TYPHOID-FEVER AT A RESORT HOTEL IN NEW-YORK - A LARGE OUTBREAK WITH AN UNUSUAL VEHICLE

The largest outbreak of typhoid fever in the United States since, 1981 occurred in 1989 among guests and staff at a New York hotel. There we re 43 culture-confirmed and 24 probable cases among guests, 1 culture- confirmed case and 1 asymptomatic culture-positive case among hotel em ployees, and 1 culture-confirmed secondary case. Twenty-one persons we re hospitalized and 2 had bowel perforation. Breakfast on 13 June was the only meal consumed by all ill persons (relative risk, infinite; P = .004). In a case-control study, case-patients were more likely than controls to have consumed orange juice (odds ratio, 5.6; 95% confidenc e interval, 1.1-54.7), which had been prepared in a 208-L container wi th ample opportunity for hand contact. No other food was associated wi th illness. S. typhi was isolated from the stool of an asymptomatic fo od worker who handled orange juice but who was not known to be a typho id carrier. S. typhi is a foodborne pathogen with continuing potential to cause large outbreaks in the United States.