Tiny Turtle–Serious Health Threat

By Abigail Ferrell, JD, MPA

As children, my brother and I talked our very patient mother into letting us have a wide variety of creatures as domestic pets. Nothing too exotic—mostly cats, dogs, and vermin (read: hamsters)—but my brother was also famous for catching wild creatures. We lived near a pond and my brother’s summers were spent feeding, wading, fishing for, and catching all kinds of aquatic life. He was usually allowed to keep a creature for an afternoon but then had to release it back to its home.

 Wild, freshwater turtles are difficult to catch and, other than a couple of accidental catches while fishing, I don’t remember many interactions with wild turtles. But once he caught two different turtle species on the same day: a common snapping turtle and a painted turtle. He commandeered two of our grandmother’s buckets and kept the turtles for a few hours before releasing them unharmed, but not before looking them up in our grandmother’s wildlife books and wearing himself out running back and forth between the two buckets and the house.
I hadn’t thought about my brother’s captive turtles in years, but they came to mind when CDC’s Public Health Law Program (PHLP) and National Center for Emerging and Zoonotic Infectious Diseases (NCEZID) began researching state laws directed at turtle-associated salmonellosis. As the attorney in charge of PHLP’s communications outreach, in cooperation with Aila Hoss and Don Benken, PHLP’s attorney subject matter experts, and the Office for State, Local, Tribal and Territorial Support’s communication team, I helped write our communications plan and identify the audiences who would most benefit from our research. Reading Ms. Hoss’ research and NCEZID’s background information about past turtle-associated salmonellosis, I suddenly remembered why my brother was discouraged from catching wild things (it’s dangerous and, in most states, illegal) and especially warned away from turtles. Turtles, particularly small turtles, can carry Salmonella—the bacteria that causes salmonellosis.

Salmonella causes an estimated one million illnesses in the United States every year, resulting in about 19,000 hospitalizations and 308 deaths. Most people infected with Salmonella develop diarrhea, fever, and abdominal cramps between 12 and 72 hours after exposure. The illness usually lasts four to seven days, and most people recover without treatment. In critical cases, the infection can spread from the intestines to the bloodstream and then to other body sites. In those cases, salmonellosis can cause death, unless the person is treated promptly with antibiotics. Elderly persons, infants, and those with impaired immune systems are more likely to get a severe illness, though those at highest risk for salmonellosis are children under age five.

Small turtles are often sold as pets for young children, which is a problem because small children might not wash their hands after handling turtles or items that have been touching the turtle or the turtle’s habitat. Also, small children might view turtles as toys and kiss, lick, or place the turtles in their mouths, as they might any other small object. In 2012, there were eight multi-state outbreaks of turtle-associated salmonellosis in the US and in Puerto Rico, resulting in 78 hospitalizations; 70% of those affected were children under age 10.

Federal law prohibits the sale of “viable turtle eggs and live turtles with a carapace length of less than 4 inches” (a standard deck of playing cards is about 3.5 inches long). Federal law allows for limited exceptions; turtles may be sold for “bona fide scientific, education, or exhibition purposes, other than use as pets.” In addition to this federal law, many states have also passed laws regulating the sale of turtles or have incorporated the federal law into their state codes by reference.

Although the federal law applies to all states, the preemption doctrine allows states to establish more stringent requirements than the federal law regarding the sale of turtles. Preemption issues are complex, but generally, if state requirements are less stringent, the federal law prevails. Some states select to enact their own laws to ensure that state resources can be used for enforcement, or if the federal standard changes.

PHLP and NCEZID have created several resources explaining turtle-associated salmonellosis, including a menu of each state’s laws  and an infographic explaining the trouble with tiny turtles. It is important to understand how illnesses like these occur and can be prevented. It is also important to recognize how law can be—and often is—used as a tool to improve public health. Take a peek under the proverbial shell and see how your individual state regulates turtle sales.

Looking back, I think my brother was pretty lucky not to get sick—other reptiles and amphibians can also carry Salmonella. Since his turtle-catching days, he has gone on to earn a degree in wildlife biology. Now he is much better informed about the hazards of interfering with wild animals. For the most part, he leaves the wild things to the wild.