Authors
M Imanishi, AE Newton, AR Vieira, G Gonzalez-Aviles, ME Kendall Scott, K Manikonda, TN Maxwell, JL Halpin, MM Freeman, F Medalla, TL Ayers, G Derado, BE Mahon, ED Mintz
Publication date
2015/8
Journal
Epidemiology & Infection
Volume
143
Issue
11
Pages
2343-2354
Publisher
Cambridge University Press
Description
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 …
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