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Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or from Pakistan - United States, 2016-2018.
MMWR Morb Mortal Wkly Rep. 2019 Jan 11; 68(1):11-13.MM

Abstract

In February 2018, a typhoid fever outbreak caused by Salmonella enterica serotype Typhi (Typhi), resistant to chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, fluoroquinolones, and third-generation cephalosporins, was reported in Pakistan. During November 2016-September 2017, 339 cases of this extensively drug-resistant (XDR) Typhi strain were reported in Pakistan, mostly in Karachi and Hyderabad; one travel-associated case was also reported from the United Kingdom (1). More cases have been detected in Karachi and Hyderabad as surveillance efforts have been strengthened, with recent reports increasing the number of cases to 5,372 (2). In the United States, in response to the reports from Pakistan, enhanced surveillance identified 29 patients with typhoid fever who had traveled to or from Pakistan during 2016-2018, including five with XDR Typhi. Travelers to areas with endemic disease, such as South Asia, should be vaccinated against typhoid fever before traveling and follow safe food and water practices. Clinicians should be aware that most typhoid fever infections in the United States are fluoroquinolone nonsusceptible and that the XDR Typhi outbreak strain associated with travel to Pakistan is only susceptible to azithromycin and carbapenems.

Authors

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Pub Type(s)

Journal Article

Language

eng

PubMed ID

30629573

Citation

Chatham-Stephens, Kevin, et al. "Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or From Pakistan - United States, 2016-2018." MMWR. Morbidity and Mortality Weekly Report, vol. 68, no. 1, 2019, pp. 11-13.
Chatham-Stephens K, Medalla F, Hughes M, et al. Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or from Pakistan - United States, 2016-2018. MMWR Morb Mortal Wkly Rep. 2019;68(1):11-13.
Chatham-Stephens, K., Medalla, F., Hughes, M., Appiah, G. D., Aubert, R. D., Caidi, H., Angelo, K. M., Walker, A. T., Hatley, N., Masani, S., Nash, J., Belko, J., Ryan, E. T., Mintz, E., & Friedman, C. R. (2019). Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or from Pakistan - United States, 2016-2018. MMWR. Morbidity and Mortality Weekly Report, 68(1), 11-13. https://doi.org/10.15585/mmwr.mm6801a3
Chatham-Stephens K, et al. Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or From Pakistan - United States, 2016-2018. MMWR Morb Mortal Wkly Rep. 2019 Jan 11;68(1):11-13. PubMed PMID: 30629573.
* Article titles in AMA citation format should be in sentence-case
TY - JOUR T1 - Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or from Pakistan - United States, 2016-2018. AU - Chatham-Stephens,Kevin, AU - Medalla,Felicita, AU - Hughes,Michael, AU - Appiah,Grace D, AU - Aubert,Rachael D, AU - Caidi,Hayat, AU - Angelo,Kristina M, AU - Walker,Allison T, AU - Hatley,Noël, AU - Masani,Sofia, AU - Nash,June, AU - Belko,John, AU - Ryan,Edward T, AU - Mintz,Eric, AU - Friedman,Cindy R, Y1 - 2019/01/11/ PY - 2019/1/11/entrez PY - 2019/1/11/pubmed PY - 2019/1/12/medline SP - 11 EP - 13 JF - MMWR. Morbidity and mortality weekly report JO - MMWR Morb Mortal Wkly Rep VL - 68 IS - 1 N2 - In February 2018, a typhoid fever outbreak caused by Salmonella enterica serotype Typhi (Typhi), resistant to chloramphenicol, ampicillin, trimethoprim-sulfamethoxazole, fluoroquinolones, and third-generation cephalosporins, was reported in Pakistan. During November 2016-September 2017, 339 cases of this extensively drug-resistant (XDR) Typhi strain were reported in Pakistan, mostly in Karachi and Hyderabad; one travel-associated case was also reported from the United Kingdom (1). More cases have been detected in Karachi and Hyderabad as surveillance efforts have been strengthened, with recent reports increasing the number of cases to 5,372 (2). In the United States, in response to the reports from Pakistan, enhanced surveillance identified 29 patients with typhoid fever who had traveled to or from Pakistan during 2016-2018, including five with XDR Typhi. Travelers to areas with endemic disease, such as South Asia, should be vaccinated against typhoid fever before traveling and follow safe food and water practices. Clinicians should be aware that most typhoid fever infections in the United States are fluoroquinolone nonsusceptible and that the XDR Typhi outbreak strain associated with travel to Pakistan is only susceptible to azithromycin and carbapenems. SN - 1545-861X UR - https://www.unboundmedicine.com/medline/citation/30629573/Emergence_of_Extensively_Drug_Resistant_Salmonella_Typhi_Infections_Among_Travelers_to_or_from_Pakistan___United_States_2016_2018_ L2 - https://doi.org/10.15585/mmwr.mm6801a3 DB - PRIME DP - Unbound Medicine ER -