5023.0: Wednesday, November 15, 2000 - 9:10 AM

Abstract #5175

Outbreak of typhoid fever associated with the consumption of frozen mamey fruit

Miguel A. Cruz1, Dolores E. Katz2, Juan Suarez3, Mary Jo Trepka4, Roberta Hammond3, and Paul Fiorella5. (1) National Center for Environmental Health, Centers for Disease Control and Prevention, 4770 Buford Highway, Mail stop F-38, Atlanta, GA 30341, 770-488-7100, mgc8@cdc.gov, (2) Bureau of Epidemiology, Florida Department of Health, (3) Bureau of Environmental Epidemiology, Florida Department of Health, (4) Office of Epidemiology and Disease Control, Miami-Dade County Health Department, (5) Bureau of Laboratories, Florida Department of Health

From December 1998 through February 1999, 16 laboratory-confirmed cases of typhoid fever were reported in Florida residents with no history of international travel. Fourteen of the cases were in Hispanic persons. The central state laboratory, performed pulse field gel electrophoresis (PFGE) on Salmonella Typhi isolates from 15 of the patients, all were identical. The Florida Department of Health conducted a case-control study, matching each case with 1 to 4 controls of the same age and ethnic background. Telephone interviewers, fluent in Spanish and English, interviewed cases and their matched controls in the case's language using a standard questionnaire that asked about food and beverage consumption. Consumption of shakes (batidos) made with frozen mamey was the only item associated with illness (matched odds ratio 8.8., 95% confidence interval 1.6 - 89.4). The frozen product is commercially imported from Central America. Tests on unopened packages of several brands tested found no S. Typhi but high levels of fecal coliforms and E. coli. The Florida Department of Agriculture and Consumer Services as well as the Florida Department of Business and Professional Regulation, ordered all frozen mamey removed from commercial sale. The Food and Drug Administration announced a voluntary recall of three brands of the product. This is the first report of a typhoid fever outbreak in the United States associated with a commercially imported food product. The expanding role of imported food consumption creates the potential for the introduction of exotic pathogens into the american food chain.

Learning Objectives: Demonstrate the power of classic epidemiologic methods combined with modern molecular epidemiology to quickly identify outbreaks; emphasizes the importance of specific disease surveillance to detect outbreaks of foodborne illness; show the importance of having public health personnel who are familiar with the language, and culture of the affected populations

Keywords: Food Safety, Emerging Health Issues

Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: None
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.

The 128th Annual Meeting of APHA