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. 2022 Jun 9;48(6):282-290.
doi: 10.14745/ccdr.v48i06a06.

A multi-provincial Salmonella Typhimurium outbreak in Canada associated with exposure to pet hedgehogs, 2017-2020

Katharine Fagan-Garcia  1 , Leann Denich  2 , Joanne Tataryn  3 , Rachelle Janicki  2 , Olivia Van Osch  2 , Ashley Kearney  4 , Cynthia Misfeldt  4 , Celine Nadon  4 , Colette Gaulin  5 , Victor Mah  6 , Raminderjeet Sandhu  7 , Michelle Waltenburg  8 , Bijay Adhikari  9 , Hanan Smadi  10 , Anne-Marie Lowe  2
Affiliations

A multi-provincial Salmonella Typhimurium outbreak in Canada associated with exposure to pet hedgehogs, 2017-2020

Katharine Fagan-Garcia et al. Can Commun Dis Rep. .

Abstract

Background: In October 2020, an investigation began in Canada on an outbreak of Salmonella Typhimurium infections of the same strain as a concomitant outbreak in the United States (US) that was linked to pet hedgehogs. The objective of this article is to identify the source of the outbreak, determine if there was a link between the Canadian and US outbreaks and identify risk factors for infection to inform public health interventions.

Methods: Cases were identified through whole genome sequencing of S. Typhimurium isolates. Information was collected on case exposures, including animal contact. Hedgehog and environmental specimens were tested for S. Typhimurium and a trace back investigation was conducted.

Results: There were 31 cases in six provinces, with illness onset dates from June 1, 2017, to October 15, 2020. Median case age was 20 years and 52% were female. Isolates grouped together between 0-46 whole genome multi locus sequence typing allele differences. Of 23 cases with available exposure information, 19 (83%) reported contact with hedgehogs in the seven days prior to symptoms; 15/18 (83%) reported direct contact and 3/18 (17%) reported indirect contact. Trace back investigation did not identify a common source of hedgehogs but uncovered an industry with a complex distribution network. The outbreak strain was detected in samples collected from a hedgehog in one case's home and from a hedgehog in a Québec zoo.

Conclusion: Direct and indirect contact with hedgehogs was identified as the source of this S. Typhimurium outbreak. Public health communications aimed to increase awareness about the risks of zoonoses from hedgehogs and shared key hygienic practices to reduce disease transmission.

Keywords: S. Typhimurium; enteric; hedgehog; outbreak; salmonella; zoonotic.

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Conflict of interest statement

Competing interests: No conflicts of interests to declare.

Figures

Figure 1
Figure 1
Number of cases with the outbreak strain of Salmonella Typhimurium by province and illness onset or specimen collection date (n=31) Note: The a indicates isolate for which only specimen collection or isolation date was available
Figure 2
Figure 2
Traceback network diagram of hedgehogs associated with sick persons infected with the outbreak strain of Salmonella Typhimuriuma a All cases with hedgehog exposures are shown in rectangles. All pet stores (depicted by hexagons) and wholesalers (depicted by half circles) in this diagram were located in Alberta and Québec, Canada. The breeders (depicted by rounded rectangles) were located in Alberta, Québec, British Columbia and Ontario, Canada and in the United States. Filled circles depict cases where further hedgehog information was not available. The triangles depict the location of hedgehog suppliers that were interviewed, and the stars depict the locations where environmental sampling was performed. Arrows illustrate the reported links by cases or suppliers
Figure 3
Figure 3
Relatedness of outbreak-associated isolates by whole genome sequencing multi-locus sequence typinga a Unweighted pair group method with arithmetic mean (UPGMA) dendogram of whole genome multilocus sequence typing (wgMLST) results for human and animal isolates included in the investigation, generated using BioNumerics v7.6 (Applied Maths)
See this image and copyright information in PMC

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