Emergence of Extensively Drug-Resistant <i>Salmonella</i> Typhi Infections Among Travelers to or from Pakistan — United States, 2016–2018

Chatham‐Stephens, Kevin; Medalla, Felicita; Hughes, Michael; Appiah, Grace D.; Aubert, Rachael D.; Caidi, Hayat; Angelo, Kristina M.; Walker, Allison Taylor; Hatley, Noël; Masani, Sofia; Nash, June; Belko, John S.; Ryan, Edward T.; Mintz, Eric D.; Friedman, Cindy R.

doi:10.15585/mmwr.mm6801a3

Cited by 117 publications

(94 citation statements)

References 4 publications

(7 reference statements)

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“…Similarly, a retrospective study conducted in Qatar, between 2005 and 2012, reported 356 cases of typhoid fever, of whom 96.9% had traveled abroad, mainly in the Indian subcontinent [17]. Over 70% of typhoid fever cases in Europe are acquired abroad and frequently caused by strains with marked antibiotic resistance profile [18,19].…”

Section: Introductionmentioning

confidence: 99%

Travel-Related Typhoid Fever: Narrative Review of the Scientific Literature

Muresu

Sotgiu

Are

et al. 2020

IJERPH

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Enteric fever is a foodborne infectious disease caused by Salmonella enterica serotypes Typhi and Paratyphi A, B and C. The high incidence in low income countries can increase the risk of disease in travelers coming from high income countries. Pre-travel health advice on hygiene and sanitation practices and vaccines can significantly reduce the risk of acquiring infections. Although the majority of the cases are self-limiting, life-threatening complications can occur. Delayed diagnosis and cases of infections caused by multi-drug resistant strains can complicate the clinical management and affect the prognosis. More international efforts are needed to reduce the burden of disease in low income countries, indirectly reducing the risk of travelers in endemic settings. Surveillance activities can help monitor the epidemiology of cases caused by drug-susceptible and resistant strains.

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Section: Introductionmentioning

confidence: 99%

Travel-Related Typhoid Fever: Narrative Review of the Scientific Literature

Muresu

Sotgiu

Are

et al. 2020

IJERPH

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“…1,2 Over the past 2 years, seven cases have been reported in returned travellers -mostly children -from Pakistan to England, Germany and the United States. 1, 3,4 We report here the first case of XDR typhoid identified in Australia. A 20-month-old Australian-born girl presented to the Children's Hospital at Westmead with features of enteric fever 14 days after her return from a 3-month trip to Karachi.…”

Section: First Reported Case Of Extensively Drug-resistant Typhoid Inmentioning

confidence: 83%

“…Since 2016, an extensively drug‐resistant (XDR) typhoid clade has emerged in Pakistan, showing resistance to all first‐line agents . Over the past 2 years, seven cases have been reported in returned travellers — mostly children — from Pakistan to England, Germany and the United States …”

mentioning

confidence: 99%

First reported case of extensively drug‐resistant typhoid in Australia

Howard‐Jones

Kesson

Outhred

et al. 2019

Medical Journal of Australia

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“…& Recent travel to Pakistan: Carbapenem or azithromycin -Ongoing outbreak of multidrug-resistant strain of S. typhi since 2016 [35] Traveler's Diarrhea…”

Section: Managementmentioning

confidence: 99%

Management of Travel-Related Infectious Diseases in the Emergency Department

Throckmorton

Hancher

2020

Curr Emerg Hosp Med Rep

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Purpose of Review Emergency physicians generally have limited exposure to internationally acquired illnesses. However, travelers can present quite ill, and delays in recognition and treatment can lead to increased morbidity and mortality. This paper aims to summarize typical presentations of common international diseases and provide the emergency physician with a practical approach based on current guidelines. Recent Findings In the treatment of traveler's diarrhea, azithromycin has become the treatment of choice due to the growing antibiotic resistance. Intravenous artesunate was approved in 2019 under investigational new drug protocol for the treatment of severe malaria, and artemisinin-based combination therapies (ACTs) have become the first-line treatment for most cases of uncomplicated malaria. Since the 2015 outbreak, Zika has become a concern to many travelers, but the current treatment is supportive. Summary Clinicians should be aware of a few noteworthy updates in the treatment of internationally acquired illnesses, but more importantly, they must recognize warning signs of severe illness and treat promptly. Future research on workup and disposition could help emergency physicians identify which patients need admission in well-appearing febrile travelers.

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Emergence of Extensively Drug-Resistant Salmonella Typhi Infections Among Travelers to or from Pakistan — United States, 2016–2018

Cited by 117 publications

References 4 publications

Travel-Related Typhoid Fever: Narrative Review of the Scientific Literature

Travel-Related Typhoid Fever: Narrative Review of the Scientific Literature

First reported case of extensively drug‐resistant typhoid in Australia

Management of Travel-Related Infectious Diseases in the Emergency Department

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