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Current Trends Human Salmonella Isolates -- United States, 1982

In 1982, 36,705 salmonellae isolates (including Salmonella typhi) from humans were reported to CDC. This represents an increase of 3% over the 35,625 isolates reported in 1981. The increase was not confined to one state or region; North Dakota reported a 117% increase (108 to 234) from 1981; Oklahoma, a 55% increase (173 to 269); Rhode Island, a 49% increase (145 to 216); Wisconsin, a 41% increase (738 to 1,042); Washington, a 38% increase (566 to 781); California, a 36% increase (3,337 to 4,536); and Massachusetts, a 27% increase (1,922 to 2,446).

The 10 most frequently isolated serotypes comprised almost 70% of total isolates (Table 4). Notable increases from 1981 were reported in three of these serotypes: S. thompson increased 84% (364 to 670); S. enteritidis increased 27% (2,554 to 3,248); and S. heidelberg increased 25% (2,049 to 2,566). Increases were also reported in some less frequently isolated serotypes: S. meleagridis increased 372% (32 to 151); S. alachua increased 226% (27 to 88); S. haardt increased 134% (53 to 124); and S. mbandaka increased 76% (110 to 194).

For some serotypes, increases clustered in one or more states. An increase in S. mbandaka and S. alachua from Minnesota, Oregon, and Washington was due to infected infants from India adopted into American families. Outbreaks of S. enteritidis and S. meleagridis were reported in Massachusetts, but no vehicles were identified. Increases in S. thompson were reported in California, Hawaii, Kansas, and Massachusetts. An outbreak of S. thompson in California was associated with gravy served at a chicken fast-food outlet; and in Kansas, an outbreak occurred in a prison system, but no vehicle was identified. Outbreaks caused by S. thompson also occurred in Florida and Massachusetts, but no specific vehicles were implicated. Increases of sporadic cases of S. haardt were reported in California, New York, and Virginia. Increases in S. heidelberg were not confined to a single state or region.

Age data were reported for 81% of the isolates (Figure 1). The rate was highest for 2- to 4-month-old infants, decreased abruptly among age groups of early childhood, and then remained relatively constant through the adult years. The rate of Salmonella isolation was slightly higher among males than among females in the under-20-year age group; it was slightly higher among females than among males in the 20- to 69-year age group. This is consistent with data from previous years. During the past 15 years, the median age of all persons from whom isolates were obtained has continued to increase from a median of 6 years in 1968 to 14 years in 1982.

In 1982, 21 of 492 reported S. typhi isolates were from carriers; 98, from patients; and the remaining 373, undesignated. The carriers' median age was 60, while that of the new patients was 23.5 Reported by Statistical Svcs Activity, Enteric Diseases Br, Div of Bacterial Diseases, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: This report is based on the Salmonella surveillance activity conducted by the Association of State and Territorial Epidemiologists and by CDC. It is a passive laboratory-based system that receives weekly reports from the states and the District of Columbia and regular summaries from the U.S. Department of Agriculture. The reports do not distinguish between clinical and subclinical infections or between chronic and convalescent carriers. Many factors affect whether an infection will be reported; however, these data permit comparison with past and future tabulations and have provided information for epidemiologic investigations and a crude index of the effectiveness of various public health measures.

The number of reported Salmonella isolations has been steadily increasing since 1977, but the 1982 increase (3%) was much less than that in 1981 (19%). The gradual increase in the last few years in the median age of all persons from whom isolates are obtained may indicate a shift in age-specific rates of exposure to contaminated vehicles.

In many outbreaks, the cause was a relatively uncommon serotype, which points to the importance of serotyping Salmonella. Outbreaks caused by common serotypes are less likely to be recognized. Recently, application of molecular biologic techniques, such as plasmid profile analysis, to epidemiologic studies has provided additional means of identifying outbreaks caused by common serotypes.

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