Unusual increase in reported cases of paratyphoid A fever among travellers returning from Cambodia

Risk assessment

This rapid risk assessment analyses the unusual increase in the number of paratyphoid A infections in EU travellers returning from Cambodia since March 2013 with a possible persistent common source.

Executive summary

​Since March 2013, 34 cases of paratyphoid A fever have been reported among travellers returning from Cambodia, including 30 among EU travellers. This represents a significant increase in reported cases from 2012 when only two cases imported from Cambodia were reported in the EU/EEA. Cases occurred over several months with a recent increase in August which suggests a common persistent source. Additional cases might occur if this source of contamination persists. However, spread within the EU through secondary transmission is expected to be limited.

Clinicians in travel clinics and in infectious diseases hospitals should be alerted about the increase in the number of S. paratyphi A infections among travellers returning from Cambodia. Travellers returning from a tropical country with a fever are recommended to seek medical attention as soon as possible and those about to visit South-East Asia should apply preventive measures including good personal and food hygiene.