798. A Multistate Outbreak of Human Salmonella Typhimurium Infections Associated with Aquatic Frogs–United States, 2009
Session: Abstracts: Oral Abstract Session: Bacterial Clinical Studies I
Friday, October 22, 2010: 3:00 PM
109-110
Background:   Salmonella causes approximately 1.4 million infections annually in the United States.  Although amphibians are known Salmonella carriers, no multistate outbreak associated with amphibians has been previously reported.   During Fall 2009, we investigated a multistate outbreak of Salmonella Typhimurium infections predominantly among children. 

Methods: We conducted a matched case-control study.  Cases were defined as Salmonella Typhimurium infection in a person whose isolate matched the outbreak strain by pulsed-field gel electrophoresis and multiple-locus variable-number tandem repeat analysis.  Controls were persons with recent infection with Salmonella strains other than the outbreak strain and matched by age and county of residence. Environmental samples were obtained from patients’ homes with subsequent tracebacks on positive samples.

Results:   We identified 113 cases from 31 states with illness onset 4/1/2009 – 3/31/2010; 35% (18/54) were hospitalized and none died.  Median age was five years (range = <1-73 years); 77% were <10 years. Among 18 cases and 29 controls, illness was significantly associated with exposure to frogs (67% cases vs 3% controls, mOR=24.4, CI=4.0-infinity). Among 6 case-patients who knew the frog type, all reported the African Dwarf Frog (ADF), a type of aquatic frog. Environmental samples from aquariums containing ADFs in 4 patients’ homes yielded isolates matching the outbreak strain. Traceback investigations of ADF’s converged to a common breeder.  Environmental samples from the breeder’s facility yielded the outbreak strain. 

Conclusion: Our investigation identified ADFs as the source of this pediatric predominant outbreak. Public education regarding risk for salmonellosis should be expanded to include risk for salmonellosis from frogs and other amphibians.


Subject Category: P. Pediatric and perinatal infections

Speakers:
Shauna L. Mettee, MSN, MPH , Centers for Disease Control and Prevention, Atlanta, GA
Linda G. Capewell, VMD, MPH , Centers for Disease Control and Prevention, Atlanta, GA
Casey Barton Behravesh, DVM, DrPH , Outbreak Response and Prevention Branch; Division of Foodborne, Waterborne, and Environmental Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA
Julia Hall, MPH , Utah Department of Health, Salt Lake City, UT
Marilee Poulson, BS , Utah Department of Health, Salt Lake City, UT
Shaun Cosgrove, BS , Colorado Department of Public Health and Environment, Denver, CO
Kate Lujan, BSN , Colorado Department of Public Health and Environment, Denver, CO
Laura Fawcett, BSN, REHS , Eagle County Environmental Health Department, Eagle, CO
Marguerite Adams-Cameron, MPH , New Mexico Department of Health, Santa Fe, NM
Paul Torres, M.S. , Scientific Laboratory Division, New Mexico Department of Health, Albuquerque, NM
Kim Winpisinger, MS , Ohio Department of Health, Columbus, OH
Ben Sun, DVM, MPVM , California Department of Public Health, Sacramento, CA
Jill Yaeger, BS , Madera County Environmental Health Department,, Madera, CA
Phil Hudecek, BS , Madera County Environmental Health Department,, Madera, CA
Nancy Garrett, BS , Centers for Disease Control and Prevention, Atlanta, GA
Eija Hyytia-Trees, Ph.D., DVM , Centers for Disease Control and Prevention, Atlanta, GA
Patti C. Lafon, MS , Centers for Disease Control and Prevention, Atlanta, GA
Jennifer Adams, BS , Centers for Disease Control and Prevention, Atlanta, GA
Brenda Le, ScD, MSPH , Centers for Disease Control and Prevention, Atlanta, GA
Gwen Ewald, MSPH , Centers for Disease Control and Prevention, Atlanta, GA
Leslie Hausman, MPH , Centers for Disease Control and Prevention, Atlanta, GA
Kari Leech, MS , Centers for Disease Control and Prevention, Atlanta, GA
Vince Hill, Ph.D, PE , Centers for Disease Control and Prevention, Atlanta, GA
Vince Radke, MPH, RS, CP-FS, DAAS, CPH , Centers for Disease Control and Prevention, Atlanta, GA
April Johnson, DVM, MPH, PhD , Purdue University School of Veterinary Medicine, West Lafayette, IN
Ian Williams, PhD , Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA
Samir Sodha, MD , Division of Foodborne, Waterborne, and Environmental Diseases, Centers for Disease Control and Prevention, Atlanta, GA

Disclosures:

S. L. Mettee, None

L. G. Capewell, None

C. Barton Behravesh, None

J. Hall, None

M. Poulson, None

S. Cosgrove, None

K. Lujan, None

L. Fawcett, None

M. Adams-Cameron, None

P. Torres, None

K. Winpisinger, None

B. Sun, None

J. Yaeger, None

P. Hudecek, None

N. Garrett, None

E. Hyytia-Trees, None

P. C. Lafon, None

J. Adams, None

B. Le, None

G. Ewald, None

L. Hausman, None

K. Leech, None

V. Hill, None

V. Radke, None

A. Johnson, None

I. Williams, None

S. Sodha, None


Findings in the abstracts are embargoed until 12:01 a.m. EST Thursday, Oct. 21 with the exception of research findings presented at IDSA press conferences.

 
 
   
 

© Copyright IDSA 2009 Infectious Diseases Society of America 1300 Wilson Boulevard, Suite 300 Arlington, VA 22209 info@idsociety.org