An outbreak of domestically acquired typhoid fever in Queens, NY

In the summer of 2000, an outbreak of endemic typhoid fever involved 6 people in Queens, NY, and a seventh person in Manhattan, NY. An investigation by the New York City Department of Health traced the likely source to an immigrant employee working at a local restaurant. The clinical presentations of 4 cases seen at New York Hospital Queens, Flushing, a 500-bed hospital, mimicked viral hepatitis or gastroenteritis. We report the clinical features of these 4 cases and review endemic typhoid fever, a diagnosis not likely to be considered in the United States absent a history of recent international travel.