Abstract
Notes from the Field: Investigation of an Outbreak of Salmonella Paratyphi B Variant L(+) tartrate + (Java) Associated with Ball Python Exposure - United States, 2017.
Highlights
Five cases were identified in four states: one each in Arizona, Oklahoma, and Oregon, and two in Indiana from different households with no epidemiologic link
Whole-genome sequencing analysis* of isolate genomes of Salmonella Paratyphi B variant L(+) tartrate + (Java) from human, from Python regius, and from environmental sources associated with the outbreak investigation† — United States, 2017
NVSL PythonAbbreviations: AZ = Arizona; hqSNP = high-quality single nucleotide polymorphism; IN = Indiana; NVSL = National Veterinary Services Laboratories; OK = Oklahoma; SNPs = single nucleotide polymorphisms. * Analysis performed using Lyve-SET version 1.1.4f (https://github.com/lskatz/lyve-SET), and hqSNPs were called at >20x coverage, >95% read support, and allowed flanking set to five base pairs. Reference used was draft assembly of Arizona case (78 contigs) without phage masking. † Three isolates from different pythons submitted to NVSL for testing
Summary
Vikram Krishnasamy, MD1,2; Lauren Stevenson, MHS2,3; Lia Koski, MPH2,4; Marilee Kellis, MPH5; Betsy Schroeder, DVM6; Madhura Sundararajan, MPH6; Stephen Ladd-Wilson, MS7; Ashley Sampsel; Mike Mannell, MPH8; Andrew Classon; Darlene Wagner, PhD2,9; Kelley Hise, MPH2; Heather Carleton, PhD2; Eija Trees, DVM, PhD2; Linda Schlater, DVM10; Kristina Lantz, DVM10; Megin Nichols, DVM2. Initial questionnaires administered by state and local health department investigators indicated animal exposure as a possible source of infection, with all five patients reporting snake exposure. Ball python sampling occurred in the Arizona, Oregon, and one of the Indiana patient residences by sampling the python cloaca, environment, water, and bedding. Feeder rodent sampling occurred in the Arizona and Indiana patient residences. A ball python bedding sample from the Arizona residence and a ball python cloacal sample from the Indiana residence yielded Salmonella Paratyphi B variant L(+) tartrate + (Java). Sampling identified Salmonella Mbandaka from a feeder rodent and a ball python at the Arizona residence. The three python isolates identified at NVSL were not closely related to any human, animal, or environmental isolate. Identifying and investigating zoonotic clusters of salmonellosis require a One Health [6] approach using multidisciplinary collaboration with departments of agriculture and health
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