Decline of Salmonella enterica Serotype Choleraesuis Infections, Taiwan

To the Editor: Human salmonellosis is a major public health problem of global concern.Salmonella enterica serotype Choleraesuis is a nontyphoid serotype; it has a narrow host range and is associated with a high proportion of invasive infections (50%-90% of isolates are from sterile sites [(1)]).In 2000, emergence of fluoroquinolone resistance in S. enterica ser.Choleraesuis was reported from Chang Gung Memorial Hospital at Linkou, Taiwan (2).Since then, we have continuously monitored the trend of these infections at this hospital in northern Taiwan and at Chang Gung Memorial Hospital at Kaohsiung in southern Taiwan.We report the decline of S. enterica ser.Choleraesuis infections coinciding with the implementation of several national control programs in Taiwan.In humans, S. enterica ser.Choleraesuis usually causes invasive infections (1).Transmission of the organism is probably from pigs to humans (3).According to an inspection program conducted by the Council of Agriculture in 2004, illegal slaughter of pigs dying of unidentified diseases and sale of the pork at a reduced price were common in Taiwan and probably were associated with transmission of the organism (4).In Taiwan during 1996-1997, a large epidemic of swine footand-mouth disease occurred (5), and consumption of pork decreased substantially.To prevent further spread of that epidemic, the government implemented massive slaughter of infected pigs and a swine vaccination policy (5).Coincidently, in 1996-1998, S. enterica ser.Choleraesuis infections among humans decreased significantly (p<0.001)(2).However, during the following years, infections among

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