In recent years, health officials have warned those who have bearded dragons, hedgehogs, ducks and chickens as pets to do their part in preventing the spread of salmonella infections.

Now, an outbreak of salmonella cases across 11 states has been linked to small turtles, prompting the Centers for Disease Control and Prevention to issue safety instructions for people who have the reptiles as pets.

A simple piece of advice from health officials: “Don’t kiss or snuggle your turtle.”

Twenty-six people have been sickened in the salmonella outbreak and at least nine people have been hospitalized in recent months, the C.D.C. said last week. No deaths have been reported, the agency said.

Although all turtles can carry salmonella germs that can make people sick, turtles with shells less than four inches long have been a known source of illness, the C.D.C. said. In 1975, the Food and Drug Administration banned the sale of turtles less than four inches in length because of the thousands of cases of severe illness at the time, particularly among children who touched their pet turtles and then their food or mouth without washing.

Officials said this month that turtle owners and those seeking to buy one should keep a few pointers in mind: Do not buy turtles for children under 5 or adults over 65; wash your hands after touching a turtle; and do not drink or eat around your turtle.

About a third of the people who’ve gotten sick during the current outbreak have been under 5 years old, the C.D.C. said. Of the 20 infected people who provided information to the C.D.C., 16 said they’d had contact with pet turtles; 12 of those said the pet turtles had shells less than four inches long.

Salmonella, a type of bacteria, causes about 1.35 million illnesses, 26,500 hospitalizations and 420 deaths in the United States every year, according to the C.D.C.

Most people with salmonellosis, the infection caused by salmonella, develop diarrhea, fever and abdominal cramps. More severe cases may lead to a high fever, aches, headaches, lethargy, a rash, blood in the urine or stool and, in some cases, become fatal.

Other salmonella outbreaks have been linked to animals and prompted similar warnings about getting too close to them: There was the hedgehog outbreak of 2019, when health officials advised people to refrain from kissing their small, spiky friends. There was the salmonella outbreak linked to backyard poultry in 2021. Officials at the time essentially said don’t kiss or snuggle your ducks and chickens. And similar salmonella warnings were issued in 2014 about bearded dragons.

In 2002, an Oklahoma man who caught a salmonella infection from his pet snake passed the illness to two people through transfusions of his blood platelets. Both recipients became ill, and one died, according to an article in The New England Journal of Medicine.

Even dog owners are not spared of the dangers of cuddling. Some bacteria in dogs’ mouths are zoonotic, meaning the animals can pass them to humans and cause disease, including salmonella.

There is potential trouble for feline lovers as well. The Cornell Feline Health Center reports that people can also contract salmonella from infected cats — especially those that feed on raw meat — which pass the bacteria in their stool. Wearing gloves when cleaning litter boxes is recommended, the center said.

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