{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T06:21:28Z","timestamp":1783405288968,"version":"3.54.6"},"reference-count":20,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T00:00:00Z","timestamp":1783382400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"\n Introduction<\/jats:title>\n Contact with animals is a known risk factor for enteric illness outbreaks, but outbreak characteristics and pathogen distribution vary by animal type. Characterizing outbreaks associated with different animal groups can improve understanding of transmission patterns and inform prevention and response efforts.<\/jats:p>\n <\/jats:sec>\n \n Methods<\/jats:title>\n \n We analyzed United States outbreak data reported to CDC\u2019s National Outbreak Reporting System from 2013 to 2021 to compare outbreaks caused by\n Salmonella<\/jats:italic>\n ,\n Campylobacter<\/jats:italic>\n ,\n Cryptosporidium<\/jats:italic>\n , or Shiga toxin-producing\n Escherichia coli<\/jats:italic>\n (STEC) associated with ruminants (e.g., cattle, goats, sheep) or non-ruminants (e.g., poultry, reptiles, companion animals). We compared outbreak size, demographics, healthcare use, and health outcomes.\n <\/jats:p>\n <\/jats:sec>\n \n Results<\/jats:title>\n \n Among 350 outbreaks (10,741 illnesses), 36% were associated with ruminants and 64% with non-ruminants. Ruminant-associated outbreaks were primarily caused by\n Cryptosporidium<\/jats:italic>\n (70%) or STEC (17%), while non-ruminant outbreaks were caused by\n Salmonella<\/jats:italic>\n (78%) or\n Campylobacter<\/jats:italic>\n (20%). Ruminant-associated outbreaks were smaller (median: 4 vs. 14 cases) and had lower hospitalization rates (11% vs. 29%) and emergency room visit rates (14% vs. 21%). Adults aged 20\u201349\u202fyears accounted for a larger proportion of illnesses in ruminant-associated outbreaks, whereas non-ruminant outbreaks affected a broader age distribution, with a lower proportion of illnesses among persons aged 5\u201319\u202fyears.\n <\/jats:p>\n <\/jats:sec>\n \n Discussion<\/jats:title>\n \n Zoonotic enteric outbreaks differ substantially by animal contact type in pathogen distribution, outbreak size, severity, and affected populations. Ruminant-associated outbreaks disproportionately affected adults aged 20\u201349\u202fyears and were more frequently associated with\n Cryptosporidium<\/jats:italic>\n or STEC, whereas non-ruminant outbreaks more commonly involved\n Salmonella<\/jats:italic>\n and showed a more evenly distributed age pattern. These findings support the need for animal-specific risk communication, targeted prevention strategies, and routine inclusion of animal exposure questions in public health investigations to improve outbreak detection and response.\n <\/jats:p>\n <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1845080","type":"journal-article","created":{"date-parts":[[2026,7,7]],"date-time":"2026-07-07T05:48:33Z","timestamp":1783403313000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":0,"title":["Comparison of zoonotic enteric disease outbreaks associated with ruminant and non-ruminant animal contact \u2014 United States, 2013\u20132021"],"prefix":"10.3389","volume":"14","author":[{"given":"Zainab","family":"Salah","sequence":"first","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention","place":["Atlanta, GA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G. Sean","family":"Stapleton","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention","place":["Atlanta, GA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Zahra","family":"Ali","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention","place":["Atlanta, GA, United States"]},{"name":"Oak Ridge Institute for Science and Education","place":["Oak Ridge, TN, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Anna J.","family":"Blackstock","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention","place":["Atlanta, GA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Megin","family":"Nichols","sequence":"additional","affiliation":[{"name":"Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention","place":["Atlanta, GA, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,7,7]]},"reference":[{"key":"ref1","year":"2017"},{"key":"ref2","year":"2021"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"S472","DOI":"10.1093\/cid\/cis051","article-title":"Estimates of enteric illness attributable to contact with animals and their environments in the United States","volume":"54","author":"Hale","year":"2012","journal-title":"Clin Infect Dis"},{"key":"ref4","doi-asserted-by":"publisher","first-page":"225","DOI":"10.3201\/eid3002.230963","article-title":"Salmonella Vitkin outbreak associated with bearded dragons, Canada and United States, 2020\u20132022","volume":"30","author":"Paphitis","year":"2024","journal-title":"Emerg Infect Dis"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"1","DOI":"10.15585\/mmwr.ss7403a1","article-title":"Enteric disease outbreaks associated with animal contact\u2014animal contact outbreak surveillance system, United States, 2009\u20132021","volume":"74","author":"Eisenstein","year":"2025","journal-title":"MMWR Surveill Summ"},{"key":"ref6","year":"2018"},{"key":"ref7","year":"2020"},{"key":"ref8","doi-asserted-by":"publisher","first-page":"1624","DOI":"10.1093\/cid\/cix624","article-title":"Increasing Campylobacter infections, outbreaks, and antimicrobial resistance in the United States, 2004\u20132012","volume":"65","author":"Geissler","year":"2017","journal-title":"Clin Infect Dis"},{"key":"ref9","doi-asserted-by":"publisher","first-page":"568","DOI":"10.15585\/mmwr.mm6825a3","article-title":"Cryptosporidiosis outbreaks\u2014United States, 2009\u20132017","volume":"68","author":"Gharpure","year":"2019","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"ref10","doi-asserted-by":"publisher","first-page":"1293","DOI":"10.3201\/eid2108.141364","article-title":"Escherichia coli O157 outbreaks in the United States, 2003\u20132012","volume":"21","author":"Heiman","year":"2015","journal-title":"Emerg Infect Dis"},{"key":"ref11","doi-asserted-by":"publisher","first-page":"2270","DOI":"10.1017\/S0950268813003233","article-title":"Outbreaks of non-O157 Shiga toxin-producing Escherichia coli infection, USA","volume":"142","author":"Luna-Gierke","year":"2014","journal-title":"Epidemiol Infect"},{"key":"ref12","doi-asserted-by":"publisher","first-page":"370","DOI":"10.1111\/zph.12569","article-title":"Outbreaks of Salmonella enterica infections linked to animal contact: demographic and outbreak characteristics and comparison to foodborne outbreaks\u2014United States, 2009\u20132014","volume":"66","author":"Marus","year":"2019","journal-title":"Zoonoses Public Health"},{"key":"ref13","year":"2020"},{"key":"ref14","doi-asserted-by":"publisher","first-page":"708","DOI":"10.1111\/zph.13134","article-title":"Multistate outbreaks of salmonellosis linked to contact with backyard poultry\u2014United States, 2015\u20132022","volume":"71","author":"Stapleton","year":"2024","journal-title":"Zoonoses Public Health"},{"key":"ref15","doi-asserted-by":"publisher","first-page":"925","DOI":"10.1111\/zph.12990","article-title":"Multistate reptile- and amphibian-associated salmonellosis outbreaks in humans, United States, 2009\u20132018","volume":"69","author":"Waltenburg","year":"2022","journal-title":"Zoonoses Public Health"},{"key":"ref16","doi-asserted-by":"publisher","first-page":"e234","DOI":"10.1017\/S0950268821002132","article-title":"Salmonella illness outbreaks linked to backyard poultry purchasing during the COVID-19 pandemic: United States, 2020","volume":"149","author":"Nichols","year":"2021","journal-title":"Epidemiol Infect"},{"key":"ref17","doi-asserted-by":"publisher","first-page":"303","DOI":"10.1089\/vbz.2022.0022","article-title":"A review of zoonotic disease threats to pet owners: a compendium of measures to prevent zoonotic diseases associated with non-traditional pets: rodents and other small mammals, reptiles, amphibians, backyard poultry, and other selected animals","volume":"22","author":"Varela","year":"2022","journal-title":"Vector Borne Zoonotic Dis"},{"key":"ref18","doi-asserted-by":"publisher","first-page":"25","DOI":"10.1186\/s13028-023-00684-z","article-title":"Cryptosporidium parvum: an emerging occupational zoonosis in Finland","volume":"65","author":"Enbom","year":"2023","journal-title":"Acta Vet Scand"},{"key":"ref19","doi-asserted-by":"publisher","first-page":"70","DOI":"10.3390\/microorganisms6030070","article-title":"Zoonotic fecal pathogens and antimicrobial resistance in Canadian petting zoos","volume":"6","author":"Conrad","year":"2018","journal-title":"Microorganisms"},{"key":"ref20","doi-asserted-by":"publisher","first-page":"65","DOI":"10.1016\/j.onehlt.2016.03.001","article-title":"Human-livestock contacts and their relationship to transmission of zoonotic pathogens: a systematic review of literature","volume":"2","author":"Klous","year":"2016","journal-title":"One Health"}],"container-title":["Frontiers in Public 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