Typhoid fever in the United States, 1985-1994

Changing risks of international travel and increasing antimicrobial resistance

Jonathan H. Mermin, John Townes, Michael Gerber, Natalie Dolan, Eric D. Mintz, Robert V. Tauxe

Research output: Contribution to journalArticle

155 Citations (Scopus)

Abstract

Background: Typhoid fever is a potentially fatal illness common in the less industrialized world. In the United States, the majority of cases occur in travelers to other countries. Methods: We reviewed surveillance forms submitted to the Centers for Disease Control with culture-confirmed typhoid fever between 1985 and 1994. Results: The Centers for Disease Control and Prevention received report forms for 2445 cases of typhoid fever. Median age of patients was 24 years (range, 0-89 years). Ten (0.4%) died. Seventy-two percent reported international travel within the 30 days before onset of illness. Six countries accounted for 80% of cases. Mexico (28%), India (25%), the Philippines (10%), Pakistan (8%), El Salvador (5%), and Haiti (4%). The percentage of cases associated with visiting Mexico decreased from 46% in 1985 to 23% in 1994, while the percentage of cases associated with visiting the Indian subcontinent increased from 25% in 1985 to 37% in 1994. The incidence of typhoid fever in US citizens traveling to the Indian subcontinent was at least 18 times higher than for any other geographic region. Complete data on antimicrobial susceptibility to ampicillin, chloramphenicol, and trimethoprim-sulfamethoxazole were reported for 330 (13%) Salmonella Typhi isolates. Isolates from 1990 to 1994 were more likely than isolates from 1985 to 1989 to be resistant to any of these antimicrobial agents (30% vs 12%; P

Original languageEnglish (US)
Pages (from-to)633-638
Number of pages6
JournalArchives of Internal Medicine
Volume158
Issue number6
DOIs
StatePublished - Mar 23 1998
Externally publishedYes

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Typhoid Fever
Centers for Disease Control and Prevention (U.S.)
Mexico
El Salvador
Haiti
Salmonella typhi
Philippines
Pakistan
Sulfamethoxazole Drug Combination Trimethoprim
Chloramphenicol
Ampicillin
Anti-Infective Agents
India
Incidence

ASJC Scopus subject areas

  • Internal Medicine

Cite this

Typhoid fever in the United States, 1985-1994 : Changing risks of international travel and increasing antimicrobial resistance. / Mermin, Jonathan H.; Townes, John; Gerber, Michael; Dolan, Natalie; Mintz, Eric D.; Tauxe, Robert V.

In: Archives of Internal Medicine, Vol. 158, No. 6, 23.03.1998, p. 633-638.

Research output: Contribution to journalArticle

Mermin, Jonathan H. ; Townes, John ; Gerber, Michael ; Dolan, Natalie ; Mintz, Eric D. ; Tauxe, Robert V. / Typhoid fever in the United States, 1985-1994 : Changing risks of international travel and increasing antimicrobial resistance. In: Archives of Internal Medicine. 1998 ; Vol. 158, No. 6. pp. 633-638.
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