Typhoid fever in SF restaurant worker

Department of Public Health Issues Alert for Customers Who Ate at Nordstrom Café in Stonestown Galleria

San Francisco, CA – Officials at the San Francisco Department of Public Health announced today that a local restaurant food handler was diagnosed with typhoid fever. The public health investigation is ongoing, but based on current information, health officials believe the infectious disease was acquired by the food handler during a trip outside of the United States.

Anyone who ate at the Nordstrom Cafe within the Nordstrom store in the Stonestown Galleria in San Francisco on April 16, 17, 18, 20, or 27, 2013 may be at risk. Health officials advise these individuals to see a healthcare provider right away if they start to experience symptoms such as fever, weakness, stomach pains, headache, nausea, vomiting, diarrhea, or loss of appetite. In some cases a rash of flat, rose-colored spots may appear. Symptoms usually begin within 8 to14 days after exposure, but could potentially appear for up to 30 days.

“Unfortunately, symptoms of typhoid fever can resemble other illnesses,” said Tomás J. Aragón, MD, Health Officer for City & County of San Francisco. “Persons who are at risk because they dined at the Stonestown Nordstrom Cafe on one of those dates should see a healthcare provider right away if they are feeling unwell, and should tell their physician that they may have been exposed to typhoid fever. There is testing and effective treatment available. If you suspect you have typhoid fever, do not prepare food or drink for anyone and do not care for young children, hospitalized patients, or persons with weakened immune systems.”

Typhoid fever is an illness caused by the bacterium Salmonella enterica serotype Typhi. Although death is uncommon, typhoid fever can be severe and life-threatening. In the United States, 300-400 cases of typhoid fever occur each year, and most of those are acquired during international travel. People are at risk of typhoid fever if they eat food or drink beverages that have been handled by someone who has typhoid fever, or if sewage contaminated with the bacteria gets into the water supply used for drinking or food preparation. Typhoid fever is still common in the developing world, where it affects about 22 million people and causes about 200,000 deaths.

The only way to know if an illness is typhoid fever is by testing samples of stool, blood, and urine for the presence of Salmonella enterica serotype Typhi. Typhoid fever can be successfully treated with appropriate antibiotics, and persons given antibiotics usually begin to feel better within 2 to3 days. Although untreated typhoid can potentially be fatal, deaths from typhoid fever are uncommon in the United States. However, persons with typhoid fever who do not get treatment can continue to have fever and feel unwell for weeks or months. Even if their symptoms go away, persons with typhoid fever may continue to pass typhoid bacteria to others, and so they should not handle food or care for children, hospitalized persons, or those with weakened immune systems until further testing proves that typhoid bacteria are gone from the body.

Nordstrom at Stonestown Galleria is cooperating with the Department of Public Health in the investigation to ensure that the public and their workers are informed and protected.

For more information about typhoid fever, go to http://www.cdc.gov/nczved/divisions/dfbmd/diseases/typhoid_fever/.
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