THURSDAY, Jan. 24, 2008 (HealthDay News) -- Small pet turtles were to blame for 103 cases of Salmonella infection in the second half of last year, mostly in young children, U.S. health officials said Thursday.
But the true number of infections with the potentially fatal bacteria is undoubtedly much higher, officials added.
Even though the sale of small turtles has been banned in the United States since 1975, the number of these reptiles being purchased for children has been increasing, according to the U.S. Centers for Disease Control and Prevention.
"This is a larger number of cases than we would usually see," said Julie Harris, a CDC Epidemic Intelligence Service Officer. "We haven't documented such a large number of cases before associated with turtle exposure."
No deaths have been reported, but the infections led to the hospitalization of dozens of children, the CDC said.
The number of turtles owned by Americans has almost doubled in the last five years to more than 2 million, Harris said. This, despite the fact that "there is a ban on the sale of turtles that are under 4 inches in length," she said.
The 103 cases that Harris and colleagues reported in the Jan. 25 issue of the CDC's Morbidity and Mortality Weekly Report represent just a fraction of the total number of salmonella infections from pet turtles, she said.
According to the report, cases were reported in all but 15 states, with most cases occurring in California, Illinois, Pennsylvania and Texas.
Two of the infected children included a 13-year-old girl and a 15-year-old girl who became stricken after swimming in an unchlorinated in-ground pool owned by the family of the older girl. Two pet turtles, purchased at a South Carolina pet store and owned by the family of the older teen, were allowed to swim in the pool, the CDC reported.
Harris said many people aren't aware of the risk of Salmonella infections from pet turtles. "Only 20 percent of these cases [in the report] said they were aware there was a connection between Salmonella infection and reptile exposure," she said.
Up to 90 percent of turtles carry Salmonella, Harris said. "This is a very serious infection, especially for small children," she added.
The infection is spread from contact with the turtles, but the contact doesn't have to be direct, Harris said. "We have one case where a baby was bathed in a sink that turtle waste was disposed in," she said.
In some cases, the children put the turtle in their mouth. In other cases, children became sick from just living in the same house with a turtle or other infected family members. Salmonella can live on surfaces for weeks, Harris noted.
Adults can get sick from Salmonella, Harris said, but children get much sicker, and some can die, she said. "Small children should not be allowed to come into contact with turtles, the outcome is too dangerous and the risk is too high," she said.
According to the CDC, Salmonella infection remains a major public health problem in the United States. Each year, 1.4 million cases are reported, an estimated 15,000 people are hospitalized, and 400 Americans die.
Gastrointestinal symptoms such as vomiting and diarrhea, caused by the bacteria, typically begin 12 to 36 hours after exposure and generally last for two to seven days.
Reptiles and amphibians, including turtles, account for about 6 percent of all Salmonella cases and 11 percent of cases for those under 21.
One infectious-disease expert strongly advised parents not to buy these turtles as pets for their children.
"This is a problem that has been with us for more than 40 years," said Dr. Pascal James Imperato, the distinguished service professor and chair of the department of preventive medicine and community health and director of the master of public health program at the State University of New York Downstate Medical Center in New York City.
Children tend to handle these turtles a great deal, Imperato said. "Their fingers come into contact with all the material on the turtle and in the water. Then. there is finger-to-mouth contact, and they acquire the infection," he said.
Imperato said that to protect themselves, people who handle these turtles should wash their hands after touching the animals. But Salmonella-contaminated water can be splashed onto surfaces and cause the germ to spread.
Also, most people aren't likely to wash their hands thoroughly after they have handled a turtle or come into contact with contaminated objects or water, he said.
"The best strategy is not to purchase these turtles," Imperato said.
For more on the Salmonella-turtle connection, visit the U.S. Centers for Disease Control and Prevention.