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Typhoid fever at a resort hotel in New York: a large outbreak with an unusual vehicle.

Authors
  • Birkhead, G S
  • Morse, D L
  • Levine, W C
  • Fudala, J K
  • Kondracki, S F
  • Chang, H G
  • Shayegani, M
  • Novick, L
  • Blake, P A
Type
Published Article
Journal
The Journal of infectious diseases
Publication Date
May 01, 1993
Volume
167
Issue
5
Pages
1228–1232
Identifiers
PMID: 8486960
Source
Medline
License
Unknown

Abstract

The largest outbreak of typhoid fever in the United States since 1981 occurred in 1989 among guests and staff at a New York hotel. There were 43 culture-confirmed and 24 probable cases among guests, 1 culture-confirmed case and 1 asymptomatic culture-positive case among hotel employees, and 1 culture-confirmed secondary case. Twenty-one persons were hospitalized and 2 had bowel perforation. Breakfast on 13 June was the only meal consumed by all ill persons (relative risk, infinite; P = .004). In a case-control study, case-patients were more likely than controls to have consumed orange juice (odds ratio, 5.6; 95% confidence interval, 1.1-54.7), which had been prepared in a 208-L container with ample opportunity for hand contact. No other food was associated with illness. S. typhi was isolated from the stool of an asymptomatic food worker who handled orange juice but who was not known to be a typhoid carrier. S. typhi is a foodborne pathogen with continuing potential to cause large outbreaks in the United States.

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