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First case of extensively drug-resistant typhoid reported in Australia

Australia’s first case of extensively drug resistant typhoid has been confirmed in a 20-month-old girl, who was taken to hospital suffering with high fever and vomiting.

Dr Philip Britton from the Children’s Hospital at Westmead and the University of Sydney said given the fact the young girl had recently returned from six weeks in Pakistan led doctors to believe she had typhoid.

“It was only actually when we grew the bug from her blood stream that we became aware it was a highly resistant form, and a bug that’s associated with an outbreak of this extensively drug resistant typhoid in Pakistan and western India,” he said.

The finding from February this year, was published in the Medical Journal of Australia on Monday.

Dr Britton, an expert in infectious diseases, said it highlighted the importance of vaccinating against typhoid as drug-resistant infections become more common.

“Prevention is always better than cure,” he said.

While Dr Britton said the girl was treated successfully, the fact they had to give her third-line antibiotics made the doctors “nervous about where this is all heading into the future”.

“As we whittle down the number of antibiotics we’ve got left to treat these organisms, we put ourselves at risk of eventually having no antibiotics left to treat [them],” he said.

Professor Raina MacIntyre, head of the Biosecurity Program at the Kirby Institute at UNSW said the problem with having fewer antibiotics the infection could be deadly if left untreated.

“You can prevent people dying by treating them with antibiotics and if the bacteria is resistant to all the available antibiotics, then you’re chance of treating them successfully is diminished,” she said.

Professor MacIntyre said her research from 2016 of about 100 typhoid cases in NSW and Victoria found the majority were in young people, and mostly those who had spent time in India, Bangladesh and Pakistan.

“The typhoid cases that we see here have been to one of those countries and tend to have travelled for a little bit longer,” she said.

Dr Britton said every year the hospitals treat between 10 and 20 children who have travelled to south Asia and returned with typhoid fever, but it was becoming increasingly common.

There were 144 cases of typhoid diagnosed in 2017 and 175 in 2018.  So far this year, there have been 146 laboratory confirmed cases.

Professor MacIntyre said people should also ensure their food is cooked properly, use boiled water and refrain from drinking tap water in countries where typhoid was a risk.

“Taking all those precautions if you’re travelling to an area that’s endemic with typhoid is super important,” she said.

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