{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:08:36Z","timestamp":1792084116783,"version":"4.4.0"},"reference-count":33,"publisher":"Wiley","issue":"8","license":[{"start":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T00:00:00Z","timestamp":1695945600000},"content-version":"vor","delay-in-days":0,"URL":"http:\/\/onlinelibrary.wiley.com\/termsAndConditions#vor"}],"content-domain":{"domain":["onlinelibrary.wiley.com"],"crossmark-restriction":true},"short-container-title":["Zoonoses and Public Health"],"published-print":{"date-parts":[[2023,12]]},"abstract":"<jats:title>Abstract<\/jats:title><jats:p>The sale and distribution of small turtles (shell length\u2009&lt;4 inches) as pets has been banned in the United States since 1975 because of the risk of <jats:italic>Salmonella<\/jats:italic> transmission, especially to children. Despite this 48\u2010year\u2010old ban, salmonellosis outbreaks continue to be linked to contact with small turtles. During investigations of turtle\u2010associated outbreaks, information regarding the turtle farm of origin is difficult to obtain because turtles are commonly sold by transient vendors. During 2020\u20132021, public health officials investigated a multistate illness outbreak caused by <jats:italic>Salmonella enterica<\/jats:italic> serotype Typhimurium linked to pet small turtles. Cases were defined as a laboratory\u2010confirmed <jats:italic>Salmonella Typhimurium<\/jats:italic> infection highly related (within 0\u20136 allele differences) to the outbreak strain based on whole\u2010genome sequencing analysis by core\u2010genome multilocus sequence typing with illness onset occurring during 27 August 2020\u201314 May 2021. Forty\u2010three patients were identified from 12 states; of these, 35% (15\/43) were children &lt;5\u2009years old. Among patients with available information, 37% (14\/38) were hospitalized, and one death was reported. Seventy\u2010four percent (25\/34) of patients reported turtle exposure in the week before illness onset, and 84% (16\/19) specified exposure to small turtles. The outbreak strain was isolated from samples collected from a Pennsylvania patient's small turtle tank. Two patients reported purchasing their small turtles from pet stores. <jats:italic>Salmonella<\/jats:italic> Braenderup was isolated from samples collected from small turtles and their habitat at one of these stores; however, at that time, this strain was not associated with any human illnesses. This investigation was notable because of the documented sale of small turtles from several pet stores combined with the identification of a single small turtle supplier to these pet stores. The high proportion of children involved in this outbreak highlights the continued need to educate the pet industry as well as parents and caregivers about the risk of turtle\u2010associated salmonellosis especially in children. Understanding and addressing the persisting challenges related to the illegal sale and distribution of small turtles could reduce the burden of turtle\u2010associated salmonellosis.<\/jats:p>","DOI":"10.1111\/zph.13080","type":"journal-article","created":{"date-parts":[[2023,9,29]],"date-time":"2023-09-29T08:35:25Z","timestamp":1695976525000},"page":"684-691","update-policy":"https:\/\/doi.org\/10.1002\/crossmark_policy","source":"Crossref","is-referenced-by-count":8,"title":["Multistate outbreak of turtle\u2010associated salmonellosis highlights ongoing challenges with the illegal sale and distribution of small turtles"],"prefix":"10.1111","volume":"70","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9260-9785","authenticated-orcid":false,"given":"Kaylea","family":"Nemechek","sequence":"first","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"Oak Ridge Institute for Science and Education  Oak Ridge Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-1784-6577","authenticated-orcid":false,"given":"G. Sean","family":"Stapleton","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"Oak Ridge Institute for Science and Education  Oak Ridge Tennessee USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"ORCID":"https:\/\/orcid.org\/0000-0002-8095-1433","authenticated-orcid":false,"given":"Michelle A.","family":"Waltenburg","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":"Mabel S. F.","family":"Low","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":"Jennifer","family":"Adams","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases Centers for Disease Control and Prevention  Atlanta Georgia USA"},{"name":"Association of Public Health Laboratories  Silver Spring Maryland USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Vi","family":"Peralta","sequence":"additional","affiliation":[{"name":"California Department of Public Health  Richmond California USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Karen","family":"Lopez","sequence":"additional","affiliation":[{"name":"Delaware Department of Agriculture  Dover Delaware USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Atisha","family":"Morrison","sequence":"additional","affiliation":[{"name":"Texas Department of State Health Services  Austin Texas USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Hannah","family":"Schnitzler","sequence":"additional","affiliation":[{"name":"Washington State Department of Health  Olympia Washington USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kelly E.","family":"Kline","sequence":"additional","affiliation":[{"name":"Pennsylvania Department of Health Bureau of Epidemiology  Harrisburg Pennsylvania USA"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Shannon","family":"McGinnis","sequence":"additional","affiliation":[{"name":"Pennsylvania Department of Health Bureau of Epidemiology  Harrisburg Pennsylvania 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":[[2023,9,29]]},"reference":[{"key":"e_1_2_12_2_1","volume-title":"Bacteriological analytical manual","author":"Andrews W. H.","year":"2021"},{"key":"e_1_2_12_3_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm6429a7"},{"key":"e_1_2_12_4_1","doi-asserted-by":"publisher","DOI":"10.3201\/eid2701.200316"},{"key":"e_1_2_12_5_1","first-page":"1149","article-title":"Turtle\u2010associated Salmonellosis, United States, 2006\u20132014","volume":"22","author":"Bosch S.","year":"2016","journal-title":"Emerging Infectious Diseases"},{"key":"e_1_2_12_6_1","first-page":"223","article-title":"Salmonellosis associated with pet turtles\u2014Wisconsin and Wyoming, 2004","volume":"54","author":"CDC","year":"2005","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_12_7_1","first-page":"649","article-title":"Turtle\u2010associated salmonellosis in humans\u2014United States, 2006\u20132007","volume":"56","author":"CDC","year":"2007","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_12_8_1","first-page":"69","article-title":"Multistate outbreak of human Salmonella infections associated with exposure to turtles\u2014United States, 2007\u20132008","volume":"57","author":"CDC","year":"2008","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_12_9_1","first-page":"191","article-title":"Multistate outbreak of human Salmonella typhimurium infections associated with pet turtle exposure\u2014United States, 2008","volume":"59","author":"CDC","year":"2010","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_12_10_1","first-page":"79","article-title":"Notes from the field: Outbreak of salmonellosis associated with pet turtle exposures\u2014United States, 2011","volume":"61","author":"CDC","year":"2012","journal-title":"MMWR. Morbidity and Mortality Weekly Report"},{"key":"e_1_2_12_11_1","unstructured":"CDC. (2016a).Menu of state turtle\u2010associated salmonellosis laws.https:\/\/www.cdc.gov\/phlp\/docs\/turtle\u2010menu.pdf"},{"key":"e_1_2_12_12_1","unstructured":"CDC. (2016b).PulseNet methods and protocols: Whole genome sequencing(WGS).https:\/\/www.cdc.gov\/pulsenet\/pathogens\/wgs.html"},{"key":"e_1_2_12_13_1","volume-title":"Antibiotic resistance threats in the United States, 2019","author":"CDC","year":"2019"},{"key":"e_1_2_12_14_1","unstructured":"CDC. (2019b).Foodnet Fast population survey.https:\/\/wwwn.cdc.gov\/Foodnetfast\/PopSurvey"},{"key":"e_1_2_12_15_1","unstructured":"CDC. (2021a).National Notifiable Disease Surveillance System(NNDSS)Salmonellosis(Salmonellaspp.).https:\/\/ndc.services.cdc.gov\/conditions\/salmonellosis\/"},{"key":"e_1_2_12_16_1","unstructured":"CDC. (2021b).Salmonellaoutbreak linked to small turtles.https:\/\/www.cdc.gov\/salmonella\/typhimurium\u201002\u201021\/index.html"},{"key":"e_1_2_12_17_1","unstructured":"CDC. (2021c).Heathy pets health people: People with weakened immune systems.https:\/\/www.cdc.gov\/healthypets\/specific\u2010groups\/high\u2010risk\/organ\u2010transplant\u2010patients.html"},{"key":"e_1_2_12_18_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1980.03300380027016"},{"key":"e_1_2_12_19_1","doi-asserted-by":"publisher","DOI":"10.1111\/zph.12466"},{"key":"e_1_2_12_20_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2009-0272"},{"key":"e_1_2_12_21_1","doi-asserted-by":"publisher","DOI":"10.1086\/649932"},{"key":"e_1_2_12_22_1","doi-asserted-by":"publisher","DOI":"10.3389\/fmicb.2017.00375"},{"key":"e_1_2_12_23_1","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a121418"},{"key":"e_1_2_12_24_1","volume-title":"Prioritizing web usability","author":"Loranger H.","year":"2006"},{"key":"e_1_2_12_25_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.ss6906a1"},{"key":"e_1_2_12_26_1","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0278443"},{"key":"e_1_2_12_27_1","doi-asserted-by":"publisher","DOI":"10.1093\/cid\/cix669"},{"key":"e_1_2_12_28_1","doi-asserted-by":"publisher","DOI":"10.15585\/mmwr.mm7219a2"},{"key":"e_1_2_12_29_1","doi-asserted-by":"publisher","DOI":"10.3390\/vetsci7020056"},{"key":"e_1_2_12_30_1","doi-asserted-by":"publisher","DOI":"10.1089\/vbz.2022.0022"},{"key":"e_1_2_12_31_1","doi-asserted-by":"publisher","DOI":"10.1111\/zph.12990"},{"key":"e_1_2_12_32_1","doi-asserted-by":"publisher","DOI":"10.1542\/peds.2015-1735"},{"key":"e_1_2_12_33_1","doi-asserted-by":"publisher","DOI":"10.1111\/jpc.13585"},{"key":"e_1_2_12_34_1","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1965.03080180005001"}],"container-title":["Zoonoses and Public Health"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/pdf\/10.1111\/zph.13080","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2023,12,13]],"date-time":"2023-12-13T01:40:28Z","timestamp":1702431628000},"score":1,"resource":{"primary":{"URL":"https:\/\/onlinelibrary.wiley.com\/doi\/10.1111\/zph.13080"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2023,9,29]]},"references-count":33,"journal-issue":{"issue":"8","published-print":{"date-parts":[[2023,12]]}},"alternative-id":["10.1111\/zph.13080"],"URL":"https:\/\/doi.org\/10.1111\/zph.13080","archive":["Portico"],"relation":{},"ISSN":["1863-1959","1863-2378"],"issn-type":[{"value":"1863-1959","type":"print"},{"value":"1863-2378","type":"electronic"}],"subject":[],"published":{"date-parts":[[2023,9,29]]},"assertion":[{"value":"2023-05-11","order":0,"name":"received","label":"Received","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-17","order":1,"name":"accepted","label":"Accepted","group":{"name":"publication_history","label":"Publication History"}},{"value":"2023-09-29","order":2,"name":"published","label":"Published","group":{"name":"publication_history","label":"Publication History"}}]}}