Summary
Introduction
Nontyphoidal Salmonella enterica (NTS) is a major zoonotic enteric pathogen. Animal contact-related NTS outbreaks have increased in the United States of America (U.S.) over the last decade. Geospatial analysis can identify locations with elevated risk of NTS outbreaks where public health authorities can focus their NTS prevention and intervention efforts.
Methods
We analyzed NTS outbreak data reported from individual states to the Centers for Disease Control via the National Outbreak Reporting System between 2009 and 2022 across the continental contiguous U.S. A geospatial analytical framework that included disease mapping, spatial interpolation, and global and local clustering methods was applied to identify regions with high NTS outbreak rates.
Results
A total of 104 NTS single-state outbreaks were reported to the National Outbreak Reporting System (NORS) during the study period. The mean annual incidence rate was 0.02 NTS outbreaks per million person-years. The primary animal contact categories associated with these outbreaks were mammals (cattle, pigs, sheep, and horses), birds (backyard chickens, ducklings, and turkeys), and reptiles (turtles and lizards). Exposure settings included farms, fairgrounds, agricultural feed stores, veterinary clinics, dairy/agricultural settings, and residential settings. The local cluster detection methods consistently identified areas with significantly high NTS animal contact-related outbreak rates in the Mountain West, Midwest, and Northeast of the US.
Conclusion
NTS animal contact-related single-state outbreaks revealed distinct spatial clustering across the United States, with potentially higher risks in the Mountain West, Midwest, and Northeast. Diversity of animal-contact sources and exposure settings depicted complex transmission dynamics of NTS. Focused prevention and control programs in these areas are needed to mitigate the burden of NTS outbreaks.
Impacts
The most common animals linked to outbreaks were mammals, birds, and reptiles
Main exposure settings included farms, veterinary clinics, feed stores, shelters, schools, and homes.
Outbreaks clustered in the Mountain West, Midwest, and Northeast regions.
Region-specific prevention and interventions are needed to reduce the burden of illnesses.