During 1994, the Washington Department of Health Public Health
Laboratory reported the isolation from a human of a rare Salmonella
serotype, Salmonella serotype Tilene. This report summarizes the
epidemiologic investigation of the case by the Seattle-King County
Department of Public Health, which suggested the infection was
related to exposure to African pygmy hedgehogs.
On April 9, 1994, a 10-month old girl was evaluated in a
hospital emergency department in King County for an acute febrile,
nonbloody diarrheal illness; the fever resolved without treatment
but the diarrhea persisted for 3 weeks. On April 28, she was
evaluated in an outpatient clinic; a stool sample yielded
Salmonella Tilene. The infant had been breast-fed and received
supplemental solid foods; she did not attend a child care center.
Her parents were asymptomatic, and cultures of stool samples from
both were negative. The family owned a dog and a breeding herd of
80 apparently healthy African pygmy hedgehogs; a stool sample from
one of three hedgehogs cultured yielded Salmonella Tilene. Although
the infant had not had direct contact with the hedgehogs, the
hedgehogs were handled frequently by one member of the family. The
infant's illness resolved after treatment for an upper respiratory
infection with trimethoprim-sulfamethoxazole.
Reported by: S Lipsky, Epidemiology Unit, T Tanino, Laboratory
Section, Seattle-King County Dept of Public Health; JH Lewis,
Public Health Laboratories, Washington Dept of Health. Foodborne
and Diarrheal Diseases Br, Div of Bacterial and Mycotic Diseases,
National Center for Infectious Diseases, CDC.
Editorial Note
Editorial Note: Salmonella Tilene is an uncommon cause of human
illness; the organism was first isolated in 1960 from a child in
Senegal (1). Although the patient in Washington had the first
documented human infection with this serotype in the United
States, * since January 1991 the U.S. Department of Agriculture
(USDA) has identified two isolates from animals at the National
Veterinary Services Laboratory -- both were from African pygmy
hedgehogs (K. Ferris, USDA, personal communication, April 1995).
Although the African pygmy hedgehog is an unusual pet, ownership of
these animals is reportedly increasing in the United States (2).
African pygmy hedgehogs are bred domestically in the United States;
importation from Africa has been prohibited since 1991 because they
can carry foot-and-mouth disease, a disease of livestock that is
not found in the United States (R. Perkins, USDA, personal
communication, May 1995).
Salmonella spp. are found worldwide in domestic and wild
animals, including mammals, reptiles, and birds. Although ingestion
of contaminated food is the most important source of salmonellosis
in humans (3), pets are another potential source of infection
(4,5). The overall risk for acquiring salmonellosis from pets is
low; however, the risk is increased with exposure to animals with
high fecal carriage rates of Salmonella. In general, carriage rates
are higher in animals that are young, have diarrhea, or live in
overcrowded conditions (4). Reported carriage rates are highest in
reptiles (as high as 90%), and lowest in dogs and cats (4).
Carriage rates have not been reported for African pygmy hedgehogs.
The investigation of this case and a recent report involving
reptile-associated transmission of Salmonella (5) underscore the
potential risk for transmission of Salmonella from an infected pet
to members of the household who do not have direct contact with the
pet. This risk can be reduced by handwashing after handling of
pets, especially before eating or handling food, and by avoiding
contact with pets' feces (6).
References
Le Minor L, Pinhede N, Kerrest J, Armengaud M, Baylet R, Drean
D. A new serotype of Salmonella, S. tilene (1,40:e,h:1,2) {French}.
Bull Soc Path Exot 1960;53:777-8.
Lermayer RM. African pygmy hedgehogs: latest pet sensation. Live
Animal Trade and Transport Magazine 1992;Dec:45-8.
Tauxe RV. Salmonella: a postmodern pathogen. J Food Protect
1991:54:563-8.
Glaser CA, Angulo FJ, Rooney J. Animal associated opportunistic
infections in HIV-infected persons. Clin Infect Dis 1994;18:14-24.
Angulo FJ, Glaser CA, Juranek DD, Lappin MR, Reginery RL. Caring
for pets of immunocompromised persons. J Am Vet Med Assoc 1994;
205:1711-8.
On June 21, the Texas Department of Health reported to CDC the
second human infection with Salmonella Tilene in the United States;
the patient's family owned a hedgehog.
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