SAN FRANCISCO (CBS SF) – A multi-state Salmonella outbreak dating back to January 2015 including 26 cases in California have been linked to the handling of small turtles, mostly by children, federal health officials announced Wednesday.

According to the Centers For Disease Control And Prevention, a total of 133 people have been infected with the outbreak strains of Salmonella in 26 states between January 16, 2015 and April 8, 2016.

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In interviews, 50 percent of the 110 people who were asked reported contact with small turtles or their environments, such as water from a turtle habitat, before their illness.

Twenty-five of those people reported purchasing the turtle from a street vendor or receiving the turtle as a gift.

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Of those stricken, according to the CDC, 38 required hospitalized and no deaths were reported. Forty-one percent of those stricken were children 5 years of age or younger.

Federal officials said all turtles, regardless of size, can carry Salmonella bacteria even if they look healthy and clean.

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The CDC has issued the following advice to parents and pet owners.

    Do not purchase, or give as a gift, turtles with a shell length of less than 4 inches in size.
  • Wash hands thoroughly with soap and water immediately after handling turtles or anything in the area where they live or roam, or after contact with pet feces. Do not touch your face, other people or any surface until hands have been washed.
  • Keep turtles out of homes with children younger than 5 years, adults older than 65 years, or people with weakened immune systems.
  • Do not handle a turtle and an infant (such as feed, change diaper, or bathe) at the same time.
  • Turtles and other reptiles should not be kept in child care centers, schools, or other facilities with children younger than 5 years.
  • Do not allow turtles to roam freely in the home or living area, especially in food preparation areas.
  • Thoroughly clean and disinfect bathtubs that are used to bathe turtles or wash their dishes, cages, or aquariums. Kitchen sinks should not be used for these purposes.