US outbreak of human Salmonella infections associated with aquatic frogs, 2008-2011.
Pediatrics
; 131(4): 724-31, 2013 Apr.
Article
in En
| MEDLINE
| ID: mdl-23478862
ABSTRACT
OBJECTIVE:
Although amphibians are known Salmonella carriers, no such outbreaks have been reported. We investigated a nationwide outbreak of human Salmonella Typhimurium infections occurring predominantly among children from 2008 to 2011.METHODS:
We conducted a matched case-control study. Cases were defined as persons with Salmonella Typhimurium infection yielding an isolate indistinguishable from the outbreak strain. Controls were persons with recent infection with Salmonella strains other than the outbreak strain and matched to cases by age and geography. Environmental samples were obtained from patients' homes; traceback investigations were conducted.RESULTS:
We identified 376 cases from 44 states from January 1, 2008, to December 31, 2011; 29% (56/193) of patients were hospitalized and none died. Median patient age was 5 years (range <1-86 years); 69% were children <10 years old (253/367). Among 114 patients interviewed, 69 (61%) reported frog exposure. Of patients who knew frog type, 79% (44/56) reported African dwarf frogs (ADF), a type of aquatic frog. Among 18 cases and 29 controls, illness was significantly associated with frog exposure (67% cases versus 3% controls, matched odds ratio 12.4, 95% confidence interval 1.9-infinity). Environmental samples from aquariums containing ADFs in 8 patients' homes, 2 ADF distributors, and a day care center yielded isolates indistinguishable from the outbreak strain. Traceback investigations of ADFs from patient purchases converged to a common ADF breeding facility. Environmental samples from the breeding facility yielded the outbreak strain.CONCLUSIONS:
ADFs were the source of this nationwide pediatric predominant outbreak. Pediatricians should routinely inquire about pet ownership and advise families about illness risks associated with animals.
Full text:
1
Collection:
01-internacional
Database:
MEDLINE
Main subject:
Pipidae
/
Salmonella Infections
/
Salmonella typhimurium
/
Disease Outbreaks
/
Contact Tracing
/
Disease Vectors
/
Pets
Type of study:
Diagnostic_studies
/
Observational_studies
/
Prognostic_studies
/
Risk_factors_studies
Limits:
Adolescent
/
Adult
/
Aged
/
Aged80
/
Animals
/
Child
/
Child, preschool
/
Female
/
Humans
/
Infant
Country/Region as subject:
America do norte
Language:
En
Journal:
Pediatrics
Year:
2013
Document type:
Article
Affiliation country:
United States