Contact with small turtles is continuing to cause Salmonella illnesses around the country, according to a new report from the Centers from Disease Control and Prevention.

These small reptiles – measuring four inches or less in length – have now been linked to 196 illnesses in 31 states since September of 2011. A total of 36 victims have been hospitalized.

The CDC first announced a series of three Salmonella outbreaks linked to tiny turtles in March of 2012. The three strains – Salmonella Sandiego, Salmonella Pomona and Salmonella Poona – had been linked to 66 illnesses in 16 states. Since that time, the agency has updated its outbreak report five times as an increasing number of cases have been reported and three more strains, including another strain of S. Sandiego, another of S. Pomona and another of S. Poona, have been connected to small turtles.

These strains are identified as Strain B in the CDC’s report.

Since the agency’s most recent update in early August, 28 more cases have been counted, bringing the total number of illnesses from 168 to 196 in 31 states. The newly reported illnesses were caused by Salmonella Sandiego, Strain A (6 new cases), Salmonella Pomona, Strain A (1 new case), Salmonella Poona, Strain A (4 new cases) and Salmonella Pomona, Strain B (17 new cases).

A possible link has been established between Salmonella Poona, Strain A infections and contact with small turtles sold at souvenir stores in the Florida panhandle.

Outbreak-specific case counts are as follows.

Salmonella Sandiego, Strain A

A total of 76 individuals have been sickened in this outbreak. Illnesses occurred in California (11), Georgia (1) Illinois (2), Massachusetts (4), Maryland (5), Minnesota (1), North Carolina (1) New Jersey (6), New Mexico (5), Nevada (2), New York (19), Pennsylvania (8), South Carolina (1), Texas (1) and Virginia (1).

Of the people for whom information about illness was available, 24 percent were hospitalized.

The 6 new cases occurred in California (1), New Jersey (2), New York (1) and Pennsylvania (2).

Those sickened range in age from less than 1 year old to 86 years, with a median age of 8.

Of the 51 people for whom information is available, 81 percent report contact with small turtles before falling ill, and 87 percent who recalled the type of turtle reported that it was a red-eared slider.

Salmonella Pomona, Strain A

A total of 16 people have been sickened with this strain. Illnesses by state are as follows: California (3), Massachusetts (1), Maryland (1), New Jersey (1), Nevada (1), New York (2), Pennsylvania (3), Texas (1) and Virginia (1). The illness in New Jersey was reported since the last update.

Victims range in age from less than 1 year old to 90 years old, with a median age of 16. Of the 13 people for whom information is available, 4 have been hospitalized.

Salmonella Poona, Strain A

According to CDC, 25 people have been sickened with this outbreak strain of Salmonella.

The new total number of illnesses by state are as follows: Alabama (1), Arizona (2), California (3), Indiana (1), Kansas (1), Kentucky (1) , Louisiana (1), Michigan (1), Mississippi (1), New York (3), Tennessee (3) and Texas (4).

The 4 new cases are from Georgia (1), Kansas (1), North Carolina (1) and Tennessee (1).

Of the 18 people for whom information is available, 6 were hospitalized. Victims range in age from less than 1 year old to age 70, with a median age of 3. When interviewed, 6 of the victims reported traveling to the Florida panhandle and purchasing or handling small turtles at a souvenir store.

In August of 2012, five different samples of turtle tank water from six souvenir stores in the panhandle of Florida tested positive for this strain of Salmonella.

Salmonella Pomona, Strain B

In total, 67 illnesses have been linked to the outbreak of Salmonella Pomona, Strain B. Of these, 17 were reported since the CDC’s last update. The new cases are from Arizona (1), California (9), Delaware (1), Illinois (1), Nevada (1), South Carolina (1), Texas (1), Virginia (1) and West Virginia (1).

These numbers bring the total case count by state to the following:

Alaska (2), Alabama (1), Arizona (2), California (11), Colorado (2), Delaware (3), Georgia (2), Illinois (1), Michigan (1), New Mexico (1), Nevada (3), New York (1), Ohio (2), Oregon (1), Pennsylvania (1), South Carolina (3), Tennessee (1), Texas (9), Virginia (2) and West Virginia (1).

Victims range in age from less than 1 year old to 94, with a median age of 2 years. Of the 33 for whom information is available, 11 were hospitalized.