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. 2024 Jan 11:152:e17.
doi: 10.1017/S0950268823002017.

Multistate nontyphoidal Salmonella and Shiga toxin-producing Escherichia coli outbreaks linked to international travel-United States, 2017-2020

Caroline A Habrun  1   2 , Meseret G Birhane  1 , Louise K François Watkins  1 , Katharine Benedict  1 , Lyndsay Bottichio  1 , Kaylea Nemechek  1   3 , Beth Tolar  1 , Morgan N Schroeder  1 , Jessica C Chen  1 , Hayat Caidi  1 , Misha Robyn  1 , Megin Nichols  1
Affiliations

Multistate nontyphoidal Salmonella and Shiga toxin-producing Escherichia coli outbreaks linked to international travel-United States, 2017-2020

Caroline A Habrun et al. Epidemiol Infect. .

Abstract

Enteric bacterial infections are common among people who travel internationally. During 2017-2020, the Centers for Disease Control and Prevention investigated 41 multistate outbreaks of nontyphoidal Salmonella and Shiga toxin-producing Escherichia coli linked to international travel. Resistance to one or more antimicrobial agents was detected in at least 10% of isolates in 16 of 30 (53%) nontyphoidal Salmonella outbreaks and 8 of 11 (73%) Shiga toxin-producing E. coli outbreaks evaluated by the National Antimicrobial Resistance Monitoring System. At least 10% of the isolates in 14 nontyphoidal Salmonella outbreaks conferred resistance to one or more of the clinically significant antimicrobials used in human medicine. This report describes the epidemiology and antimicrobial resistance patterns of these travel-associated multistate outbreaks. Investigating illnesses among returned travellers and collaboration with international partners could result in the implementation of public health interventions to improve hygiene practices and food safety standards and to prevent illness and spread of multidrug-resistant organisms domestically and internationally.

Keywords: STEC; Salmonella; antimicrobial resistance; international travel; outbreak; travel-associated.

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Conflict of interest statement

The authors declare none.

Figures

Figure 1.
Figure 1.
Number of travel-associated multistate outbreaks and number of ill people by pathogen per year—United States, 2017–2020.
Figure 2.
Figure 2.
Proportion of multistate travel-associated nontyphoidal Salmonella outbreaks and serotypes by destination of travel in Latin America/Caribbean prior to illness onset—United States, 2017–2020. Five Salmonella outbreaks consisted of people reporting travel to two Latin America/Caribbean travel destinations prior to illness onset or people in the outbreak reporting travel to different Latin America/Caribbean travel destinations.
Figure 3.
Figure 3.
Number of ill people and specimen source in multistate travel-associated outbreaks by age group—United States, 2017–2020. Variables are reported based on information available. Unknown data were considered missing. Information on age and source was available for 977 ill people. *Other sources included skin, wound, gall bladder, abscess, respiratory cerebrospinal fluid, or other tissue or body fluid.
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