Outbreak of Human Salmonella Typhimurium in Fresh water frogs

FROM CDC to ARAV  
Sent: Wednesday, December 09, 2009 11:51 AM
Subject: Outbreak of Human Salmonella Typhimurium


Dear ARAV Members, the CDC has just released an announcement regarding an
outbreak of human Salmonella typhimurium infections associated with contact
with water frogs.  Please see the announcement below and take the
appropriate actions and precautions.
 
 
Salmonella 

Salmonella> Salmonella Outbreak Investigations > Investigation Announcement:
Outbreak of Human Salmonella Typhimurium Infections Associated with Contact
with Water Frogs

Investigation Announcement: Outbreak of Human Salmonella Typhimurium
Infections Associated with Contact with Water Frogs

Persons Infected with the Outbreak Strain of Salmonella Typhimurium, United
States, by State, June 24, 2009 to November 14, 2009
http://www.cdc.gov/salmonella/typh1209/map.html

Infections with the outbreak strain of Salmonella Typhimurium, by week of
illness onset (n=48 for whom information was reported as of 12/7/09)
http://www.cdc.gov/salmonella/typh1209/epi_curve.html

Update for December 07, 2009

CDC is collaborating with public health officials in many states to
investigate a multistate outbreak of human Salmonella serotype Typhimurium
infections due to contact with water frogs including African Dwarf Frogs.
Water frogs commonly live in aquariums or fish tanks. Amphibians such as
frogs and reptiles such as turtles, are recognized as a source of human
Salmonella infections.  In the course of routine assessment, a number of
cases with the same strain have been identified over many months.

As of 12pm EST on December 7, 2009, 48 individuals infected with the
outbreak strain of Salmonella Typhimurium have been reported from 25 states.
 The number of ill persons identified in each state is as follows: Arizona
(1), California (2), Colorado (2), Florida (1), Georgia (1), Idaho (1),
Illinois (5), Kentucky (1), Louisiana (1), Massachusetts (2), Maryland (2),
Michigan (3), Minnesota (1), Missouri (2), Mississippi (1), New Jersey (2),
New Mexico (1), New York (1), Ohio (2), Pennsylvania (3), Tennessee (2),
Texas (3), Utah (6), Virginia (1), and Washington (1).

Among the persons with reported dates available, illnesses began between
June 24, 2009 and November 14, 2009.  Infected individuals range in age from
<1 year old to 54 years old. Seventy-seven percent (77%) of patients are
younger than 10 years old and the median age is 4 years.  Fifty-five percent
(55%) of patients are female.  No deaths have been reported.

Investigation of the Outbreak

In an epidemiologic study, ill persons answered questions about contact with
animals and foods consumed during the days before becoming ill and
investigators compared their responses to those of persons of similar age
and gender previously reported to State Health Departments with other
illnesses. Preliminary analysis of this study suggests contact with frogs,
including water frogs such as African Dwarf Frogs, is a likely source of the
infections. In addition, environmental samples taken from aquariums
containing aquatic frogs in three homes of ill persons have yielded isolates
of Salmonella Typhimurium matching the outbreak strain. 

Advice to Consumers

•         Always wash hands thoroughly with soap and water after touching
any amphibian (e.g., frog) or reptile (e.g, turtle), their housing, or
anything (for example, food) that comes in contact with them or their
housing.   Adults should assist young children with hand washing.   

•         Watch for symptoms of Salmonella infection, such as diarrhea,
fever, and abdominal cramps.  Call your health care provider if you or a
family member have any of these symptoms. 

Persons who should avoid contact with amphibians and reptiles and their
habitats (e.g., aquarium, fish tank, or terrarium)

•         Persons at increased risk for serious infection from salmonellosis
are children < 5 years old, elderly persons, and persons with weakened
immune systems. 

•         These persons should avoid contact with amphibians (e.g., frogs)
and reptiles (e.g., turtles) and anything that comes in contact with them
(e.g., aquarium, habitat, and water). 

•         Keep amphibians and reptiles out of homes with children < 5 years
old or people with weakened immune systems. 

Placement and maintenance of habitats 

•         Amphibians (e.g., frogs) and reptiles (e.g., turtles) should not
be kept in child-care centers. 

•         Habitats containing amphibians or reptiles should not be kept in a
child’s bedroom, especially children aged < 5 years. 

•         Do not allow amphibians or reptiles to roam freely through the
house, especially in food preparation areas. 

•         Keep amphibians and reptiles out of kitchens and other areas where
food and drink is prepared or served to prevent contamination. 

•         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. 

•         Do not bathe animals or their habitats in your kitchen sink. If
bathtubs are used for these purposes, they should be thoroughly cleaned
afterward. Use bleach to disinfect a tub or other place where reptile or
amphibian habitats are cleaned. 

•         Children aged <5 years should not clean habitats. 

•         Always wash hands thoroughly with soap and water after cleaning
habitats. 

Advice to Pet Store Owners and Others Who Sell or Display Amphibians and
Reptiles

•         Pet store owners and others who sell or display amphibians (e.g.,
frogs) and reptiles (e.g., turtles) should provide information to owners and
potential purchasers of amphibians and reptiles about the risks of acquiring
salmonellosis from these animals. 

•         More information on displaying animals in public settings can be
found in the 2009 Compendium of Measures to Prevent Diseases Associated with
Animals in Public Settings. 

Advice to Health Care Providers

•         Health care providers should question patients on pet and animal
ownership and should provide education about the risks of acquiring
salmonellosis from amphibians (e.g., frogs) and reptiles (e.g., turtles). 

•         Health care providers should advise patients on proper hand
washing practices. 

Advice to Veterinarians

•         Veterinarians should provide education to amphibian and reptile
owners about the risks of acquiring salmonellosis from these animals. 

•         Veterinarians should provide education to amphibian and reptile
owners on how to properly clean the animal habitat.

Clinical Features/Signs and Symptoms

Most persons infected with Salmonella develop diarrhea, fever, and abdominal
cramps 12–72 hours after infection. Infection is usually diagnosed by
culture of a stool sample. The illness usually lasts from 4 to 7 days.
Although most people recover without treatment, severe infections may occur.
Infants, elderly persons, and those with weakened immune systems are more
likely than others to develop severe illness. When severe infection occurs,
Salmonella may spread from the intestines to the bloodstream and then to
other body sites and can cause death unless the person is treated promptly
with antibiotics.

More general information about Salmonella can be found here under Salmonella
FAQs.

Additional Resources

•         US Food and Drug Administration Center for Veterinary Medicine -
FDA Reminds Public that Frogs Carry Salmonella

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