Stop kissing turtles, or chickens, or snakes or lizards or anything that is nothing more than a Salmonella factory

Posted on December 7, 2018 by Douglas Powell

Ten years after 100 US kids were sickened in a Salmonella outbreak linked to pet turtles, another 76 have gotten sick (and thousands more in between)

Growing up in late-1960s suburbia, my parents thought dogs should run on farms like their dogs had, and cats were a nuisance.

So I had a turtle.

Turtles were inexpensive, popular, and low maintenance, with an array of groovy pre-molded plastic housing designs to choose from. Invariably they would escape, only to be found days later behind the couch along with the skeleton of the class bunny my younger sister brought home from kindergarten one weekend.

But eventually, replacement turtles became harder to come by. Reports started surfacing that people with pet turtles were getting sick. In 1975, the U.S. Food and Drug Administration (FDA) banned commercial distribution of turtles less than 4 inches in length, and it has been estimated that the FDA ban prevents some 100,000 cases of salmonellosis among children each year.

Maybe I got sick from my turtle.

Maybe I picked up my turtle, rolled around on the carpet with it, pet it a bit, and then stuck my finger in my mouth. Maybe in my emotionally vacant adolescence I kissed my turtle. Who can remember?

The U.S. Centers for Disease Control reports today that in June 2017, PulseNet, the national molecular subtyping network for foodborne disease surveillance, identified 17 Salmonella Agbeni clinical isolates with indistinguishable XbaI enzyme pattern (outbreak strain) by pulsed-field gel electrophoresis. The same Salmonella Agbeni XbaI pattern was isolated from a turtle in 2015; in a 2016 investigation involving the same outbreak strain, 63% of patients reported contact with turtles (CDC, unpublished data, 2016). Despite prohibition of sale of small turtles (shell length less <4 inches) in the United States since 1975 (1), illness outbreaks associated with turtle contact continue to occur. Ill persons in previous Salmonella Poona and Salmonella Pomona outbreaks linked to turtles were geographically concentrated in the Southwest region of the United States (2,3). Turtle production is known to be higher in the Southeast region of the country (2). An outbreak investigation by CDC and health departments was initiated to identify the source of the 2017 illness outbreak.

A case was defined as isolation of Salmonella Agbeni with the outbreak strain from an ill patient during April–December 2017. State and local health officials interviewed patients to ascertain turtle exposure information, including details about the species of turtle and purchasing information. Purchase locations reported by patients were contacted for traceback information. Whole genome sequencing (WGS), using high quality single nucleotide polymorphism (hqSNP) analysis, was performed by CDC on clinical isolates from the 2017 outbreak, the 2016 illness cluster, and the turtle isolate from 2015 to characterize genetic relatedness.

Seventy-six cases were identified in 19 states in 2017; two thirds (67%) of patients resided in East Coast states (Connecticut, Delaware, Maryland, Massachusetts, New Jersey, New York, Pennsylvania, Rhode Island, and Virginia).* Patient ages ranged from <1–100 years (median = 21 years). Among 63 (83%) patients with information on hospitalization, 30 (48%) were hospitalized; no deaths were reported. Fifty-nine (78%) patients provided exposure information, including 23 (39%) who reported contact with turtles; among these, 14 (61%) specified small turtles. Among 12 patients who reported how the turtles were obtained, six purchased them from a street or roadside vendor, three purchased them from a retail store, two purchased them at festivals, and one reported receiving them as a gift. The traceback investigation did not identify a common turtle farm that supplied purchase locations. WGS hqSNP analysis indicated that the 2017 and 2016 clinical isolates and the 2015 turtle isolate were closely related, differing by 0–18 SNPs.

This salmonellosis outbreak was linked to contact with small turtles and was associated with a higher frequency of hospitalization (48%) than multistate foodborne pathogen outbreaks (27%) as well as recent Salmonella outbreaks linked to turtles (28%–33%) (2–4). The geographic distribution of patients differed from that of previous outbreaks, suggesting the need to better understand the breeding of turtles and distribution of turtle sales in the United States. WGS hqSNP analysis was used to link historic illnesses and turtle isolates to isolates from 2017 patients, supporting the hypothesis that turtles were the likely source of this outbreak. This outbreak indicates further need to educate consumers and retail store staff members regarding the ban on sale of small turtles and to educate consumers to prevent transmission of Salmonella from pets to humans.

Notes from the Field: An Outbreak of Salmonella Agbeni Infections Linked to Turtle Exposure — United States, 2017

MMWR 67(48);1350

Lia Koski, MPH^1,2; Lauren Stevenson, MHS^1,3; Jasmine Huffman¹; Amy Robbins, MPH⁴; Julia Latash, MPH^5,6; Enoma Omoregie, PhD⁵; Kelly Kline, MPH⁷; Megin Nichols, DVM¹ (View author affiliations)

References

Turtles intrastate and interstate requirements, 21 C.F.R. Sect. 1240.62 (2011). https://www.accessdata.fda.gov/scripts/cdrh/cfdocs/cfcfr/cfrsearch.cfm?fr=1240.62
Gambino-Shirley K, Stevenson L, Concepción-Acevedo J, et al. Flea market finds and global exports: four multistate outbreaks of human Salmonellainfections linked to small turtles, United States—2015. Zoonoses Public Health 2018;65:560–8. CrossRef PubMed
Basler C, Bottichio L, Higa J, Prado B, Wong M, Bosch S. Multistate outbreak of human SalmonellaPoona infections associated with pet turtle exposure—United States, 2014. MMWR Morb Mortal Wkly Rep 2015;64:804. CrossRef PubMed
Surveillance for foodborne disease outbreaks, United States, 2016: annual report. Atlanta, Georgia: US Department of Health and Human Services, CDC; 2018. https://www.cdc.gov/fdoss/pdf/2016_FoodBorneOutbreaks_508.pdf

2600 sick, 5 dead over 14 years: Stop kissing chicks

Posted on September 15, 2016 by Douglas Powell

Backyard poultry flocks have increased in popularity concurrent with an increase in live poultry–associated salmonellosis (LPAS) outbreaks. Better understanding of practices that contribute to this emerging public health issue is needed.

We reviewed outbreak reports to describe the epidemiology of LPAS outbreaks in the United States, examine changes in trends, and inform prevention campaigns. LPAS outbreaks were defined as ≥2 culture-confirmed human Salmonella infections linked to live poultry contact. Outbreak data were obtained through multiple databases and a literature review.

During 1990–2014, a total of 53 LPAS outbreaks were documented, involving 2,630 illnesses, 387 hospitalizations, and 5 deaths. Median patient age was 9 years (range <1 to 92 years). Chick and duckling exposure were reported by 85% and 38% of case-patients, respectively. High-risk practices included keeping poultry inside households (46% of case-patients) and kissing birds (13%). Comprehensive One Health strategies are needed to prevent illnesses associated with live poultry.

Outbreaks of human Salmonella infections associated with live poultry, United States, 1990-2014

Emerg. Infect. Dis., Volume 22, Number 10 – October 2016 [ahead of print], DOI: 10.3201/eid2210.150765

Colin Basler, Thai-An Nguyen, Tara C. Anderson, Thane Hancock, Casey Barton Behravesh

http://wwwnc.cdc.gov/eid/article/22/10/15-0765_article

Don’t be creepy: Singer gave Lionel Richie Norovirus after lips smooch at Glastonbury

Posted on June 11, 2015 by Douglas Powell

Alex Jones gave the Norovirus to Lionel Richie after he planted a kiss on her lips.

The One Show host joked the singer, who had to cancel two of his gigs after contracting the infection by pecking her at Glastonbury, should have just gone for her cheek to avoid having to cancel two of his gigs as a result.

She told The Sun: “After Lionel and I had just finished our chat on the show, I went to give him a kiss on the cheek and he went in for the lips.

“He caught the Norovirus off me and had to cancel two of his tour dates.”

Kissing transfers 80 million bacteria, scientists say

Posted on November 19, 2014 by Douglas Powell

French kiss, tongue swapping, tonsil hockey: whatever it’s called, people like to kiss.

And while a 10-second “intimate kiss” can transfer 80 million bacteria from one mouth to another, according to a new report in the journal Microbiome, that’s nothing compared to the trillions of bacteria we all carry.

A team of Dutch researchers recruited 21 couples who happened to be visiting the Artis Royal Zoo in Amsterdam on a summer day. All 42 volunteers (whose ages ranged from 17 to 45) allowed the researchers to wipe their tongues with a cotton swab several times. They also agreed to spit into sterile tubes and answer questions about their kissing habits.

The researchers found that the particular community of bacteria living on a volunteer’s tongue was more similar to the bacteria on his or her kissing partner’s tongue than to a stranger’s tongue. They quantified this using a measure called the Morisita-Horn index, where 0 indicates complete overlap and 1 means no overlap at all. The MH index value for kissing couples was 0.37, significantly lower than the 0.55 for strangers.

Then the volunteers engaged in some public displays of affection (a 10-second kiss “involving full tongue contact and saliva exchange”) and had their tongues swabbed again. According to the bacterial analysis, a fresh kiss barely budged the similarity index value. That suggests that the overlap in tongue bacteria is probably “a long-term effect of couples living together” – sharing meals, toothpaste and other items from daily life.

In a further test, some of the volunteers were given a probiotic yogurt drink spiked with a marker bacteria. Researchers swabbed their tongues and asked them to kiss their partners. Then the partners had their tongues swabbed. Comparing the contents of the yogurt-drinkers’ swabs and their partners’ swabs, the researchers calculated that a single kiss can deposit 80,000,000 bacteria from one tongue to another.

Shaping the oral microbiota through intimate kissing

Microbiome 2014; 2:41

Remco Kort, Martien Caspers, Astrid van de Graaf, Wim van Egmond, Bart Keijser and Guus Roeselers

http://www.microbiomejournal.com/content/2/1/41

Abstract

Background

The variation of microbial communities associated with the human body can be the cause of many factors, including the human genetic makeup, diet, age, surroundings, and sexual behavior. In this study, we investigated the effects of intimate kissing on the oral microbiota of 21 couples by self-administered questionnaires about their past kissing behavior and by the evaluation of tongue and salivary microbiota samples in a controlled kissing experiment. In addition, we quantified the number of bacteria exchanged during intimate kissing by the use of marker bacteria introduced through the intake of a probiotic yoghurt drink by one of the partners prior to a second intimate kiss.

Results

Similarity indices of microbial communities show that average partners have a more similar oral microbiota composition compared to unrelated individuals, with by far most pronounced similarity for communities associated with the tongue surface. An intimate kiss did not lead to a significant additional increase of the average similarity of the oral microbiota between partners. However, clear correlations were observed between the similarity indices of the salivary microbiota of couples and self-reported kiss frequencies, and the reported time passed after the latest kiss. In control experiments for bacterial transfer, we identified the probiotic Lactobacillus and Bifidobacterium marker bacteria in most kiss receivers, corresponding to an average total bacterial transfer of 80 million bacteria per intimate kiss of 10 s.

Conclusions

This study indicates that a shared salivary microbiota requires a frequent and recent bacterial exchange and is therefore most pronounced in couples with relatively high intimate kiss frequencies. The microbiota on the dorsal surface of the tongue is more similar among partners than unrelated individuals, but its similarity does not clearly correlate to kissing behavior, suggesting an important role for specific selection mechanisms resulting from a shared lifestyle, environment, or genetic factors from the host. Furthermore, our findings imply that some of the collective bacteria among partners are only transiently present, while others have found a true niche on the tongue’s surface allowing long-term colonization.

‘Gasquet’s kiss’ to clear Contador of clenbuterol?***

Posted on February 1, 2011 by Douglas Powell

It was just a kiss.

Two years ago French tennis player Richard Gasquet was cleared of doping after insisting he had tested positive for a tiny quantity of cocaine because he had kissed a girl in a disco in Miami. Both the French Tennis Federation and WADA considered that even though this was an unlikely cause for a positive, it was the most probable reason.

Cycling Weekly – which I read daily – reports that a lawyer for Alberto Contador will use essentially the same defense: that even if eating contaminated beef sounds like an implausible reason for finding tiny traces of a banned substance in his organism, that is the most likely explanation.

If the glove don’t fit you must acquit.

Also, like Gasquet said about his cocaine positive, the clenbuterol could have had no effect on his performance because it was present in such tiny quantities.

Cycling is a mess.

Don’t kiss turtle or frogs; additional Salmonella risk

Posted on February 27, 2010 by Douglas Powell

Some federal food safety thingy decided he just had to tell me how disappointed he was because I ran the don’t-kiss-frogs-and-salmonella story and the U.K. version that linked it to a Disney movie, The Frog and the Prince.

“Your non-apology for your role is (sic) amplifying the ‘far-fetched, but sorta fun’ story makes me wonder how serious you are about your posts and your role in our public health community.”

Who is ‘our?’ Writing 101 mistake.

And dude, join the end of the line. Lots of people are disappointed with me.

The headline of the blog post was, Don’t kiss frogs or turtles, whether it’s in a Disney film or not. And with a new report from CDC, let me reiterate, don’t kiss turtles.

On September 4, 2008, the Philadelphia Department of Public Health (PDPH) and the Pennsylvania Department of Health (PADOH) notified CDC of an outbreak of possible turtle-associated human Salmonella Typhimurium infections detected by identifying strains with similar pulsed-field gel electrophoresis (PFGE) patterns in PulseNet. Turtles and other reptiles have long been recognized as sources of human Salmonella infections (1), and the sale or distribution of small turtles (those with carapace lengths <4 inches) has been prohibited in the United States since 1975 (2,3). CDC and state and local health departments conducted a multistate investigation during September–November 2008. This report summarizes the results of that investigation, which identified 135 cases in 25 states and the District of Columbia; 45% were in children aged ≤5 years. Among 70 patients with primary infection, 37% reported turtle exposure, of which 81% was to small turtles most commonly purchased from street vendors. A matched case-control study showed a significant association between illness and exposure to turtles (matched odds ratio [mOR] = 16.5). Increasing enforcement of existing local, state, and federal regulations against the sale of small turtles, increasing penalties for illegal sales, and enacting more state and local laws regulating the sale of small turtles (e.g., requiring Salmonella awareness education at the point-of-sale), could augment federal prevention efforts. …

This S. Typhimurium outbreak is the third multistate, turtle-associated Salmonella outbreak in the United States since 2006. Before 2006, no large multistate turtle-associated Salmonella outbreaks were identified. One reason for this apparent increase might be PulseNet, which has improved the ability to detect multistate outbreaks. Increased pet turtle ownership in the United States also might contribute to the recurrent outbreaks: the proportion of households in the United States owning pet turtles doubled during 1996–2006, from 0.5% to 1.0% (4). Together, the three recent Salmonella outbreaks account for 258 laboratory-confirmed cases of salmonellosis (5–7) and many more unreported illnesses likely occurred. As with past outbreaks, most ill persons reporting turtle exposure were exposed to turtles with shell lengths <4 inches; these turtles were mainly acquired from flea markets, street vendors, and souvenir shops. The case-control study found a significant association of Salmonella infection with turtle exposure; however, 63% of primary cases in the outbreak had no knownturtle exposure, and 60% had no reptile exposure. This might have resulted, in part, from failure to recall a turtle exposure. Parents or guardians were interviewed as proxies for young children and they might have been unaware of their child’s turtle exposure outside of the home. In addition, certain patients might have had unknown indirect turtle exposure through environmental cross-contamination or unrecognized person-to-person transmission or have been sporadic or background cases.

Don’t kiss frogs or turtles, whether it’s in a Disney film or not

Posted on February 18, 2010 by Douglas Powell

On Jan. 7, 2010, the U.S. Centers for Disease Control and Prevention issued a summary report regarding on a Multistate Outbreak of Human Salmonella Typhimurium Infections Associated with Aquatic Frogs — United States, 2009.

During April–July 2009, the Utah Department of Health identified five cases of Salmonella Typhimurium infection with indistinguishable pulsed-field gel electrophoresis (PFGE) patterns, predominantly among children. In August,
CDC began a multistate outbreak investigation to determine the source of the infections. This report summarizes the results of this ongoing investigation, which, as of December 30, had identified 85 S. Typhimurium human isolates with the outbreak strain from 31 states. In a multistate case-control study, exposure to frogs was found to be significantly associated with illness (63% of cases versus 3% of controls; matched odds ratio [mOR] = 24.4). Among 14 case-patients who knew the type of frog, all had exposure to an exclusively aquatic frog species, the African dwarf frog.

On Feb. 1, 2010, the U.K. Daily Express published its version of the story, saying kids were getting sick kissing frogs by copying the Disney movie, The Princess and the Frog. I knew it was far-fetched, but sorta fun and published an edited version as a barfblog post.

A couple of readers took me to task, but the original CDC report was solid. Leave it to Bill Keene, senior epidemiologist with the Oregon state Public Health Division, to wrap things up.

The outbreak has spread like the plague across the U.S. since the release of Disney’s film, "The Princess and the Frog," according to news reports and bloggers from Britain to Japan.

Problem is the story, which was fabricated from a whimsical quote in The Oregonian and on Oregonlive.com in December, is not true.

But the basic facts in that Oregonian story — 50 sickened, including many young girls, by salmonella traced to frogs — were just too good not to spin into a Internet sensation based on a quote by William Keene.

Keene said, cracking a verbal smile, that it’s not a good idea to kiss frogs, which carry salmonella.

But there is no evidence that girls are smooching the amphibians after seeing the movie.

"This is a totally mythical story," Keene said. "But it’s funny so it’s being picked up."

From the sensationalist Daily Express in Britain, which appears to have spun out the first story, the warning has fired up news sites, chat rooms and bloggers from Europe to Asia.

Don’t kiss frogs or turtles: Disney film Princess and the Frog leads to 50 sick kids

Posted on February 1, 2010 by Douglas Powell

The U.K. Daily Express reports that 50 U.S. children have become sick with Salmonella after emulating the heroine in Disney’s latest film, The Princess And The Frog.

Doctors blamed the cases in 25 US states on youngsters kissing frogs after seeing the film. Most were under 10, with half being girls.

Experts in the US and UK urged parents not to allow their youngsters to copy Princess Tiana after seeing the animated film, which is out on Friday. Trevor Beebee, president of the British Herpetological Society, said: “Kissing frogs is not hygienic and they also have various toxic things on their skin, which are unpleasant.”

The Health Protection Agency advises against kissing any reptiles, saying: “All should be presumed to carry salmonella in their gut, even if they do not show any signs of infection.”

Tiny turtles still making kids sick

Posted on October 18, 2009 by Douglas Powell

Growing up in late-1960s suburbia, I had a turtle.

Maybe I got sick from my turtle.

Maybe I picked up my turtle, rolled around on the carpet with it, pet it a bit, and then stuck my finger in my mouth. Maybe in my emotionally vacant adolescence I kissed my turtle. Who can remember?

A report that will be published tomorrow in the journal Pediatrics documents how 107 people in 34 states became sick with Salmonella from the small turtles between 2007 and 2008 – including two girls who swam with pet turtles in a backyard pool.

The paper notes that one-third of all patients had to be hospitalized, and in many cases, parents didn’t know turtles could carry salmonella.

Julie Harris, a scientist at the U.S. Centers for Disease Control and Prevention and the report’s lead author said other cases turned up elsewhere, many involving direct contact with turtles, including children kissing turtles or putting them in their mouths.

I’m familiar with that.

David Bergmire-Sweat, a North Carolina epidemiologist who investigated the Union County case, said he’s heard of families letting turtles walk on kitchen surfaces where food is prepared, and babies being bathed in sinks where turtle cages are washed.

Veterinarian Mark Mitchell, a University of Illinois zoological medicine professor, has been working with Louisiana turtle farmers in research aimed at raising salmonella-free turtles, says the industry has been unfairly saddled with harsher restrictions than producers of human foods also blamed for recent salmonella outbreaks.

Maybe, but people need to eat. They don’t need to kiss turtles.

Air kissing or ‘la bise’ discouraged in France because of H1N1 flu

Posted on September 7, 2009 by Douglas Powell

It was so confusing when I was in France: do you kiss anyone on the cheek or just friends; two pecks or three (the further south, the greater the frequency of the tri-peck). I usually defaulted to a handshake, but after a fabulous lunch with tons of great wine at a chateau near Bordeaux where I had unlimited Internet access for the first time in two weeks, I gave the dude a bi-peck at the train station – we had just met, and he was a little taken aback (that’s me and the dude at a wedding in Montreal a couple of months later 2007, right, below; look at that suit).

Now, according to Associated Press, the French tradition of "la bise," the cheek-to-cheek peck that the French use to say hello or goodbye, has come under pressure from a globalized threat: swine flu.

Some French schools, companies and a Health Ministry hotline are telling students and employees to avoid the social ritual out of fear the pandemic could make it the kiss of death, or at least illness, as winter approaches.

For kids in two schools in the town of Guilvinec, in France’s western Brittany region, the first lesson of the year came from local officials: no more cheek kisses to teachers or other students.

The national government isn’t calling for a ban. But the Health Ministry, on its swine flu phone hotline, recommends that people avoid "close contact — including shaking hands and giving the bise."

barfblog

safe food from farm to fork

Tag Archives: Kiss