Drinking contaminated water and food with poo on it. More of a tropical diseases, most US outbreaks associated with imported fresh produce such as basil, cilantro, lettuce, raspberries (a big one), and snow peas.
There was a restaurant outbreak in Texas (PubMed) but the specific food wasn't identified.
Incubation period is up to 2 weeks.
Tends to be low in number, so patient may need to submit multiple stools. It is acid fast and they are autofluorescent, glowing under UV light.
Diarrhea with prolonged constitutional symptoms.
TMP/Sulfa bid x 7 days. No alternatives for the sulfa allergic.
Last update: 05/05/18