Khatami A, Khan F, Macartney KK
Enteric fever is a vaccine-preventable disease with cases in Australia predominantly acquired overseas. The aim of this study was to define the burden of enteric fever in children presenting to a pediatric hospital in Western Sydney between 2003 and 2015.
Cases between January 2003 and December 2013 were ascertained through medical records using ICD-coded discharge diagnoses, cross-referenced with microbiology laboratory data for all isolates of Salmonella enterica serovar Typhi (S. typhi) and Salmonella enterica serovar Paratyphi. Prospective cases from January 2014 to April 2015 were additionally captured through records maintained by the infectious diseases team.
71 cases of enteric fever were identified in 12.3 years with an average of 4 cases/year between 2003-2008 and 7 cases/year between 2009-2014. Two were visitors to Australia, 8 were recent migrants, and 59 were Australian residents returning from overseas travel. Two children had no history of overseas travel. Countries of travel predominantly included the Indian subcontinent (60/69) and South East Asia (7/69). Of 30 children with information available on pre-travel medical consultation, one was offered and received typhoid vaccine. 94% of children (67) required admission for 1-28 days (median 5 days). 3 children required readmission, with one case of presumed relapse. 90% (64) were diagnosed by blood or stool culture with S. typhi the predominant organism (54/64).
In Australia, hospitalizations for pediatric enteric fever appear to be increasing; predominantly occurring in Australian-resident children. Greater awareness and education is required for parents and clinicians regarding travel health risks and prevention strategies.
Click here to view the article, published in The Pediatric infectious disease journal