Slide 1: Question: What disease is prevented by the “4-inch law”?

Slide 2: Answer: Non-typhoidal salmonellosis!

Slide 3: The 4-inch law is the federal FDA ban that prohibits the sale of turtles under 4 inches in length. Turtles’ GI tracts are commonly colonized with non-typhoidal Salmonella. Since domestic turtles swim in their own feces in terrariums, many are covered in Salmonella.

Slide 4: What happens when exposed? Depends on risk! Non-typhoidal Salmonella, normal risk, non-bloody diarrhea and dysentery. Non-typhoidal Salmonella, high risk (e.g. children), sepsis, septic arthritis, meningitis, and death.

Slide 5: Because children are more likely to directly handle (and even ingest) small turtles compared to larger ones, the “4-inch law” has prevent an estimated 100,000 cases of salmonellosis in children each year!


  • Hoss A, Benken DE, Penn MS. Menu of state turtle-associated salmonellosis laws. Public Health Law Program (Centers for Disease Control and Prevention (U.S.); Centers for Disease Control and Prevention (U.S.). Office for State, Tribal, Local and Territorial Support. Published April 30, 2015. Updated 2016.Link.
  • Crum-Cianflone NF. Salmonellosis and the gastrointestinal tract: more than just peanut butter. Curr Gastroenterol Rep. 2008 Aug;10(4):424-31. PMID 18627657.
  • Bosch S, Tauxe RV, Behravesh CB. Turtle-Associated Salmonellosis, United States, 2006-2014. Emerg Infect Dis. 2016 Jul;22(7):1149-55. PMID 27315584.

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