An Outbreak of Typhoid Fever in Florida Associated with an Imported Frozen Fruit

• Published in: The Journal of infectious diseases Vol. 186; no. 2; pp. 234 - 239
• Main Authors: Katz, Dolores J., Cruz, Miguel A., Trepka, Mary Jo, Suarez, Juan A., Fiorella, Paul D., Hammond, Roberta M.
• Format: Journal Article
• Language: English
• Published: Chicago, IL The University of Chicago Press 15.07.2002; University of Chicago Press; Oxford University Press
• Subjects: Adolescent; Adult; Aged; Bacterial diseases; Biological and medical sciences; Child; Child, Preschool; Disease Outbreaks; Diseases; DNA, Bacterial - chemistry; DNA, Bacterial - genetics; Electrophoresis, Gel, Pulsed-Field; Epidemiology; Feces - microbiology; Female; Florida - epidemiology; Food safety; Foodborne illnesses; Frozen Foods - microbiology; Fruit - microbiology; Guatemala; Honduras; Human bacterial diseases; Humans; Infectious diseases; Major Articles; Male; Medical sciences; Middle Aged; Miscellaneous; Notifiable diseases; Preventive medicine; Salmonella; Salmonella Food Poisoning - blood; Salmonella Food Poisoning - epidemiology; Salmonella Food Poisoning - microbiology; Salmonella typhi; Salmonella typhi - isolation & purification; Typhoid fever; Typhoid Fever - blood; Typhoid Fever - epidemiology; Typhoid Fever - microbiology; Guatemala; Florida; Honduras; Epidemic; Human; Import; Fruit; Frozen food; Salmonella typhi; Typhoid; Infection; Etiology; Food poisoning; Bacteriosis; Bacteria; Salmonellosis; Food safety; Biological contamination; Enterobacteriaceae
• ISSN: 0022-1899; 1537-6613
• DOI: 10.1086/341208

An outbreak of typhoid fever in Florida involving at least 16 persons during the winter of 1998-99 was investigated using case-control, environmental, and laboratory methods. The genomic profiles of Salmonella serovar Typhi (Salmonella Typhi) isolates from the 15 confirmed case subjects were identical. Consumption of fruit shakes made with frozen mamey, a tropical fruit, was significantly associated with illness (matched odds ratio, 7.6; 95% confidence interval, 1.4–81.4). Laboratory testing showed that the fruit was heavily contaminated with fecal coliforms; no Salmonella Typhi was isolated. The frozen mamey was prepared in plants in Guatemala and Honduras. No further cases occurred after the frozen product was recalled. As our nation’s food sources become increasingly globalized, the risk of outbreaks of exotic diseases linked to contaminated imported food will increase. This outbreak highlights the need for new approaches to ensure the safety of our food supply