Pediatric reptile-associated salmonellosis a substantial burden

1. Reptile-associated salmonellosis (RAS) accounted for over a quarter of Salmonella infections in children under 5 years of age

2. RAS was associated with higher rates of hospitalization and invasive disease than non-RAS cases.

Evidence Rating Level: 3 (Average)

Study Rundown: Salmonellae are bacteria known to cause serious infections such as gastroenteritis, osteomyelitis, and meningitis. Pet reptiles, such as iguanas, snakes, and chameleons, excrete Salmonella from their gut and can transmit this bacteria to humans, particularly infants and preschool children. The purpose of this study was to determine the proportion of Salmonella cases in children that were actually Reptile-associated salmonellosis (RAS) and to determine the severity of infection. In a three-year period in the southwest region of the United Kingdom (UK), 27.4% of children under 5 years of age with diagnosed Salmonella infection had previous exposure to reptiles. Compared to non-RAS cases, children with RAS were younger, admitted to the hospital more often, and more likely to have invasive disease such as bacteremia and meningitis.

This study presented the most current data on the prevalence of RAS in children under 5 years of age, and benefited from a relatively large sample size. Additionally, cases in which incomplete information was present were excluded, allowing us to reason that the included cases were children truly exposed to reptiles. Overall, this study suggests that RAS is a more common problem than previously thought and may lead to more invasive infections than non-RAS cases. This presents an opportunity to counsel parents on practices to decrease childhood disease burden and prevent dramatic disease.

Click to read the study in Archives of Disease in Childhood

Relevant Reading: A case-control study of the epidemiology of sporadic Salmonella infection in infants

In-Depth [case-control study]: This study determined the prevalence of RAS in children under 5 years of age in the South West area of the UK from January 2010 to December 2013. Of 175 children with salmonellosis, 48 had previous exposure to reptiles (27.4%). The median age of RAS cases was significantly lower than that of non-RAS cases (0.5 vs. 1.0 years, p=0.001). In addition, the hospitalization rate of RAS cases was higher than that of non-RAS cases (48% vs. 19%, p=0.0002), which was also true for children under 12 months of age (50% vs. 19%, p=0.003). Finally, invasive disease such as bacteremia and meningitis was more common in the RAS group (17% vs. 3%, p=0.0016).

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