Bacteria

Typhoid Fever Outbreaks in the United States

Author Stephen A. Berger, MD , 06-May-2013

Table of contents

60 outbreaks of typhoid were reported from 1960 to 1999 – 54 of these (a total of 957 cases, four fatal) following exposure within the United States. Five drinking water-associated outbreaks of this disease were reported from 1971 to 2006.

The best-known clusters of typhoid fever in history were those ascribed to Mary Mallon (also known as ”Typhoid Mary”), a chronic carrier who was responsible for nine outbreaks (54 cases, four fatal) in the New York area from 1900 to 1915.

A Chronology of Notable Outbreaks:

1843 – Outbreaks of typhoid were reported in New York City and Boston.
1898 – An outbreak of typhoid was reported in Florida.
1909 – Another outbreak was reported in an “infant asylum” in Baltimore, Maryland.
1911 – An outbreak of typhoid was reported in Yakima, Washington.
1913 (publication year) – An outbreak was reported in Illinois.
1913 (publication year) – An outbreak of paratyphoid fever in Massachusetts was ascribed to contaminated milk.
1936 (publication year) – An outbreak in Philadelphia, Pennsylvania, was associated with supper.
1937 (publication year) – An outbreak was reported in Michigan.
1947 – An outbreak (4 cases) of typhoid in Alaska was associated with a commercial air flight.
1953 (publication year) – An outbreak of typhoid was reported in rural New York.
1956 – An outbreak was reported in the Midwest.
1959 – An outbreak of typhoid was reported among migrant workers in Virginia.
1964 – An outbreak of typhoid fever was reported in Atlanta, Georgia.
1967 – An outbreak (31 cases) was reported among students at a university in California.
1970 – An outbreak (81 cases) was reported among passengers aboard a British ship traveling to Canada and the United States.
1972 to 1973 – An outbreak (1,515 cases, 39 fatal) was reported in Mexico City in 1972, with an additional 667 cases from January to June 1973. A related outbreak (80 cases) was reported in the United States.
1973 – An outbreak (230 cases) in Dade Country, Florida, may have originated from water contaminated by a typhoid carrier.
1981 – An outbreak (80 cases) of typhoid at a restaurant in Texas was associated with contaminated “barbacoa” (a mixture of muscle, lips, ears, tongue, and eyes from steamed bovine heads).
1981 – An outbreak (6 cases) on an Indian reservation was linked to a typhoid carrier.
1981 – Michigan outbreak (18 cases, 0 fatal) was assumed to be related to a typhoid carrier.
1986 – Contaminated shrimp caused an outbreak at a restaurant in Maryland. {p 3384930}
1989 – An outbreak (43 cases) of typhoid at a hotel in New York was ascribed to contaminated orange juice.
1990 – An outbreak (17 cases) of food-borne typhoid followed a family gathering in Washington State. {p 2120571}
1990 – An outbreak (24 cases, 16 confirmed) was associated with a family picnic in Maryland.
1998 to 1999 – An outbreak (16 cases or more) in Florida was ascribed to frozen mamey (a tropical fruit) imported from Honduras and Guatemala.
2000 – An outbreak (7 cases) in Indiana, Ohio, and Kentucky occurred among men who have sex with men.
2000 – An outbreak (7 cases) in New York City was traced to an infected restaurant employee.
2005 – An outbreak (2 cases) in New York City was related to a carrier from Haiti.
2009 – An outbreak (3 cases) of typhoid was reported in Tennessee.
2010 – An outbreak (12 cases) in California and Nevada was ascribed to the ingestion of contaminated mamey fruit pulp imported from Guatemala.

The background data used in this blog post was abstracted from the GIDEON e-book series. [1,2]

References:
1. Berger SA. Infectious Diseases of the United States, 2013. 1119 pages, 470 graphs, 11030 references. Gideon e-books
2. Berger SA. Typhoid and Enteric Fever: Global Status, 2013. 258 pages, 401 graphs, 728 references. Gideon e-books

Note featured on ProMED

 

Author
Stephen A. Berger, MD

Stephen A. Berger, M.D. is affiliated with the Tel Aviv Medical Center, where he has served as Director of both Geographic Medicine and Clinical Microbiology. He also holds an appointment as Emeritus Associate Professor of Medicine at the University of Tel-Aviv School of Medicine. Dr. Berger co-founded GIDEON Informatics, developers of the GIDEON (Global Infectious Diseases and Epidemiology Online Network) web app, and the GIDEON series of ebooks.

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