WHO 2016 Annual Report on Salmonella

National Enteric Disease Surveillance: Salmonella Annual Report, 2016

National Enteric Disease Surveillance:
Salmonella Annual Report, 2016
The Laboratory-based Enteric Disease Surveillance (LEDS) system contributes to the understanding of human salmonellosis in the United States by collecting reports of infections from state and regional public health laboratories. Reporting to LEDS is voluntary; the number of laboratories submitting reports varies somewhat from year to year, although almost all laboratories report every year. Diagnosing Salmonella infections based on results from culture-independent diagnostic tests (CIDTs) has become more common in recent years (1). Cases confirmed only by CIDT provide no serotype information and are listed in the “Unknown serotype” category. Occasionally, more than one isolate is reported from a single episode of infection in a person; this report includes only one isolate of a given Salmonella serotype per person within a 30-day period.
An overview of surveillance methods and systems for Salmonella infections is available at http://www.cdc.gov/nationalsurveillance/PDFs/NationalSalmSurveillOverview_508.pdf (2).
Data in this report are current as of February 28, 2018.
Summary
●  In 2016, 53 state and regional public health laboratories reported 46,623 cases of culture-confirmed
Salmonella infections to LEDS, which is 2.4% fewer than in 2015.
●  The incidence of culture-confirmed salmonellosis in 2016 declined to 14.51 cases per 100,000 population from 14.85 in 2015.
●  Whereas overall incidence of infection declined in 2016 compared with 2015, infections caused by serotypes Infantis, Muenchen, Montevideo, and Braenderup increased (Figure 1).
●  Reports of infection for which the isolate was not serotyped increased by 51% in 2016 compared with 2015 (1.75 vs 1.16 cases per 100,000 respectively).
●  As in previous years, infants (children <1 year old) had the highest incidence of infection (110.81 cases per 100,000 population for boys and 108.81 for girls; Table 1b).
●  Twenty-six states had incidence above the national average. More than half were in the South (AL, AR, GA, LA, MS, NC, OK, TN and SC) and Midwest (IA, MN, MO, ND, and SD) regions.
●  As in previous years, the largest percentage of cases were reported during the summer months.
1 For reporting year 2016, the LEDS Salmonella Annual Report only includes Salmonella infections confirmed by culture.
2 LEDS is currently unable to differentiate reports of culture-confirmed Salmonella infection of unknown serotype from reports of Salmonella diagnosed only by non-culture methods.
3 Geographic regions in this report are those defined by the United States Census Bureau (https://www.census.gov/geo/pdfs/maps-data/maps/ reference/us_regdiv.pdf)
4 The key to state name abbreviations can be found at http://www.census.gov/geo/reference/ansi_statetables.html.
Tables, Figures, and Appendices
Figure 1. Incidence rate of culture-confirmed human Salmonella infection reported to LEDS (all serotypes and individual serotypes with ≥1000 infections reported in 2016), by year, United States, 1970–2016                         4
Table 1a. Culture-confirmed human Salmonella infections reported to LEDS, with the 20 most frequently reported serotypes listed individually, United States, 2016                                                                           5
Table 1b. Incidence rate of culture-confirmed human Salmonella infections reported to LEDS, by age group and sex, United States, 2016 (n = 38,535 with age and sex information reported)                                                     5
Table 2. Percentage change among the 20 Salmonella serotypes most frequently reported to LEDS, comparing 2006, 2011, and 2016                                                                                                                               6
Figure 2a. Incidence rate of culture-confirmed human Salmonella infections reported to LEDS, by jurisdiction, United States, 2016 (n = 46,623)                                                                                                                7
Figure 2b. Incidence rate of culture-confirmed human Salmonella serotype Enteritidis infection reported to LEDS, by jurisdiction, United States, 2016 (n = 7,830)                                                                                             8
Figure 2c. Incidence rate of culture-confirmed human Salmonella serotype Newport infection reported to LEDS, by jurisdiction, United States, 2016 (n = 4,728)                                                                                             9
Figure 2d. Incidence rate of culture-confirmed human Salmonella serotype Typhimurium infection reported to LEDS, by jurisdiction, United States, 2016 (n = 4,581)                                                                                   10
Figure 2e. Incidence rate of culture-confirmed human Salmonella serotype Javiana infection reported to LEDS, by jurisdiction, United States, 2016 (n = 2,719)                                                                                                11
Figure 2f. Incidence rate of culture-confirmed human Salmonella serotype I 4,[5],12:i:- infection reported to LEDS, by jurisdiction, United States, 2016 (n = 2,179)                                                                                           12
Figure 2g. Incidence rate of culture-confirmed human Salmonella serotype Infantis infection reported to LEDS, by jurisdiction, United States, 2016 (n = 1,281)                                                                                                13
Figure 2h. Incidence rate of culture-confirmed human Salmonella serotype Muenchen infection reported to LEDS, by jurisdiction, United States, 2016 (n = 1,216)                                                                                           14
Figure 2i. Incidence rate of culture-confirmed human Salmonella serotype Montevideo infection reported to LEDS, by jurisdiction, United States, 2016 (n = 1,018)                                                                                   15
Figure 2j. Incidence rate of culture-confirmed human Salmonella serotype Braenderup infection reported to LEDS, by jurisdiction, United States, 2016 (n = 1,001)                                                                                           16
Figure 2k. Incidence rate of culture-confirmed human Salmonella serotype Thompson infection reported to LEDS, by jurisdiction, United States, 2016 (n = 792)                                                                                              17
Figure 2l. Incidence rate of culture-confirmed human Salmonella serotype Saintpaul infection reported to LEDS, by jurisdiction, United States, 2016 (n = 778)                                                                                              18
Figure 2m. Incidence rate of culture-confirmed human Salmonella serotype Heidelberg infection reported to LEDS, by jurisdiction, United States, 2016 (n = 754)                                                                                     19
Figure 2n. Incidence rate of culture-confirmed human Salmonella serotype Oranienburg infection reported to LEDS, by jurisdiction, United States, 2016 (n = 692)                                                                                     20
Figure 2o. Incidence rate of culture-confirmed human Salmonella serotype Mississippi infection reported to LEDS, by jurisdiction, United States, 2016 (n = 536)                                                                                              21
Figure 2p. Incidence rate of culture-confirmed human Salmonella serotype Typhi infection reported to LEDS, by jurisdiction, United States, 2016 (n = 423)                                                                                                  22
Figure 2q. Incidence rate of culture-confirmed human Salmonella serotype Bareilly infection reported to LEDS, by jurisdiction, United States, 2016 (n = 412)                                                                                                  23
Figure 2r. Incidence rate of culture-confirmed human Salmonella serotype Berta infection reported to LEDS, by jurisdiction, United States, 2016 (n = 369)                                                                                                  24
Figure 2s. Incidence rate of culture-confirmed human Salmonella serotype Agona infection reported to LEDS, by jurisdiction, United States, 2016 (n = 362)                                                                                                  25
Figure 2t. Incidence rate of culture-confirmed human Salmonella serotype Paratyphi B var. L(+) tartrate+ infection reported to LEDS, by jurisdiction, United States, 2016 (n = 343)                                                                     26
Figure 2u. Incidence rate of culture-confirmed human Salmonella serotype Anatum infection reported to LEDS, by jurisdiction, United States, 2016 (n = 257)                                                                                                  27
Figure 3. Percentage of culture-confirmed Salmonella infections reported to LEDS, by month of specimen collection, United States, 2016 and median percentage during 2006 to 2015                                                  28
Appendix 1. Culture-confirmed Salmonella infections reported to LEDS by age group and sex, 2016                  32
Appendix 2a. Culture-confirmed Salmonella infections reported to LEDS by serotype and reporting jurisdiction, (Alaska to Kansas)                                                                                                                                 33
Appendix 2b. Culture-confirmed Salmonella infections reported to LEDS by serotype and reporting jurisdiction, 2016 (Kentucky to Nevada)                                                                                                                     43
Appendix 2c. Culture-confirmed Salmonella infections reported to LEDS by serotype and reporting jurisdiction, 2016 (New York to Wyoming)                                                                                                                  53
Appendix 3a. Culture-confirmed Salmonella infections reported to LEDS by serotype and year, 2006-2016         63
Appendix 3b. Partially serotyped culture-confirmed Salmonella infections reported to LEDS by serogroup and year, 2006-2016                                                                                                                                    85
Figure 1. Incidence rate of culture-confirmed human Salmonella infection reported to LEDS (all serotypes and individual serotypes with ≥1000 infections reported in 2016), by year, United States, 1970–2016
30
20
10
0                                                                                                                                                                               3
2
1
0
All serotypes               Enteritidis                   Newport                           Typhimurium Javiana                        I 4,[ 5],12:i:-                  Montevideo                      Infantis
         Muenchen                   Braenderup                 Unknown serotype           Partially serotyped
●  The incidence rate of infection with Salmonella overall has increased by 33% since a nadir in 2001. Incidence rates of infection have increased the most with serotypes I 4,[5],12:i:- (↑580%), Infantis (↑167%), Braenderup (↑138%), and Javiana (↑136%) over the same period.
●  The large increase in serotype I 4,[5],12:i:- may be due in part to changes in reporting practices and increasing awareness of this serotype.
●  “Unknown serotype” indicates cases with no serotype information. This is likely due to serotyping not being performed (1)(2).
●  The peak in incidence of serotype Typhimurium infections in 1985 was due to an outbreak associated with pasteurized milk (3).
Note: Data for these charts can be found at https://www.cdc.gov/nationalsurveillance/data/salm2016/Fig1.xlsx
Table 1a. Culture-confirmed human Salmonella infections reported to LEDS, with the 20 most frequently reported serotypes listed individually, United States, 2016
Table 1b. Incidence rate of culture-confirmed human Salmonella infections reported to LEDS, by age group and sex, United States, 2016 (n = 38,535 with age and sex information reported)
RankSerotypeNumber reportedPercentIncidence (per 100,000)
1Enteritidis7,83016.82.44
2Newport4,72810.11.47
3Typhimurium4,5819.81.43
4Javiana2,7195.80.85
5I 4,[5],12:i:-2,1794.70.68
6Infantis1,2812.70.4
7Muenchen1,2162.60.38
8Montevideo1,0182.20.32
9Braenderup1,0012.10.31
10Thompson7921.70.25
11Saintpaul7781.70.24
12Heidelberg7541.60.23
13Oranienburg6921.50.22
14Mississippi5361.10.17
15Typhi4230.90.13
16Bareilly4120.90.13
17Berta3690.80.11
18Agona3620.80.11
19Paratyphi B var. L(+) tartrate+3430.70.11
20Anatum2570.60.08
 Subtotal32,27169.2 
Other serotyped*7,70919.32.4
Unknown serotype5,62512.11.75
Partially serotyped8011.70.25
Rough, mucoid, and/or nonmotile2170.50.07
Subtotal14,35230.8 
Total46,62310014.51
Age group, yearsIncidence
FemaleMale
<1108.81110.8
1–435.3836.73
5–913.7814.9
10–198.819.27
20–2911.549
30–3910.739.26
40–4911.168.59
50–5913.3210.41
60–6914.7413.01
70–7916.3714.92
≥8016.8914.58
Overall14.6513.25
* Listed individually in Appendix 3

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