Locally acquired typhoid fever outbreak linked to chronic carriage in Ottawa, Canada, 2018–2022
Bibliographic record
Abstract
Background: serovar Typhi infections are uncommon and typically travel-related. In November 2021, Ottawa Public Health identified a link between two typhoid fever cases, with no recent history of international travel, to the same grocery store ready-to-eat counter. Objective: Typhi carriage in Ottawa, Ontario, Canada and provides recommendations for investigations of small-scale protracted outbreaks. Methods: We administered exposure questionnaires using a single interviewer approach, tested stool samples of contacts and food handlers, inspected food premises, collected food samples and reviewed takeout receipts. Social network, spatial and whole genome sequencing analyses were used to investigate additional possible links between cases. Results: Typhi carrier. Whole-genome sequencing confirmed that all eight isolates matched the outbreak cluster. All cases and carrier resided within an eight km radius in Ottawa. The chronic carrier worked as a food handler at various locations of a grocery store chain, including the implicated ready-to-eat counter. Transmission occurred via food handling, shared workspaces and social and household networks. Conclusion: The chronic carrier was excluded from food handling until successful completion of treatment and clearance testing. We overcame the challenges of a small but prolonged outbreak by identifying an asymptomatic carrier using a multi-method approach including whole genome sequencing and social network analysis.
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How this classification was reachedexpand
Full frame machine prediction
Teacher imitationNot calibrated prevalence, not ground truth. Human validation pending. The Gemma side is a direct model label for every work in the frame, read from the title-only record. The Codex side is a classifier learned from the 10,348 direct Codex labels and calibrated to design-weighted sample rates; fields without enough sample support carry no Codex call. Candidate is the union of the two sides; consensus is their intersection. These outputs are machine_predicted_unvalidated and are not human labels.
Distilled classifier scores by category (both heads)
| Category | Codex | Gemma |
|---|---|---|
| Metaresearch | 0.000 | 0.001 |
| Meta-epidemiology (narrow) | 0.000 | 0.000 |
| Meta-epidemiology (broad) | 0.000 | 0.000 |
| Bibliometrics | 0.001 | 0.002 |
| Science and technology studies | 0.005 | 0.001 |
| Scholarly communication | 0.001 | 0.000 |
| Open science | 0.001 | 0.002 |
| Research integrity | 0.001 | 0.001 |
| Insufficient payload (model declined to judge) | 0.002 | 0.000 |
Machine scores (provisional)
The two teacher heads of the student model, read on this work. A score orders the frame for review; it never asserts a category, and the validation status ships verbatim with every row.
Baseline scores from an immature model (maturity gate not passed, 7 training rounds). Scores rank; they never assert a category.
score_only:v0-immature-baseline · verbatim from the scoring run: score_only means the number may rank works, and no category label ships from itClassification
machine, unvalidatedMachine predicted; a candidate call from one source (direct Gemma or distilled Codex), not a consensus.
How this classification was reached, model by model and score by score, is at the end of the page under "How this classification was reached".