Infectious Agent Salmonella Typhi. It is a generalised infection with non-specific onset characterised by involvement of the lymphoid tissues and fever, bradycardia, 'rose spots', splenomegaly and abdominal symptoms. Complications such as intestinal haemorrhage or perforation can develop in untreated patients or when treatment is delayed. Paratyphoid infection presents a similar clinical picture but is usually milder, shorter in duration and with fewer complications. Public Health Significance and Occurrence Occurrence is worldwide.
Outbreaks occur in areas with poor sanitation and inadequate sewerage systems.
In Victoria, approximately 30 to 40 cases of enteric fever occur each year, the majority being in returned travellers, especially from the Indian subcontinent. Repeated sampling may be necessary. For travellers, important sources are water or ice, raw vegetables, salads and shellfish. It is communicable as long as typhoid or paratyphoid bacilli are present in excreta. Some patients become permanent carriers.