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Enteric fever hospitalizations in San Francisco, USA. The incidence of enteric fever in San Francisco, USA, has been increasing since 1976. The objective of this study was to describe the incidence, demographics, microbiology, hospital course and outcomes of enteric fever in San Francisco from 1993 to 2003. Laboratory information and hospitalization records were obtained for all cases of enteric fever in San Francisco, which occurred in 1993, 1996 and 2003. A case of enteric fever was defined as isolation of Salmonella enterica serotype Typhi from a blood culture, or isolation of an S. enterica serotype Typhi-positive blood culture in a patient with fever and two or more other clinical findings consistent with enteric fever. A total of 178 cases of enteric fever were identified from 1993 to 2003. The incidence of enteric fever was highest among older men and women. There was no change in the predominant serotype during the study period; all isolates were sensitive to chloramphenicol. The case-fatality rate declined from 2.9% in 1993 to 0.8% in 2003. Enteric fever remains a significant problem in San Francisco. Case-fatality rates were significantly lower than those observed in previous studies, and were no longer increasing. However, only a small percentage of patients have a documented diagnosis and nearly 60% of patients were not appropriately treated.require_relative '../../../spec_helper' require 'pathname' describe "File.join" do before :each do @join1 = Pathname.new('/a/b/c/d') @join2 = Pathname.new('/a/b/c/d/e/f') end it "converts the passed paths to absolute paths" do @join1.join(@join2).to_s.should == "/a/b/c/d/e/f" it "can join two absolute paths to a path relative to the current working directory" do path = "/a/b/c/d" expected = Pathname.new(path).join(@join2) expected.should == @join2 it "works with paths containing ::Enumerable or ::Array instances" do @join1.join

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