Ryan C A, Hargrett-Bean N T, Blake P A
Division of Bacterial Diseases, Centers for Disease Control, Atlanta, Georgia 30333.
Rev Infect Dis. 1989 Jan-Feb;11(1):1-8. doi: 10.1093/clinids/11.1.1.
To explore changes in the epidemiology of typhoid fever in the United States, cases reported to the Morbidity and Mortality Weekly Report (MMWR) and typhoid case report forms submitted by state and local governments are reviewed. The incidence of typhoid fever in the United States fell from one case per 100,000 population in 1955 to 0.2 cases per 100,000 in 1966 and has since remained fairly stable. Review of case report forms for 2,666 cases of acute typhoid fever that occurred between 1975 and 1984 showed that 62% were imported, in contrast to only 33% during 1967-1972. The proportion of cases imported has continued to rise, reaching 69% in 1984. The major sources of the 1975-1984 cases were Mexico (39%) and India (14%). The case-fatality rate was 1.3%. Antimicrobial resistance was a minor problem, and large outbreaks were unusual. Further decline in the incidence of typhoid fever in the United States probably must await the advent of an effective vaccine with minimal adverse effects for use by travelers.
为探究美国伤寒热流行病学的变化，我们对向《发病率与死亡率周报》（MMWR）报告的病例以及州和地方政府提交的伤寒病例报告表进行了审查。美国伤寒热的发病率从1955年的每10万人1例降至1966年的每10万人0.2例，此后一直保持相当稳定。对1975年至1984年间发生的2666例急性伤寒热病例报告表的审查显示，62%的病例为输入性病例，相比之下，1967年至1972年间这一比例仅为33%。输入性病例的比例持续上升，1984年达到69%。1975年至1984年病例的主要来源地是墨西哥（39%）和印度（14%）。病死率为1.3%。抗菌素耐药性是一个小问题，大规模疫情并不常见。美国伤寒热发病率的进一步下降可能必须等待出现一种对旅行者副作用最小的有效疫苗。
