Typhoid and paratyphoid fever in Western Sydney Local Health District, NSW, January-June 2011.

We undertook a study of enteric fever, caused by Salmonella enterica enterica subtypes Typhi and Paratyphi A, presenting in residents of the Western Sydney Local Health District for the period January-June 2011. Twelve cases of S. Typhi and eight of S. Paratyphi A were notified. Patients were predominantly young adults (median age 26 years, 70% female) who had been visiting friends and relatives in India, Samoa, Bangladesh or Sri Lanka. No cases were associated with travel for less than 3 weeks; 17 (85%) required hospitalisation. None received pre-travel vaccination; reasons cited for this included pregnancy, expense, being too busy, or considering the disease too mild to warrant vaccination. Three S. Typhi isolates acquired at large social gatherings in Samoa had the same phage [corrected] type and susceptibility profiles; these results were communicated to Samoan public health personnel. There are opportunities to strengthen enteric fever prevention, including pre-travel health advice and S. Typhi vaccination for people visiting endemic areas for 3 or more weeks, especially those in the vulnerable 'visiting friends and relative' category.