Salmonellosis Epidemiology

Salmonella typhi and Salmonella paratyphi, which cause typhoid fever, have high host specificity for humans. In the United States, typhoid fever has become less prevalent and is associated primarily with international travel, especially to developing countries. Nontyphoidal Salmonella are important causes of reportable food-borne infection. There are an estimated 1.4 million cases of nontyphoid Salmonella illness an-

nually in the United States. The highest incidence is in those younger than 1 year of age and older than 65 years of age or in those with HIV/AIDS. Outbreaks of intestinal salmonellosis have been associated with unpasteurized orange juice, tomatoes, cantaloupe, alfalfa sprouts, and cilantro, among others. Exotic pets, especially reptiles (e.g., snakes, turtles, and iguanas), are an increasing source of human salmonellosis, accounting for 3% to 5% of all cases.

Risk factors for salmonellosis include extremes of age, alteration of the endogenous bowel flora of the intestine (e.g., as a result of antimicrobial therapy or surgery), diabetes, malignancy, rheumatologic disorders, HIV infection, and therapeutic immunosuppression of all types.

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