Volume 21, Number 6—June 2015
Letter
Salmonella enterica Paratyphi A Infections in Travelers Returning from Cambodia, United States
To the Editor: Health authorities from Cambodia and European Union member states recently described a pronounced increase in Salmonella enterica serotype Paratyphi A infections in Cambodia resulting from an ongoing outbreak (1,2). To further characterize this outbreak, we analyzed 2013–2014 data on Paratyphi A infections associated with travel to Southeast Asia that were reported to the Centers for Disease Control and Prevention (CDC) National Typhoid and Paratyphoid Fever Surveillance (NTPFS) system and the CDC National Antimicrobial Monitoring System (NARMS).

NTPFS began tracking Salmonella Paratyphi A infections in 2008. During 2008–2012, ten cases were reported in patients who had traveled to Southeast Asia within 30 days before illness onset; only 1, who also reported travel to Sri Lanka, Nepal, and Nigeria, reported travel to Cambodia. During January 1, 2013–August 22, 2014, however, NTPFS received 19 reports of laboratory-confirmed Paratyphi A infection in travelers returning from Southeast Asia; 13 traveled to Cambodia, and 8 of them reported travel only to Cambodia (Table). Of the 7 patients who traveled only to Cambodia and reported reason for travel, all cited “visiting friends and relatives.” Six (75%) of the 8 patients who traveled only to Cambodia were hospitalized (median duration 7 days, range 2–10 days), and all recovered. Cases occurring in 2014, especially later in the year, might not yet have been reported, so the 2014 data most likely are an underestimate. Although many cases reported to health authorities in Cambodia and the European Union clustered in the Phnom Penh region (1,2), we lack information about destinations within Cambodia for US patients.
https://wwwnc.cdc.gov/eid/article/21/6/15-0088_article