Typhoid Fever in the United States, 1985-1994

Mermin, Jonathan; Townes, John M.; Gerber, Mark E.; Dolan, Natalie; Mintz, Eric D.; Tauxe, Robert V.

doi:10.1001/archinte.158.6.633

Cited by 164 publications

(31 citation statements)

References 20 publications

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“…For years, the proportion of enteric fever cases acquired during international travel has increased in the United States [11, 13–15] and in other industrialized countries [20, 25–27]. In our 5-year study, 86% of typhoid cases were travel-associated, compared with 79% during 1999–2006 [14]; the travel-associated percentage was even higher (91%) for paratyphoid fever.…”

Section: Discussionmentioning

confidence: 67%

“…Travelers since 1970s, especially those returning from southern Asia, have accounted for an increasing proportion of cases [13–15]. Vaccination is recommended for US travelers to countries where typhoid is endemic [17], but no vaccine against paratyphoid fever is available.…”

mentioning

confidence: 99%

“…Resistance to antimicrobial agents has increased in cases diagnosed in the United States, reflecting similar changes in southern and southeastern Asia [3, 7, 18]. Multidrug-resistant (MDR) Salmonella Typhi, defined as resistance to at least ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole—agents historically used in the United States and other countries to treat enteric fever—has been reported in US patients [14, 15, 19]. Treatment recommendations include fluoroquinolones (eg, ciprofloxacin) and third-generation cephalosporins (eg, ceftriaxone), so the recent emergence of strains with decreased susceptibility to fluoroquinolone agents is concerning.…”

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confidence: 99%

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Changing Patterns in Enteric Fever Incidence and Increasing Antibiotic Resistance of Enteric Fever Isolates in the United States, 2008–2012

et al. 2016

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Background Enteric fever in the United States has been primarily associated with travel and with worrisome changes in global patterns of antimicrobial resistance. We present the first comprehensive report of National Typhoid and Paratyphoid Fever Surveillance System (NTPFS) data for a 5-year period (2008–2012). Methods We reviewed data on laboratory-confirmed cases reported to NTPFS, and related antimicrobial susceptibility results of Salmonella Typhi and Paratyphi A isolates sent for testing by participating public health laboratories to the Centers for Disease Control and Prevention’s National Antimicrobial Resistance Monitoring System laboratory. Results During 2008–2012, 2341 enteric fever cases were reported, 80% typhoid and 20% paratyphoid A. The proportion caused by paratyphoid A increased from 16% (2008) to 22% (2012). Foreign travel within 30 days preceding illness onset was reported by 1961 (86%) patients (86% typhoid and 92% paratyphoid A). Travel to southern Asia was common (82% for typhoid, 97% for paratyphoid A). Among 1091 (58%) typhoid and 262 (56%) paratyphoid A isolates tested for antimicrobial susceptibility, the proportion resistant to nalidixic acid (NAL-R) increased from 2008 to 2012 (Typhi, 60% to 68%; Paratyphi A, 91% to 94%). Almost all NAL-R isolates were resistant or showed decreased susceptibility to ciprofloxacin. Resistance to at least ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole (multidrug resistant [MDR]) was limited to Typhi isolates, primarily acquired in southern Asia (13%). Most MDR isolates were also NAL-R. Conclusions Enteric fever in the United States is primarily associated with travel to southern Asia, and increasing resistance is adding to treatment challenges. A bivalent typhoid and paratyphoid vaccine is needed.

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Section: Discussionmentioning

confidence: 67%

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confidence: 99%

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confidence: 99%

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Changing Patterns in Enteric Fever Incidence and Increasing Antibiotic Resistance of Enteric Fever Isolates in the United States, 2008–2012

et al. 2016

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“…The case fatality rate is approximately 10% for untreated cases in low income settings and <1% for patients receiving care in high income countries (13)(14)(15)(16)(17).…”

Section: Introductionmentioning

confidence: 99%

Summary of the Statement on International Travellers and Typhoid by the Committee to Advise on Tropical Medicine and Travel (CATMAT)

Greenaway¹,

Catmat²,

Schofield³

et al. 2014

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Background: Typhoid fever is an enteric febrile illness with symptoms that range from mild to potentially fatal. Among Canadians it is usually acquired during travel to typhoid endemic countries. The Committee to Advise on Tropical Medicine and Travel (CATMAT) assembled a typhoid working group to update recommendations on typhoid and international travel. This document is a summary of the new typhoid statement.

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“…Antimicrobial resistance in S . Typhi strains has increased markedly during the past ~25 years, especially in Asia [4, 26–28]. Lower rates of drug resistance in infections acquired in the United States may be due in part to the source of some domestically acquired typhoid infections being chronic carriers who acquired the infection before widespread establishment of resistant strains or who came from areas where drug resistance is less common.…”

Section: Discussionmentioning

confidence: 99%

Typhoid fever acquired in the United States, 1999–2010: epidemiology, microbiology, and use of a space–time scan statistic for outbreak detection

et al. 2014

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SUMMARY Although rare, typhoid fever cases acquired in the United States continue to be reported. Detection and investigation of outbreaks in these domestically acquired cases offer opportunities to identify chronic carriers. We searched surveillance and laboratory databases for domestically acquired typhoid fever cases, used a space–time scan statistic to identify clusters, and classified clusters as outbreaks or non-outbreaks. From 1999 to 2010, domestically acquired cases accounted for 18% of 3373 reported typhoid fever cases; their isolates were less often multidrug-resistant (2% vs. 15%) compared to isolates from travel-associated cases. We identified 28 outbreaks and two possible outbreaks within 45 space–time clusters of ⩾2 domestically acquired cases, including three outbreaks involving ⩾2 molecular subtypes. The approach detected seven of the ten outbreaks published in the literature or reported to CDC. Although this approach did not definitively identify any previously unrecognized outbreaks, it showed the potential to detect outbreaks of typhoid fever that may escape detection by routine analysis of surveillance data. Sixteen outbreaks had been linked to a carrier. Every case of typhoid fever acquired in a non-endemic country warrants thorough investigation. Space–time scan statistics, together with shoe-leather epidemiology and molecular subtyping, may improve outbreak detection.

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Typhoid Fever in the United States, 1985-1994

Cited by 164 publications

References 20 publications

Changing Patterns in Enteric Fever Incidence and Increasing Antibiotic Resistance of Enteric Fever Isolates in the United States, 2008–2012

Changing Patterns in Enteric Fever Incidence and Increasing Antibiotic Resistance of Enteric Fever Isolates in the United States, 2008–2012

Summary of the Statement on International Travellers and Typhoid by the Committee to Advise on Tropical Medicine and Travel (CATMAT)

Typhoid fever acquired in the United States, 1999–2010: epidemiology, microbiology, and use of a space–time scan statistic for outbreak detection

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