Investigation Details
Posted November 21, 2023
These outbreak investigations are over. Small turtles can carry Salmonella germs that can spread to you and make you sick. Always take steps to stay healthy around your pet turtles.
CDC and public health officials in several states investigated multistate outbreaks of Salmonella Stanley, Salmonella Pomona, and Salmonella Poona infections.
Epidemiologic, laboratory, and traceback data showed that contact with small turtles made people sick.
As of November 17, 2023, these outbreaks are over.
Epidemiologic Data
The true number of sick people in an outbreak is likely much higher than the number reported, and these outbreaks may not have been limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella.
Public health officials collected many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate and animals they had contact with in the week before they got sick. This information provided clues to help investigators identify the source of the outbreak. The table below has information about sick people in these outbreaks (“n” is the number of people with information available for each demographic).
| Demographics | Information |
|---|---|
| Age (n=80) |
Range from <1 to 90 years Median age of 9 years 36% under 5 years |
| Sex (n=80) |
51% female 49% male |
| Race (n=55) |
67% White 29% African American or Black 2% Asian 2% Native American or Alaska Native |
| Ethnicity* (n=67) |
32% non-Hispanic 67% Hispanic |
*Ethnicity by Salmonella serotype: Salmonella Poona (n=31 cases with information available) 55% report Hispanic ethnicity; Salmonella Stanley and Pomona (n=36 cases with information available) 14% report Hispanic ethnicity.
State and local public health officials interviewed people about the animals they had contact with in the week before they got sick. Of the 63 people who provided this information, 43 (68%) reported contact with pet turtles. Of the 34 people who reported the size of the pet turtle, 34 (100%) reported contact with pet turtles with shells less than 4 inches long.
Thirty-seven people provided information about where they obtained their pet turtle: 10 (27%) people reported buying their turtle from a roadside stand or flea market, 9 (24%) people reported purchasing their pet turtles from online retailers, 8 (22%) people reported buying their turtle from stores, 5 (14%) people reported receiving their turtle as a gift, 2 (5%) people reported winning their turtle at a carnival or fair, and 1 person each reported getting their turtles at a reptile show, swap meet, or finding their turtle in a park (8%).
Laboratory and Traceback Data
Public health investigators used the PulseNet system to identify illnesses that were part of these outbreaks. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause gastrointestinal illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).
WGS showed that bacteria from sick people’s samples were closely related genetically. This means that people in these outbreaks likely got sick from the same type of animal.
In July 2023, the Tennessee Department of Health collected samples from two turtles and their tank in a sick person’s home for testing. These turtles were purchased from a pet store. WGS showed that the Salmonella on the turtles and their environment were closely related to bacteria from sick people.
In August 2023, samples were collected from a sick person’s turtle in Washington State for testing. This turtle was purchased at a flea market. WGS performed by the Washington State Public Health Laboratories showed that the Salmonella serotype Poona from the turtle and its environment were closely related to the bacteria from sick people.
WGS analysis of bacteria from 79 people’s samples, 3 animal samples, and 4 environmental samples did not predict resistance to any antibiotics. More information is available at the National Antimicrobial Resistance Monitoring System (NARMS) site.
Public Health Actions
Although these outbreaks have ended, CDC always advises that you always take steps to wash your hands, play safely, and keep supplies and the pet area clean. Do not buy small turtles with shells less than 4 inches long and do not give small turtles as gifts.
CDC and public health officials in several states are investigating multistate outbreaks of Salmonella Stanley, Salmonella Pomona, and Salmonella Poona infections.
Epidemiologic and laboratory data showed that contact with small turtles made people sick.
Epidemiologic Data
Since the last update on August 18, 33 new illnesses and one new serotype, Salmonella Poona, have been reported. A total of 59 people infected with the outbreak strains of Salmonella Stanley (30 people), Salmonella Pomona (3 people), or Salmonella Poona (26 people) were reported from 18 states (see map). Illnesses started on dates ranging from October 27, 2022, to August 26, 2023 (see timeline).
The true number of sick people in an outbreak is likely much higher than the number reported, and this outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.
Public health officials collect many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provides clues to help investigators identify the source of the outbreak. The table below has information about sick people in this outbreak (“n” is the number of people with information available for each demographic).
| Demographics | Information |
|---|---|
| Age (n=59) |
Range from <1 to 90 years Median age of 7 39% under 5 years |
| Sex (n=59) |
53% female 47% male |
| Race (n=41) |
68% White 27% African American or Black 2% Asian 2% Native American or Alaska Native |
| Ethnicity* (n=50) |
74% non-Hispanic 26% Hispanic |
*Ethnicity by Salmonella serotype: Salmonella Poona (n=20 cases with information available) 50% report Hispanic ethnicity; Salmonella Stanley and Pomona (n=30 cases with information available) 10% report Hispanic ethnicity.
State and local public health officials interviewed people about the animals they had contact with in the week before they got sick. Of the 46 people who provided this information, 33 (72%) reported contact with pet turtles. Of the 26 people who reported the size of the pet turtle, 26 (100%) reported contact with pet turtles with shells less than 4 inches long.
Twenty-seven people provided information about where they obtained their pet turtle: 7 (26%) people reported purchasing their pet turtles from online retailers, 6 (22%) people reported buying their turtle from stores, 6 (22%) people reported buying their turtle from a roadside stand or flea market, 4 (15%) people reported receiving their turtle as a gift, and 1 person each reported getting their turtles at a reptile show, swap meet, finding their turtle in a park, or winning their turtle at a carnival (15%).
Laboratory Data
Whole genome sequencing (WGS) showed that bacteria from sick people’s samples are closely related genetically. This means that people in this outbreak likely got sick from the same type of animal. Bacteria from this outbreak of Salmonella serotypes Stanley and Pomona is closely related to a previous outbreak of Salmonella illnesses linked to small turtles.
In August 2023, samples were collected from a sick person’s turtle in Washington State for testing. This turtle was purchased at a flea market. WGS performed by the Washington State Public Health Laboratories showed that the Salmonella serotype Poona from the turtle and its environment are closely related to the bacteria from sick people.
WGS analysis of bacteria from 57 people’s samples, 3 animal samples, and 2 environmental samples did not predict resistance to any antibiotics. Standard antibiotic susceptibility testing by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory is currently under way.
CDC and public health officials in several states are investigating a multistate outbreak of Salmonella Stanley and Salmonella Pomona infections.
Epidemiologic, laboratory, and traceback data showed that contact with small turtles made people sick.
Epidemiologic Data
A total of 26 people infected with the outbreak strain of Salmonella Stanley (24 people) or Salmonella Pomona (2 people) were reported from 11 states (see map). Illnesses started on dates ranging from October 27, 2022, to July 16, 2023 (see timeline).
The true number of sick people in an outbreak is likely much higher than the number reported, and this outbreak may not be limited to the states with known illnesses. This is because many people recover without medical care and are not tested for Salmonella. In addition, recent illnesses may not yet be reported as it usually takes 3 to 4 weeks to determine if a sick person is part of an outbreak.
Public health officials collect many different types of information from sick people, including their age, race, ethnicity, other demographics, and the foods they ate in the week before they got sick. This information provides clues to help investigators identify the source of the outbreak. The table below has information about sick people in this outbreak (“n” is the number of people with information available for each demographic).
| Demographics | Information |
|---|---|
| Age (n=26) |
Range from <1 to 64 years Median age of 14 31% under 5 years |
| Sex (n=26) |
42% female 58% male |
| Race (n=22) |
68% White 27% African American/Black 5% Asian 0% Native American or Alaska Native 0% Native Hawaiian or other Pacific Islander 0% reported more than one race |
| Ethnicity (n=24) |
88% non-Hispanic 13% Hispanic |
State and local public health officials interviewed people about the animals they had contact with in the week before they got sick. Of the 20 people who provided this information, 16 (80%) reported contact with pet turtles. Of the 13 people who reported the size of the pet turtle, 12 (92%) reported contact with pet turtles with shells less than 4 inches long.
Laboratory and Traceback Data
Public health investigators are using the PulseNet system to identify illnesses that may be part of this outbreak. CDC PulseNet manages a national database of DNA fingerprints of bacteria that cause gastrointestinal illnesses. DNA fingerprinting is performed on bacteria using a method called whole genome sequencing (WGS).
WGS showed that bacteria from sick people’s samples are closely related genetically. This means that people in this outbreak likely got sick from the same type of animal.
In July 2023, the Tennessee Department of Health collected samples from two turtles and their tank in a sick person’s home for testing. These turtles were purchased from a pet store. WGS showed that the Salmonella on the turtles and their environment are closely related to bacteria from sick people.
WGS analysis of bacteria from 26 people’s samples, 3 animal samples, and 1 environmental sample did not predict resistance to any antibiotics. Standard antibiotic susceptibility testing of five people’s samples by CDC’s National Antimicrobial Resistance Monitoring System (NARMS) laboratory also found no resistance.
Thirteen people were interviewed about where they purchased their pet turtle: 6 (46%) people reported purchasing their pet turtles from online retailers, 5 (38%) people reported buying their turtle from stores, and 1 (8%) person reported buying their turtle from a reptile show. Investigators are working to determine if there is a common source of turtles.
Public Health Actions
CDC advises that you always take steps to stay healthy around your pet turtle: wash your hands, play safely, and keep supplies and the pet area clean. Do not buy small turtles with shells less than 4 inches long.
