The nation's first documented case of sexually transmitted typhoid fever was traced to an outbreak in Cincinnati, health officials said Wednesday.

        Typhoid fever is a rare disease usually spread in food or water tainted by fecal matter. It can be treated with antibiotics and is rarely fatal. Most of the 400 cases treated each year in the United States are contracted via food overseas.

        Researchers at the Centers for Disease Control said Wednesday that a Cincinnati man contracted typhoid during a visit to Puerto Rico last May.

        Then he passed it to seven other men here who had sex with him last summer. An eighth man from Indianapolis also contracted it here, but it is unclear how.

        At first, local hospitals could not explain why they had several cases of such a rare disease here; there appeared to be no food or water connection between the victims, said Malcolm Adcock, Cincinnati's health commissioner.

        The state health department got the CDC to investigate. It was likely circulated by highly risky oral-anal contact, said Megan Reller, an epidemiologist with the U.S. Centers for Disease Control and Prevention.

        It is not possible to know how many other men may have been exposed because the men who were diagnosed were uncooperative, Ms. Reller said.

        The disease was officially labeled a sexually transmitted disease at a conference in Atlanta this week.

        “Even though this is the first documented case, it shouldn't really come as any surprise,” Dr. Adcock said.

        “This is another example that warnings about HIV and high-risk behaviors are not being adhered to the way they ought to be.”

        Basically, any disease that can be picked up through contact with fecal matter can be picked up by people involved in anal sex, said Dr. Adcock, who has a Ph.D. in microbiology.

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