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Several human cases and outbreaks of serotypes Typhimurium and Tielene have been linked to pet hedgehog contacts (Table 1), and Salmonella Enteritidis and Sofia have also been isolated from hedgehogs kept as pets (Additional file 1: Table S1). Salmonella Tielene represents a very rare serotype. Human cases are strongly associated with hedgehog exposure, and children appear to be at heightened risk of infection [195]. Salmonella Tielene was first isolated in the USA in 1994 during a human outbreak associated with an African pygmy hedgehog breeding colony [195]. In Canada the geographic distribution of human Tielene cases starkly resembles that of pet hedgehogs, emphasizing the epidemiological role of this pet species [196]. Human Tielene outbreaks have also been linked to sugar glider exposure, indicating a role of this exotic pet in Salmonella Tielene epidemiology [196].
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Salmonella survives over long time periods in the environment, and a number of human outbreaks have been attributed to indirect reptile contact (Additional file 2: Table S3). Reptile-associated salmonellosis occurs frequently in small children, which are rarely allowed direct contact with snakes or lizards, strongly suggesting indirect exposure routes (Additional file 2: Table S3). In fact, a case-control study found presence of reptiles in the home to be a highly significant risk factor for salmonellosis in infants Salmonella outbreak with at least 65 cases was linked to contact with a wooded barrier around a Komodo dragon habitat in the Colorado zoo [270]. In 1994, hospitalized infants were infected with Salmonella Kintambo [271]. One infant's family owned a lizard which shed Kintambo and the infant's mother reported diarrheal illness shortly before giving birth, potentially indicating prior infection. In 2001, Salmonella Nima was isolated from a sick infant and a boa at the school where the infant's father worked [273]. The father reported carefully washing his hands after handling the snake or its container, but frequently draped the snake around his arm and did not change his clothes before handling the infant. In 2004, Salmonella Typhimurium was isolated from an 80 year old woman and the bowl in which her daughter's turtle was kept [274]. The women had no direct contact with the turtle or its bowl, but the bowl was cleaned in the kitchen sink. Given the large number of indirect transmissions, the USA CDC recommends that households with young children (i.e. 041b061a72