{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,10,15]],"date-time":"2026-10-15T17:08:38Z","timestamp":1792084118542,"version":"4.4.0"},"reference-count":29,"publisher":"American Academy of Pediatrics (AAP)","issue":"1","content-domain":{"domain":[],"crossmark-restriction":false},"short-container-title":[],"published-print":{"date-parts":[[2016,1,1]]},"abstract":"<jats:sec><jats:title>OBJECTIVE:<\/jats:title><jats:p>Turtle-associated salmonellosis (TAS), especially in children, is a reemerging public health issue. In 1975, small pet turtles (shell length &amp;lt;4 inches) sales were banned by federal law; reductions in pediatric TAS followed. Since 2006, the number of multistate TAS outbreaks has increased. We describe 8 multistate outbreaks with illness-onset dates occurring in 2011\u20132013.<\/jats:p><\/jats:sec><jats:sec><jats:title>METHODS:<\/jats:title><jats:p>We conducted epidemiologic, environmental, and traceback investigations. Cases were defined as infection with \u22651 of 10 molecular subtypes of Salmonella Sandiego, Pomona, Poona, Typhimurium, and I 4,[5],12:i:-. Water samples from turtle habitats linked to human illnesses were cultured for Salmonella.<\/jats:p><\/jats:sec><jats:sec><jats:title>RESULTS:<\/jats:title><jats:p>We identified 8 outbreaks totaling 473 cases from 41 states, Washington DC, and Puerto Rico with illness onsets during May 2011\u2013September 2013. The median patient age was 4 years (range: 1 month\u201394 years); 45% percent were Hispanic; and 28% were hospitalized. In the week preceding illness, 68% (187 of 273) of case-patients reported turtle exposure; among these, 88% (124 of 141) described small turtles. Outbreak strains were isolated from turtle habitats linked to human illnesses in seven outbreaks. Traceback investigations identified 2 Louisiana turtle farms as the source of small turtles linked to 1 outbreak; 1 outbreak strain was isolated from turtle pond water from 1 turtle farm.<\/jats:p><\/jats:sec><jats:sec><jats:title>CONCLUSIONS:<\/jats:title><jats:p>Eight multistate outbreaks associated with small turtles were investigated during 2011\u20132013. Children &amp;lt;5 years and Hispanics were disproportionately affected. Prevention efforts should focus on patient education targeting families with young children and Hispanics and enactment of state and local regulations to complement federal sales restrictions.<\/jats:p><\/jats:sec>","DOI":"10.1542\/peds.2015-1735","type":"journal-article","created":{"date-parts":[[2015,12,25]],"date-time":"2015-12-25T03:24:36Z","timestamp":1451013876000},"source":"Crossref","is-referenced-by-count":37,"title":["Outbreaks of Salmonellosis From Small Turtles"],"prefix":"10.1542","volume":"137","author":[{"given":"Maroya Spalding","family":"Walters","sequence":"first","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia;"},{"name":"Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Latoya","family":"Simmons","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Tara C.","family":"Anderson","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia;"},{"name":"Epidemic Intelligence Service, Scientific Education and Professional Development Program Office, Centers for Disease Control and Prevention, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Jamie","family":"DeMent","sequence":"additional","affiliation":[{"name":"Florida Department of Health, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kathleen","family":"Van Zile","sequence":"additional","affiliation":[{"name":"Florida Department of Health, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Laura P.","family":"Matthias","sequence":"additional","affiliation":[{"name":"Florida Department of Health, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Sonia","family":"Etheridge","sequence":"additional","affiliation":[{"name":"Florida Department of Health, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ronald","family":"Baker","sequence":"additional","affiliation":[{"name":"Florida Department of Health, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Healan","sequence":"additional","affiliation":[{"name":"Florida Department of Health, Jacksonville, Florida;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rita","family":"Bagby","sequence":"additional","affiliation":[{"name":"Los Angeles County Department of Health, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Roshan","family":"Reporter","sequence":"additional","affiliation":[{"name":"Los Angeles County Department of Health, Los Angeles, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Akiko","family":"Kimura","sequence":"additional","affiliation":[{"name":"California Department of Public Health, Gardena, California;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cassandra","family":"Harrison","sequence":"additional","affiliation":[{"name":"New York City Department of Health and Mental Hygiene, New York, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kadri","family":"Ajileye","sequence":"additional","affiliation":[{"name":"New York State Health Department, Albany, New York;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Julie","family":"Borders","sequence":"additional","affiliation":[{"name":"Texas Department of State Health Services, Austin, Texas;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Kia","family":"Crocker","sequence":"additional","affiliation":[{"name":"Maryland Department of Health and Mental Hygiene, Baltimore, Maryland;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Aaron","family":"Smee","sequence":"additional","affiliation":[{"name":"Pennsylvania Department of Health, Reading, Pennsylvania;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Meg","family":"Adams-Cameron","sequence":"additional","affiliation":[{"name":"New Mexico Department of Health, Albuquerque, New Mexico"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Lavin A.","family":"Joseph","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Beth","family":"Tolar","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Eija","family":"Trees","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Ashley","family":"Sabol","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Nancy","family":"Garrett","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Cheryl","family":"Bopp","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Stacey","family":"Bosch","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Casey Barton","family":"Behravesh","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases, Atlanta, Georgia;"}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"417","published-online":{"date-parts":[[2016,1,1]]},"reference":[{"issue":"1","key":"2021120907223556400_B1","doi-asserted-by":"crossref","first-page":"7","DOI":"10.3201\/eid1701.P11101","article-title":"Foodborne illness acquired in the United States\u2014major pathogens.","volume":"17","author":"Scallan","year":"2011","journal-title":"Emerg Infect Dis"},{"key":"2021120907223556400_B2","author":"Davis","year":"1981"},{"issue":"6","key":"2021120907223556400_B3","doi-asserted-by":"crossref","first-page":"2380","DOI":"10.1542\/peds.2006-1218","article-title":"A case-control study of the epidemiology of sporadic Salmonella infection in 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Reptiles, Amphibians, and Salmonella. 2013. Available at: http:\/\/www.cdc.gov\/features\/salmonellafrogturtle\/. Accessed March 14, 2014, 2014"},{"issue":"6","key":"2021120907223556400_B11","doi-asserted-by":"crossref","first-page":"511","DOI":"10.1093\/oxfordjournals.aje.a121418","article-title":"Turtle-associated salmonellosis. I. An estimation of the magnitude of the problem in the United States, 1970\u20131971.","volume":"95","author":"Lamm","year":"1972","journal-title":"Am J Epidemiol"},{"key":"2021120907223556400_B12","unstructured":"Food and Drug Administration Code of Federal Regulations . Vol CFR1240.62 Title 21 volume 8. Turtles intrastate and interstate requirements, 1975. Revised April 1, 2015. Available at: https:\/\/www.accessdata.fda.gov\/scripts\/cdrh\/cfdocs\/cfcfr\/cfrsearch.cfm?fr=1240.62. 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