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.
Susceptibility and Resistance Susceptibility is general. Immunity following clinical disease or immunisation is insufficient to protect against large infectious doses of organisms. Control of Case Hospitalisation is required for an acute infection. Ciprofloxacin, ceftriaxone, chloramphenicol, amoxycillin or co-trimoxazole are used in treatment. However, strains resistant to chloramphenicol, amoxycillin and co-trimoxazole are common in south Asia.