IGUANAS AND SALMONELLA MARINA INFECTION IN CHILDREN - A REFLECTION OFTHE INCREASING INCIDENCE OF REPTILE-ASSOCIATED SALMONELLOSIS IN THE UNITED-STATES

Objective. To investigate clinical aspects and risk factors for Salmon ella serotype Marina infection in the United States. Methods. We ident ified all isolates of S Marina reported in 1994 to the National Salmon ella Surveillance System. Patients were interviewed about demographic information, clinical course, diet, travel history, and contact with r eptiles before illness. Results. Twenty-six (81%) of 32 patients were infants (<1 year of age) and 24 (75%) were male. This differs from oth er Salmonella isolates reported to the Centers for Disease Control and Prevention in 1994, of which 14% were from infants and 49% from male patients. Eleven patients (34%) were hospitalized for a median of 3.5 days (range: 2 to 21 days), and 1 died. Of 28 patients (88%) with repo rted iguana exposure, only 4 (14%) touched the reptile, and only 12 re spondents (43%) realized that it might have been the source of infecti on. Seven (32%) of 22 families who owned an iguana at the time of illn ess continued to own an iguana when contacted a median of 28 weeks lat er. Persons who thought that the iguana was the source of infection we re more likely to have given away or sold the pet than those who did n ot. Four isolates (13%) were from blood. Bacteremia was associated wit h taking antibiotics during the 30 days before S Marina infection (odd s ratio: 24; 95% confidence interval: 1.2-1309). Conclusion. S Marina infection is a potentially serious illness associated with iguana expo sure, and it reflects the larger problem of reptile-associated salmone llosis. Many parents do not know that owning an iguana puts their chil dren at risk for Salmonella infection. Pediatricians, veterinarians, a nd pet store owners should inform their patients and customers of the potential risks of owning reptiles and provide appropriate preventive education.