Background
Methods
Setting
Laboratory testing and methods
Case ascertainment and data collection
Comparison of travel-related (TR) and domestically-acquired (DA) cases
Salmonella Enteritidis (SE) risks associated with travel
Results
Comparison of travel-related (TR) and domestically-acquired (DA) Salmonella Enteritidis (SE) cases
Travel | Domestic | Total | P value* | ||||
---|---|---|---|---|---|---|---|
n | % | n | % | n | % | ||
Age (median)
| |||||||
Median (yrs) | 35 | 21 | <0.001 | ||||
0–11 | 51 |
15.7
| 93 |
31.0
| 144 |
23.1
| |
12–19 | 25 |
7.7
| 47 |
15.7
| 72 |
11.5
| |
20–34 | 83 |
25.6
| 64 |
21.3
| 147 |
23.6
| |
35–54 | 105 |
32.4
| 54 |
18.0
| 159 |
25.5
| |
55–64 | 40 |
12.3
| 17 |
5.7
| 57 |
9.1
| |
65+ | 20 |
6.2
| 25 |
8.3
| 45 |
7.2
| |
Male**
| 175 |
54.2
| 153 |
51.3
| 328 |
52.6
| 0.479 |
Symptoms
§
| |||||||
Diarrhea | 320 |
99.4
| 291 |
98.0
| 611 |
98.7
| 0.124 |
Abdominal Cramps | 280 |
88.3
| 252 |
86.9
| 532 |
87.6
| 0.686 |
Nausea | 213 |
66.4
| 152 |
51.7
| 365 |
59.4
| <0.001 |
Vomiting | 127 |
39.7
| 116 |
39.3
| 243 |
39.5
| 0.926 |
Fever | 219 |
68.4
| 217 |
73.1
| 436 |
70.7
| 0.523 |
Other | 214 |
68.2
| 183 |
62.5
| 397 |
65.4
| 0.140 |
Visited Emergency Room†
| 105 |
33.4
| 131 |
45.2
| 236 |
36.8
| 0.003 |
Admitted to hospital‡ | 16 |
5.1
| 45 |
15.2
| 61 |
10.0
| <0.001 |
Salmonella Enteritidis (SE) risks associated with travel to various world regions and countries
Travel region/country | Estimated no. of travelers† | Controls† | Reported cases†† | Rate/100 000 |
---|---|---|---|---|
Africa | 108,486 | 75 | 6 | 5.53 |
Asia | 419,489 | 449 | 15 | 3.58 |
Caribbean and Mexico | 1,173,785 | 1,682 | 283 | 24.11 |
Antigua
|
17,433
|
16
|
13
|
74.57
|
Cuba
|
287,797
|
418
|
77
|
26.75
|
Dominican Republic
|
370,653
|
549
|
108
|
29.14
|
Jamaica
|
57,465
|
78
|
53
|
92.23
|
Mexico
|
254,160
|
418
|
17
|
6.69
|
Other*
|
186,277
|
203
|
15
|
8.05
|
Central America | 85,476 | 112 | 4 | 4.68 |
Europe | 1,267,932 | 1,240 | 8 | 0.63 |
Oceania | 26,521 | 52 | 1 | 3.77 |
South America | 106,769 | 100 | 3 | 2.81 |
USA | 5,920,574 | 13,160 | 2 | 0.03 |
Total
|
9,109,032
|
16,870
|
322
|
3.53
|
Unadjusted | Adjusted* | |||
---|---|---|---|---|
OR | 95% CI | OR | 95% CI | |
World Region Analysis (Cases: 318, Controls: 3,454)†
| ||||
Region
| ||||
Europe
| Ref |
-
| Ref |
-
|
Africa
| 12.40 |
4.20–36.66
| 14.01 |
4.68–41.91
|
Asia
| 5.18 |
2.18–12.30
| 6.41 |
2.67–15.41
|
Central America
| 5.54 |
1.64–18.67
| 5.85 |
1.71–20.03
|
Caribbean
| 32.37 |
15.95–65.70
| 37.29 |
17.87–77.82
|
North America (Mexico only)
| 6.30 |
2.70–14.71
| 6.89 |
2.86–16.60
|
Oceania
| 2.98 |
0.37–24.28
| 3.68 |
0.45–30.25
|
South America
| 4.65 |
1.22–17.80
| 5.71 |
1.48–22.08
|
Age (years)
| ||||
0–11 | 9.53 |
5.50–16.49
| 7.85 |
4.37–14.13
|
12–19 | 3.22 |
1.75–5.92
| 2.36 |
1.25–4.46
|
20–34 | 3.60 |
2.18–5.96
| 2.31 |
1.37–3.90
|
35–54 | 2.32 |
1.42–3.79
| 1.61 |
0.97–2.66
|
55–64 | 1.31 |
0.75–2.29
| 1.08 |
0.61–1.91
|
65+ | Ref |
-
| Ref |
-
|
Travel Period: “Winter” | 0.50 |
0.39 – 0.65
| 1.31 |
0.98–1.74
|
Caribbean Country and Mexico Sub-Analysis (Cases: 279, Controls: 1,489)‡
| ||||
Country
| ||||
Mexico
| Ref |
-
| Ref |
-
|
Cuba
| 4.53 |
2.63–7.79
| 4.75 |
2.73–8.25
|
Dominican Republic
| 4.84 |
2.86–8.19
| 5.00 |
2.92–8.56
|
Jamaica
| 16.71 |
9.19–30.36
| 17.28 |
9.29–32.13
|
Antigua
| 19.98 |
8.30–48.07
| 19.63 |
7.78–49.52
|
Curacao
| 1.12 |
0.25–5.00
| 1.50 |
0.33–6.91
|
Bahamas
| 2.20 |
0.78–6.18
| 2.02 |
0.70–5.85
|
Barbados
| 12.29 |
2.83–53.38
| 13.18 |
2.96–58.69
|
St. Lucia
| 8.20 |
0.81–82.95
| 6.59 |
0.64–68.44
|
Age (years)
| ||||
0–11 | 5.35 |
2.91–9.83
| 5.75 |
3.02–10.95
|
12–19 | 2.10 |
1.08–4.08
| 2.39 |
1.20–4.77
|
20–34 | 2.12 |
1.23–3.63
| 1.78 |
1.01–3.14
|
35–54 | 1.42 |
0.84–2.39
| 1.28 |
0.74–2.20
|
55–64 | 0.80 |
0.44–1.48
| 0.80 |
0.43–1.50
|
65+ | Ref |
–
| Ref |
–
|
Travel Period: “Winter” | 1.83 |
1.36–2.46
| 1.35 |
0.96–1.89
|
Travel characteristics and phage type (PT) distributions by common travel destination among travel-related cases
Country and phage type | 2010* | 2011** | Total | |||
---|---|---|---|---|---|---|
n | % | n | % | n | % | |
Antigua
| ||||||
13a
| 0 | 0.0 | 6 | 46.2 | 6 | 46.2 |
8
| 0 | 0.0 | 7 | 53.8 | 7 | 53.8 |
Total
| 0 |
-
| 13 |
100.0
| 13 |
100.0
|
Cuba
| ||||||
4 | 2 | 8.3 | 2 | 3.8 | 4 | 5.2 |
5b | 18 | 75.0 | 27 | 50.9 | 45 | 58.4 |
8 | 1 | 4.2 | 2 | 3.8 | 3 | 3.9 |
Atypical | 2 | 8.3 | 21 | 39.6 | 23 | 29.9 |
Other1
| 1 | 4.2 | 1 | 1.9 | 2 | 2.6 |
Total
|
24
|
100.0
|
53
|
100.0
|
77
|
100.0
|
Dominican Republic
| ||||||
1 | 14 | 100.0 | 82 | 87.2 | 96 | 88.9 |
53 | 0 | 0 | 2 | 2.1 | 2 | 1.9 |
5b | 0 | 0 | 2 | 2.1 | 2 | 1.9 |
8 | 0 | 0 | 3 | 3.2 | 3 | 2.8 |
Other2
| 0 | 0 | 5 | 5.3 | 5 | 4.6 |
Total
| 14 |
100.0
| 94 |
100.0
| 108 |
100.0
|
Jamaica
| ||||||
13a | 5 | 50.0 | 25 | 58.1 | 30 | 56.6 |
8 | 5 | 50.0 | 14 | 32.6 | 19 | 35.8 |
2 | 0 | 0.0 | 2 | 4.7 | 2 | 3.8 |
Other3
| 0 | 0.0 | 2 | 4.7 | 2 | 3.8 |
Total
|
10
|
100.0
|
43
|
100.0
|
53
|
100.0
|
Mexico
| ||||||
7a | 2 | 66.7 | 6 | 42.9 | 8 | 47.1 |
21 | 0 | 0.0 | 2 | 14.3 | 2 | 11.8 |
Other4
| 1 | 33.3 | 6 | 42.9 | 7 | 41.2 |
Total
| 3 |
100.0
| 14 |
100.0
| 17 |
100.0
|