0
We're unable to sign you in at this time. Please try again in a few minutes.
Retry
We were able to sign you in, but your subscription(s) could not be found. Please try again in a few minutes.
Retry
There may be a problem with your account. Please contact the AMA Service Center to resolve this issue.
Contact the AMA Service Center:
Telephone: 1 (800) 262-2350 or 1 (312) 670-7827  *   Email: subscriptions@jamanetwork.com
Error Message ......
From the Centers for Disease Control and Prevention |

Notes From the Field: Update on Human Salmonella Typhimurium Infections Associated With Aquatic Frogs—United States, 2009-2011 FREE

JAMA. 2011;306(4):376. doi:.
Text Size: A A A
Published online

CDC is collaborating with state and local public health departments in an ongoing investigation of human Salmonella Typhimurium infections associated with African dwarf frogs (ADFs).1 ADFs are aquatic frogs of the genus Hymenochirus commonly kept in home aquariums as pets. From April 1, 2009 to May 10, 2011, a total of 224 human infections with a unique strain of S. Typhimurium were reported from 42 states. The isolates are indistinguishable by pulsed-field gel electrophoresis and multiple-locus variable-number tandem repeat analysis. This outbreak likely includes considerably more than the 224 laboratory-confirmed cases reported to CDC; only an estimated 3% of Salmonella infections are laboratory confirmed and reported to surveillance systems.2 Surveillance for additional cases continues through PulseNet, the national molecular subtyping network for foodborne disease surveillance.

The median age of patients in this outbreak was 5 years (range: <1-67 years), and 70% (156 of 223) were aged <10 years. Approximately 52% (111 of 215) were female. No deaths have been reported, but 30% (37 of 123) of patients were hospitalized. Sixty-five percent (56 of 86) of patients interviewed reported contact with frogs in the week before illness; 82% (45 of 55) reported that this contact took place in the home. Of those who could recall the type of frog, 85% (29 of 34) identified ADFs. Median time from acquiring a frog to illness onset was 15 days (range: 7-240 days).

Samples collected during 2009-2011 from aquariums housing ADFs in six homes of patients yielded the S. Typhimurium outbreak strain. Traceback investigations conducted during 2009-2011 from 21 patient homes and two ADF distributors identified a breeder in California as the common source of ADFs. This breeder sells ADFs to distributors, not directly to pet stores or to the public. Environmental samples collected at the breeding facility in January 2010, April 2010, and March 2011 yielded the outbreak strain. Based on these epidemiologic, traceback, and laboratory findings, the breeder voluntarily suspended distribution of ADFs on April 19, 2011. Public health officials are working with the breeder to implement control measures.

Distribution of ADFs currently is unregulated by federal or state agencies. To prevent infection, the public needs to be aware of the risk of Salmonella infections associated with keeping amphibians, including frogs, as pets. Education of consumers, health-care professionals, and the pet industry is needed. Persons at high-risk for Salmonella infections, especially children <5 years, pregnant women, and immunocompromised persons, should avoid contact with frogs, water used by the frogs, and their habitats. Additional information is available at http://www.cdc.gov/salmonella/water-frogs-0411.

Reported by: Jill Yaeger, Phil Hudecek, Madera County Dept of Environmental Health. Curtis L. Fritz, Debra Gilliss, Duc J. Vugia, Gregory Inami, Rita A. Brenden, California Dept of Public Health. Jennifer K. Adams, Cheryl A. Bopp, Eija Trees, Vincent Hill, Amy Kahler, Jeshua Pringle, Ian Williams, Casey Barton Behravesh, Div of Foodborne, Waterborne, and Environmental Diseases, National Center for Emerging and Zoonotic Infectious Diseases; Sarah D. Bennett, Shauna L. Mettee, EIS officers, CDC. Corresponding contributor: Sarah D. Bennett, sbennett@cdc.gov, 404-639-2274.

REFERENCES

Centers for Disease Control and Prevention (CDC).  Multistate outbreak of human Salmonella Typhimurium infections associated with aquatic frogs—United States, 2009.  MMWR. 2010;58:1433-1436
Voetsch AC, Van Gilder TJ, Angulo FJ,  et al.  Emerging Infections Program FoodNet Working Group. FoodNet estimate of the burden of illness caused by nontyphoidal Salmonella infections in the United States.  Clin Infect Dis. 2004;38:(Suppl 3)  S127-S134
Link to Article

Figures

Tables

References

Centers for Disease Control and Prevention (CDC).  Multistate outbreak of human Salmonella Typhimurium infections associated with aquatic frogs—United States, 2009.  MMWR. 2010;58:1433-1436
Voetsch AC, Van Gilder TJ, Angulo FJ,  et al.  Emerging Infections Program FoodNet Working Group. FoodNet estimate of the burden of illness caused by nontyphoidal Salmonella infections in the United States.  Clin Infect Dis. 2004;38:(Suppl 3)  S127-S134
Link to Article
CME
Also Meets CME requirements for:
Browse CME for all U.S. States
Accreditation Information
The American Medical Association is accredited by the Accreditation Council for Continuing Medical Education to provide continuing medical education for physicians. The AMA designates this journal-based CME activity for a maximum of 1 AMA PRA Category 1 CreditTM per course. Physicians should claim only the credit commensurate with the extent of their participation in the activity. Physicians who complete the CME course and score at least 80% correct on the quiz are eligible for AMA PRA Category 1 CreditTM.
Note: You must get at least of the answers correct to pass this quiz.
Please click the checkbox indicating that you have read the full article in order to submit your answers.
Your answers have been saved for later.
You have not filled in all the answers to complete this quiz
The following questions were not answered:
Sorry, you have unsuccessfully completed this CME quiz with a score of
The following questions were not answered correctly:
Commitment to Change (optional):
Indicate what change(s) you will implement in your practice, if any, based on this CME course.
Your quiz results:
The filled radio buttons indicate your responses. The preferred responses are highlighted
For CME Course: A Proposed Model for Initial Assessment and Management of Acute Heart Failure Syndromes
Indicate what changes(s) you will implement in your practice, if any, based on this CME course.

Multimedia

Some tools below are only available to our subscribers or users with an online account.

Related Content

Customize your page view by dragging & repositioning the boxes below.

Articles Related By Topic
Related Collections
PubMed Articles