The increasing healthcare burden of enteric fever in a low-incidence setting

Infect Dis Now. 2024 Jun;54(4):104919. doi: 10.1016/j.idnow.2024.104919. Epub 2024 Apr 21.


Objectives: Enteric fever carries appreciable morbidity in non-endemic settings, particularly in returned travelers. This study aimed to characterize the healthcare burden of enteric fever in a low-incidence setting and to identify risk factors and opportunities for preventative interventions.

Methods: Analysis of a retrospective case series from a tertiary pediatric center (2015-2019), augmented by public health notification and microbiological laboratory data (2018-2019), from Western Sydney, Australia, a region with frequent travel links to South Asia.

Results: Eighty-nine (89) patients were diagnosed with enteric fever, including 43 children with complete demographic and travel data. Enteric fever cases increased over time (by 4.9 % per year) and incidence was three times higher in the pediatric population (<15 years old) compared to adults. Travel to India and visiting friends and relatives (VFR) travel were risk factors. Few children received enteric fever vaccination prior to travel, as pre-travel advice most commonly was not sought.

Conclusions: Children visiting relatives in high-incidence countries are increasingly at risk for enteric fever, particularly when travelling to South Asia. Targeted health advice to travelers visiting friends and relatives is warranted to mitigate the healthcare burden of enteric fever in low-incidence settings.

Keywords: Enteric Fever; Salmonella Typhi Infection; Typhoid Fever.

MeSH terms

  • Adolescent
  • Adult
  • Australia / epidemiology
  • Child
  • Child, Preschool
  • Cost of Illness
  • Female
  • Humans
  • Incidence
  • India / epidemiology
  • Infant
  • Male
  • Retrospective Studies
  • Risk Factors
  • Travel*
  • Typhoid Fever* / epidemiology
  • Vaccination
  • Young Adult