An infant returning from Pakistan has been identified as Australia’s first case of extensively drug-resistant typhoid.

The plight of the 20-month-old girl, who presented to the Children’s Hospital at Westmead in Sydney with features of enteric fever after spending three months in Karachi, is being used to flag the importance of typhoid vaccination for travellers to South and South-East Asia.

Doctors treating the girl say she developed diarrhoea in Pakistan six weeks before her return, despite the use of oral antibiotics prescribed locally.

She was subsequently admitted to Westmead after 10 days of high fever, irritability, vomiting and reduced oral intake.