).Salmonellaand reptiles: Veterinary guidelines. Retrieved fromhttps:\/\/arav.org\/salmonella\u2010reptiles\u2010veterinary\u2010guidelines\/#:~:text=All%20reptiles%20should%20be%20presumed Salmonella%20infection%20status%20is%20discouraged"},{"key":"e_1_2_11_6_1","doi-asserted-by":"publisher","DOI":"10.5625\/lar.2016.32.3.166"},{"key":"e_1_2_11_7_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6429a7"},{"key":"e_1_2_11_8_1","doi-asserted-by":"publisher","DOI":"10.1089\/fpd.2019.2650"},{"key":"e_1_2_11_9_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkaa345"},{"key":"e_1_2_11_10_1","doi-asserted-by":"publisher","DOI":"10.5818\/1076\u20103139.8.2.14"},{"key":"e_1_2_11_11_1","doi-asserted-by":"publisher","DOI":"10.1186\/1471\u20102105\u201010\u2010421"},{"key":"e_1_2_11_12_1","volume-title":"Center for Genomic Epidemiology","author":"Center for Genomic Epidemiology","year":"2011"},{"key":"e_1_2_11_13_1","volume-title":"Multistate Outbreak of Human Salmonella Cotham and Salmonella Kisarawe Infections Linked to Contact with Pet Bearded Dragons (Final Update)","author":"Centers for Disease Control and Prevention","year":"2014"},{"key":"e_1_2_11_14_1","volume-title":"Four Multistate Outbreaks of Human Salmonella Infections Linked to Small Turtles","author":"Centers for Disease Control and Prevention","year":"2016"},{"key":"e_1_2_11_15_1","volume-title":"National Antimicrobial Resistance Monitoring System for Enteric Bacteria (NARMS)","author":"Centers for Disease Control and Prevention","year":"2016"},{"key":"e_1_2_11_16_1","volume-title":"Whole Genome Sequencing (WGS)","author":"Centers for Disease Control and Prevention","year":"2016"},{"key":"e_1_2_11_17_1","volume-title":"National Salmonella Surveillance Annual Report, 2016","author":"Centers for Disease Control and Prevention","year":"2018"},{"key":"e_1_2_11_18_1","volume-title":"Healthy Pets, Healthy People","author":"Centers for Disease Control and Prevention","year":"2019"},{"key":"e_1_2_11_19_1","volume-title":"Surveillance for Outbreaks of Enteric Disease Associated with Animal Contact: Summary for 2017","author":"Centers for Disease Control and Prevention","year":"2020"},{"key":"e_1_2_11_20_1","doi-asserted-by":"publisher","DOI":"10.1177\/10406387100220010"},{"key":"e_1_2_11_21_1","doi-asserted-by":"publisher","DOI":"10.2460\/javma.248.9.1050"},{"key":"e_1_2_11_22_1","volume-title":"Performance Standards for Antimicrobial Susceptibility Testing","author":"Clinical and Laboratory Standards Institute","year":"2020"},{"key":"e_1_2_11_23_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2701.190676"},{"key":"e_1_2_11_24_1","doi-asserted-by":"publisher","DOI":"10.1086\/375602"},{"key":"e_1_2_11_25_1","unstructured":"Food and Drug Administration(2019).Title 21 Code of Federal Regulations Part 1240.62 \u2013 turtles intrastate and interstate requirements. Retrieved fromhttps:\/\/www.ecfr.gov\/cgi\u2010bin\/text\u2010idx?SID=4c9a67b171e6febc17e3533fd4b10934&mc=true&node=se21.8.1240_162&rgn=div8"},{"key":"e_1_2_11_26_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2019.00172"},{"key":"e_1_2_11_27_1","doi-asserted-by":"publisher","DOI":"10.1638\/2011\u20100281R1.1"},{"key":"e_1_2_11_28_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkq242"},{"key":"e_1_2_11_29_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis051"},{"key":"e_1_2_11_30_1","doi-asserted-by":"publisher","DOI":"10.1086\/649932"},{"key":"e_1_2_11_31_1","doi-asserted-by":"publisher","DOI":"10.3389\/fpubh.2019.00242"},{"key":"e_1_2_11_32_1","doi-asserted-by":"publisher","DOI":"10.1186\/1297\u20109716\u201042\u201034"},{"key":"e_1_2_11_33_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cis600"},{"key":"e_1_2_11_34_1","doi-asserted-by":"publisher","DOI":"10.1086\/588823"},{"key":"e_1_2_11_35_1","doi-asserted-by":"publisher","DOI":"10.1111\/zph.12507"},{"key":"e_1_2_11_36_1","doi-asserted-by":"publisher","DOI":"10.1111\/zph.12701"},{"key":"e_1_2_11_37_1","doi-asserted-by":"publisher","DOI":"10.1111\/j.1863\u20102378.2011.01403.x"},{"key":"e_1_2_11_38_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6906a1"},{"key":"e_1_2_11_39_1","doi-asserted-by":"publisher","DOI":"10.1111\/zph.12569"},{"key":"e_1_2_11_40_1","doi-asserted-by":"publisher","DOI":"10.1128\/AAC.01030\u201016"},{"key":"e_1_2_11_41_1","doi-asserted-by":"publisher","DOI":"10.2460\/javma.231.7.1036"},{"key":"e_1_2_11_42_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2012\u20102031"},{"key":"e_1_2_11_43_1","doi-asserted-by":"publisher","DOI":"10.2460\/ajvr.68.2.158"},{"key":"e_1_2_11_44_1","doi-asserted-by":"publisher","DOI":"10.1053\/saep.2001.19798"},{"key":"e_1_2_11_45_1","doi-asserted-by":"publisher","DOI":"10.1292\/jvms.67.97"},{"key":"e_1_2_11_46_1","doi-asserted-by":"publisher","DOI":"10.1016\/B978-1-4557-4801-3.00225-3"},{"key":"e_1_2_11_47_1","doi-asserted-by":"publisher","DOI":"10.1016\/S1473\u20103099(06)70599\u20100"},{"key":"e_1_2_11_48_1","doi-asserted-by":"publisher","DOI":"10.1016\/j.drup.2016.09.001"},{"key":"e_1_2_11_49_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix669"},{"key":"e_1_2_11_50_1","doi-asserted-by":"publisher","DOI":"10.1093\/ilar.48.3.297"},{"key":"e_1_2_11_51_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid1812.120784"},{"key":"e_1_2_11_52_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015\u20101735"},{"key":"e_1_2_11_53_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.13585"},{"key":"e_1_2_11_54_1","doi-asserted-by":"publisher","DOI":"10.1111\/zph.12140"},{"key":"e_1_2_11_55_1","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dkx217"}],"container-title":["Zoonoses and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/zph.12990","content-type":"application\/pdf","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/full-xml\/10.1111\/zph.12990","content-type":"application\/xml","content-version":"vor","intended-application":"text-mining"},{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/zph.12990","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,8,21]],"date-time":"2023-08-21T22:39:46Z","timestamp":1692657586000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/zph.12990"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2022,8,10]]},"references-count":54,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2022,12]]}},"alternative-id":["10.1111\/zph.12990"],"URL":"https:\/\/doi.org\/10.1111\/zph.12990","archive":["Portico"],"relation":{},"ISSN":["1863-1959","1863-2378"],"issn-type":[{"value":"1863-1959","type":"print"},{"value":"1863-2378","type":"electronic"}],"subject":[],"published":{"date-parts":[[2022,8,10]]},"assertion":[{"value":"2021-10-08","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-07-20","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2022-08-10","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}