Researchers analyzed travel-related infections among people who returned to the United States from abroad.
From 2017 to 2020, the Centers for Disease Control and Prevention investigated 41 multistate outbreaks of nontyphoidal Salmonella and Shiga toxin-producing E. coli (STEC) associated with international travel.
During the same period, CDC handled 470 domestically confirmed multistate outbreaks caused by Salmonella, STEC, and Listeria monocytogenes.
CDC has investigated 30 Salmonella outbreaks and 11 STEC outbreaks associated with international travel. There were 1,666 cases of illness among residents of 49 states and the District of Columbia.
Research published in journals epidemiology and infectious diseasesNow, we have explained in detail about infectious diseases related to overseas travel. It was acknowledged that the number of Salmonella and STEC illnesses is likely an underestimate due to self-limited infections that resolve before return to the United States.
Outbreaks linked to popular destinations
Salmonella outbreaks represented eight serotypes: Brendup, Concord, Enterotidis, Munich, Newport, Strathcona, Thompson, and Salmonella Typhimurium and were associated with multiple regions. Most of the outbreaks are associated with Latin America and the Caribbean.
The 11 STEC outbreaks included four serotypes: O111, O157, O103, and O123/O186, all associated with travel to Mexico. Mexico was the most common foreign destination for U.S. travelers from 2017 to 2020.
Salmonella outbreaks ranged from 4 to 365 people, and STEC outbreaks ranged from 5 to 12 people. Salmonella outbreaks tended to occur year-round, whereas STEC outbreaks typically began in winter or spring.
Of the 1,066 illnesses, 982 were salmonella infections. The patients ranged in age from less than a year old to 87 years old, more than 550 were women, seven were hospitalized, and three died.
The STEC outbreak affected 84 people. Patients ranged in age from less than 1 year to 90 years, and 50 were female. One person was hospitalized and another died.
The ages of the deceased ranged from 17 to 82 years, and three had Salmonella Newport infection and one had O103:H2 infection.
Improving hygiene and food safety standards
Of the 631 people with epidemiological information available, 437 reported international travel. Travelers on the list took 317 trips to Mexico and 81 trips to the Dominican Republic. All 62 STEC patients mentioned traveling to Mexico.
Salmonella enteritidis caused all outbreaks associated with the Dominican Republic and Jamaica, and Salmonella Newport and STEC outbreaks were all associated with Mexico. Some outbreaks have been linked to travel to Europe, Thailand, the Philippines, and Caribbean cruises.
This study used people who reported international travel in the 7 days before onset of symptoms as the exposure criterion to define a travel-related outbreak. This may have resulted in the inclusion of people infected domestically or the exclusion of people with travel-related infections due to short or long incubation periods. Single-state travel-related outbreaks are not included because data are not available.
The scientists also looked at antimicrobial resistance patterns in travel-related outbreaks.
Researchers said investigating illnesses in returned travelers and working with international partners could lead to the implementation of public health interventions to improve hygiene practices and food safety standards. Ta.
“Our findings demonstrate that improved epidemiological understanding of enterobacterial diseases associated with international travel could provide insight into the development of public health guidance for travelers and health care workers. “This study highlights the potential for a better understanding of the challenges faced by other regions when it comes to preventing enteric diseases,” the researchers added.
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