Materiały źródłowe

• #1 Shigellosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/182767-overview

  Shigellosis is a major public health problem in both developed and underdeveloped countries, especially with increasing resistance to first- and second-line antimicrobial agents. […] Shigellosis is highly infectious and spreads by fecal-oral transmission. Shigella sonnei and Shigella flexneri cause 90% of the cases of shigellosis; Shigella dysenteriae has produced epidemic shigellosis. […] Shigellosis is the third most common cause of bacterial gastroenteritis in the United States. Approximately 500,000 cases of shigellosis are estimated to occur annually in the United States, accounting for 100,000 hospitalizations and 500 deaths every year. […] Most US cases of shigellosis occur in international travelers returning from areas that are prevalent in shigellosis. Relatively recent studies have evaluated an increasing incidence in men who have sex with men (MSM) with local spread of the bacteria.

• #2 Shigellosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482337/

  Shigellosis occurs globally but is most common in resource-poor countries and has a propensity for endemicity and outbreaks. […] The estimated annual global incidence of shigellosis is 188 million cases; approximately 164,000 cases result in death. […] In high-income countries, the transmission of Shigella is mostly via the fecal-oral route or by direct person-to-person contact, including sexual contact. […] In low- and middle-income countries, transmission via the fecal-oral route is most commonly from contaminated food or water. […] Shigellae is the most common cause of dysentery in children aged 6 months to 5 years. […] The second-most common etiologic agent is S sonnei. […] Shigellosis outbreaks occur whenever war or natural disasters result in unhygienic living conditions, overcrowding, and poor sanitation. […] Rising temperatures also remarkably increase the risk of diarrheal diseases such as shigellosis. […] There is no gender or ethnic predilection for shigellosis.

• #3 Shigella infection: Epidemiology, clinical manifestations, and diagnosis – UpToDate

  http://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-shigella-infection

  Shigella species are a common cause of diarrhea worldwide. […] Worldwide, 188 million cases of Shigella occur annually, with 164,000 associated deaths. Shigella is the most common cause of invasive (bloody) diarrhea among children in resource-limited settings. […] In many resource-limited settings, S. flexneri is the predominant species. S. sonnei is the second most prevalent; however, S. sonnei appears to be emerging in economically transitional regions. […] S. dysenteriae is rarely isolated in surveillance; its decline is likely due to improvements in sanitation and antimicrobial access. S. boydii infections are uncommon outside the Indian subcontinent.

• #4 Shigella infection: Epidemiology, clinical manifestations, and diagnosis – UpToDate

  http://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-shigella-infection

  Shigella species are a common cause of diarrhea worldwide. […] Worldwide, 188 million cases of Shigella occur annually, with 164,000 associated deaths. Shigella is the most common cause of invasive (bloody) diarrhea among children in resource-limited settings. […] In many resource-limited settings, S. flexneri is the predominant species. S. sonnei is the second most prevalent; however, S. sonnei appears to be emerging in economically transitional regions. […] S. dysenteriae is rarely isolated in surveillance; its decline is likely due to improvements in sanitation and antimicrobial access. S. boydii infections are uncommon outside the Indian subcontinent.

• #5 Shigella-Shigellosis

  https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs/community_epidemiology/dc/Shigella.html

  Shigella can easily spread from person to person and make people sick. There are about 450,000 infections in the U.S. each year. […] Those with lower immune systems, young children, men who have sex with men, and international travels can be at a high risk of catching Shigella. […] Shigella germs spread easily from one person to another it only takes a small amount of Shigella germs to make someone sick (too small to see). […] Healthcare providers can order laboratory tests to find Shigella bacteria in the stool of a sick person. […] Most people with shigellosis will get better within 5 to 7 days without medical treatment. However, Shigella bacteria can cause more severe illness in infants, older adults, or people with weakened immune systems. […] Contact your healthcare provider if you, or someone you know, has blood or prolonged diarrhea (diarrhea lasting more than 3 days) or severe stomach cramping or tenderness, especially if you also have a fever or feel very sick.

• #6 Shigellosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/182767-overview

  Shigellosis is a major public health problem in both developed and underdeveloped countries, especially with increasing resistance to first- and second-line antimicrobial agents. […] Shigellosis is highly infectious and spreads by fecal-oral transmission. Shigella sonnei and Shigella flexneri cause 90% of the cases of shigellosis; Shigella dysenteriae has produced epidemic shigellosis. […] Shigellosis is the third most common cause of bacterial gastroenteritis in the United States. Approximately 500,000 cases of shigellosis are estimated to occur annually in the United States, accounting for 100,000 hospitalizations and 500 deaths every year. […] Most US cases of shigellosis occur in international travelers returning from areas that are prevalent in shigellosis. Relatively recent studies have evaluated an increasing incidence in men who have sex with men (MSM) with local spread of the bacteria.

• #7 Shigellosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/182767-overview

  Shigellosis is a major public health problem in both developed and underdeveloped countries, especially with increasing resistance to first- and second-line antimicrobial agents. […] Shigellosis is highly infectious and spreads by fecal-oral transmission. Shigella sonnei and Shigella flexneri cause 90% of the cases of shigellosis; Shigella dysenteriae has produced epidemic shigellosis. […] Shigellosis is the third most common cause of bacterial gastroenteritis in the United States. Approximately 500,000 cases of shigellosis are estimated to occur annually in the United States, accounting for 100,000 hospitalizations and 500 deaths every year. […] Most US cases of shigellosis occur in international travelers returning from areas that are prevalent in shigellosis. Relatively recent studies have evaluated an increasing incidence in men who have sex with men (MSM) with local spread of the bacteria.

• #8 Shigellosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482337/

  Shigellosis occurs globally but is most common in resource-poor countries and has a propensity for endemicity and outbreaks. […] The estimated annual global incidence of shigellosis is 188 million cases; approximately 164,000 cases result in death. […] In high-income countries, the transmission of Shigella is mostly via the fecal-oral route or by direct person-to-person contact, including sexual contact. […] In low- and middle-income countries, transmission via the fecal-oral route is most commonly from contaminated food or water. […] Shigellae is the most common cause of dysentery in children aged 6 months to 5 years. […] The second-most common etiologic agent is S sonnei. […] Shigellosis outbreaks occur whenever war or natural disasters result in unhygienic living conditions, overcrowding, and poor sanitation. […] Rising temperatures also remarkably increase the risk of diarrheal diseases such as shigellosis. […] There is no gender or ethnic predilection for shigellosis.

• #9 Shigella infection: Epidemiology, clinical manifestations, and diagnosis – UpToDate

  http://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-shigella-infection

  Shigella species are a common cause of diarrhea worldwide. […] Worldwide, 188 million cases of Shigella occur annually, with 164,000 associated deaths. Shigella is the most common cause of invasive (bloody) diarrhea among children in resource-limited settings. […] In many resource-limited settings, S. flexneri is the predominant species. S. sonnei is the second most prevalent; however, S. sonnei appears to be emerging in economically transitional regions. […] S. dysenteriae is rarely isolated in surveillance; its decline is likely due to improvements in sanitation and antimicrobial access. S. boydii infections are uncommon outside the Indian subcontinent.

• #10 Shigella infection: Epidemiology, clinical manifestations, and diagnosis – UpToDate

  http://www.uptodate.com/contents/clinical-manifestations-and-diagnosis-of-shigella-infection

  Shigella species are a common cause of diarrhea worldwide. […] Worldwide, 188 million cases of Shigella occur annually, with 164,000 associated deaths. Shigella is the most common cause of invasive (bloody) diarrhea among children in resource-limited settings. […] In many resource-limited settings, S. flexneri is the predominant species. S. sonnei is the second most prevalent; however, S. sonnei appears to be emerging in economically transitional regions. […] S. dysenteriae is rarely isolated in surveillance; its decline is likely due to improvements in sanitation and antimicrobial access. S. boydii infections are uncommon outside the Indian subcontinent.

• #11 Shigellosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482337/

  Shigellosis occurs globally but is most common in resource-poor countries and has a propensity for endemicity and outbreaks. […] The estimated annual global incidence of shigellosis is 188 million cases; approximately 164,000 cases result in death. […] In high-income countries, the transmission of Shigella is mostly via the fecal-oral route or by direct person-to-person contact, including sexual contact. […] In low- and middle-income countries, transmission via the fecal-oral route is most commonly from contaminated food or water. […] Shigellae is the most common cause of dysentery in children aged 6 months to 5 years. […] The second-most common etiologic agent is S sonnei. […] Shigellosis outbreaks occur whenever war or natural disasters result in unhygienic living conditions, overcrowding, and poor sanitation. […] Rising temperatures also remarkably increase the risk of diarrheal diseases such as shigellosis. […] There is no gender or ethnic predilection for shigellosis.

• #12 Shigella Surveillance | Shigella – Shigellosis | CDC

  https://www.cdc.gov/shigella/data-research/surveillance/index.html

  National Shigella surveillance data are collected through passive surveillance of laboratory-confirmed human Shigella infections. […] State and territorial public health laboratories report Shigella infections electronically to CDC through a variety of mechanisms. Data are collected into the Laboratory-Based Enteric Disease Surveillance (LEDS) system. The annual summaries of these data are the national source of species and subtype information for Shigella.

• #13 Shigella Surveillance | Shigella – Shigellosis | CDC

  https://www.cdc.gov/shigella/data-research/surveillance/index.html

  National Shigella surveillance data are collected through passive surveillance of laboratory-confirmed human Shigella infections. […] State and territorial public health laboratories report Shigella infections electronically to CDC through a variety of mechanisms. Data are collected into the Laboratory-Based Enteric Disease Surveillance (LEDS) system. The annual summaries of these data are the national source of species and subtype information for Shigella.

• #14 For health professionals: Shigellosis (Shigella) – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/shigella/health-professionals.html

  Shigellosis is a common cause of diarrhea in Canada. In recent years, approximately 880 cases of shigellosis have been reported annually in Canada. […] Shigellosis is a nationally notifiable disease. Health professionals are to report cases to their provincial or territorial public health authorities. […] Health professionals in Canada play a critical role in identifying and reporting cases of shigellosis. See the surveillance section for more information on surveillance in Canada.

• #15 For health professionals: Shigellosis (Shigella) – Canada.ca

  https://www.canada.ca/en/public-health/services/diseases/shigella/health-professionals.html

  Shigellosis is a common cause of diarrhea in Canada. In recent years, approximately 880 cases of shigellosis have been reported annually in Canada. […] Shigellosis is a nationally notifiable disease. Health professionals are to report cases to their provincial or territorial public health authorities. […] Health professionals in Canada play a critical role in identifying and reporting cases of shigellosis. See the surveillance section for more information on surveillance in Canada.

• #16 Shigellosis | Australian Government Department of Health and Aged Care

  https://www.health.gov.au/diseases/shigellosis

  Shigellosis is a nationally notifiable disease. […] We monitor cases through the National Notifiable Disease Surveillance System (NNDSS). […] OzFoodNet is a network of epidemiologists that monitors and responds to foodborne diseases in Australia, including shigellosis.

• #17 Shigellosis | Australian Government Department of Health and Aged Care

  https://www.health.gov.au/diseases/shigellosis

  Shigellosis is a nationally notifiable disease. […] We monitor cases through the National Notifiable Disease Surveillance System (NNDSS). […] OzFoodNet is a network of epidemiologists that monitors and responds to foodborne diseases in Australia, including shigellosis.

• #18

  https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON364

  National health authorities are conducting epidemiological and genomic investigations in their respective countries to determine the route of transmission and the genomic linkage of the cases with the representative strain of the cluster detected in the United Kingdom. […] Based on the limited information available at this stage, the likelihood of spread from the United Kingdom to other countries and the prevalence of XDR S. sonnei is high. […] The recent increase in S. sonnei infections in the United Kingdom may represent an increase in reporting activities following the COVID-19 pandemic and resumption of social contact, especially in MSM exposed to high-risk sexual practices and in immunocompromised adults. […] The geographical spread of XDR S. sonnei is under reported. WHO advises national authorities to reinforce Shigella surveillance including testing for antimicrobial resistance to detect potential introductions to new areas and to prevent the establishment of local cycles of transmission in communities.

• #19

  https://www.gov.uk/government/publications/non-travel-associated-shigella-infections/sexually-transmitted-shigella-spp-in-england-2016-to-2023

  Shigella spp. (S. dysenteriae, S. flexneri, S. boydii and S. sonnei) are bacterial enteric pathogens, transmitted through faecal-oral contact, which can cause dysentery. […] However, in England shigellosis is increasingly acquired domestically by men who have sex with men (MSM). […] Throughout this report, adult men not reporting travel, or where travel is unknown, are assumed to most likely have acquired their infection through sexual transmission and are described as presumptive MSM. […] The key observations from this report are that: following the COVID-19 pandemic, reported diagnoses of Shigella spp. related to both travel and presumed sexual transmission increased and returned to pre-pandemic 2019 levels, and have substantially exceeded pre-pandemic levels among presumptive MSM.

• #20

  https://journals.lww.com/ijmr/fulltext/2016/43050/shigellosis__epidemiology_in_india.6.aspx

  The annual number of shigellosis episodes throughout the world is estimated to be 164.7 million, with 69 per cent of all episodes and 61 per cent of all deaths attributable to shigellosis involving children 5 yr of age. […] Reports of shigellosis from various parts of the country have shown an overall isolation rate of shigellae varying from 3-6 per cent of all stool samples with diarrhoea. […] In India, epidemics have been reported from southern India, Vellore (1972-1973, 1997-2001), eastern India (1984), Andaman and Nicobar islands (1986) and Chandigarh (2003) in northern India. […] The re-emergence of S. dysenteriae type 1 with added resistance to ciprofloxacin which has epidemic potential, has also been reported from our centre. […] These outbreaks indicate that in India, food- and water-borne routes for transmission of shigellosis may not be so uncommon, and thus reinforces the need to provide adequate sanitation.

• #21

  https://journals.lww.com/ijmr/fulltext/2016/43050/shigellosis__epidemiology_in_india.6.aspx

  The annual number of shigellosis episodes throughout the world is estimated to be 164.7 million, with 69 per cent of all episodes and 61 per cent of all deaths attributable to shigellosis involving children 5 yr of age. […] Reports of shigellosis from various parts of the country have shown an overall isolation rate of shigellae varying from 3-6 per cent of all stool samples with diarrhoea. […] In India, epidemics have been reported from southern India, Vellore (1972-1973, 1997-2001), eastern India (1984), Andaman and Nicobar islands (1986) and Chandigarh (2003) in northern India. […] The re-emergence of S. dysenteriae type 1 with added resistance to ciprofloxacin which has epidemic potential, has also been reported from our centre. […] These outbreaks indicate that in India, food- and water-borne routes for transmission of shigellosis may not be so uncommon, and thus reinforces the need to provide adequate sanitation.

• #22 The genomic epidemiology of shigellosis in South Africa | Nature Communications

  https://www.nature.com/articles/s41467-023-43345-5

  Shigellosis, a leading cause of diarrhoeal mortality and morbidity globally, predominantly affects children under five years of age living in low- and middle-income countries. […] In this study, we applied WGSA to large sub-sample of surveillance isolates from South Africa, collected from 2011 to 2015, focussing on Shigella flexneri 2a and Shigella sonnei. […] Our results support serotype specific lifestyles as a driver for epidemiological differences, show AMR is not required for epidemiological success in S. flexneri, and that the HIV epidemic may have promoted Shigella population expansion. […] Despite the greatest shigellosis disease burden falling on those living in sub-Saharan Africa (SSA) and Asia, the use of WGSA for studying shigellosis in SSA has been under-utilised. […] While this provides a useful snapshot into the diversity of Shigella strains circulating regionally, detailed national studies are needed to further unpick the epidemiology of shigellosis in the region.

• #23 The genomic epidemiology of shigellosis in South Africa | Nature Communications

  https://www.nature.com/articles/s41467-023-43345-5

  Shigellosis, a leading cause of diarrhoeal mortality and morbidity globally, predominantly affects children under five years of age living in low- and middle-income countries. […] In this study, we applied WGSA to large sub-sample of surveillance isolates from South Africa, collected from 2011 to 2015, focussing on Shigella flexneri 2a and Shigella sonnei. […] Our results support serotype specific lifestyles as a driver for epidemiological differences, show AMR is not required for epidemiological success in S. flexneri, and that the HIV epidemic may have promoted Shigella population expansion. […] Despite the greatest shigellosis disease burden falling on those living in sub-Saharan Africa (SSA) and Asia, the use of WGSA for studying shigellosis in SSA has been under-utilised. […] While this provides a useful snapshot into the diversity of Shigella strains circulating regionally, detailed national studies are needed to further unpick the epidemiology of shigellosis in the region.

• #24 The genomic epidemiology of shigellosis in South Africa | Nature Communications

  https://www.nature.com/articles/s41467-023-43345-5

  Shigellosis, a leading cause of diarrhoeal mortality and morbidity globally, predominantly affects children under five years of age living in low- and middle-income countries. […] In this study, we applied WGSA to large sub-sample of surveillance isolates from South Africa, collected from 2011 to 2015, focussing on Shigella flexneri 2a and Shigella sonnei. […] Our results support serotype specific lifestyles as a driver for epidemiological differences, show AMR is not required for epidemiological success in S. flexneri, and that the HIV epidemic may have promoted Shigella population expansion. […] Despite the greatest shigellosis disease burden falling on those living in sub-Saharan Africa (SSA) and Asia, the use of WGSA for studying shigellosis in SSA has been under-utilised. […] While this provides a useful snapshot into the diversity of Shigella strains circulating regionally, detailed national studies are needed to further unpick the epidemiology of shigellosis in the region.

• #25 The genomic epidemiology of shigellosis in South Africa | Nature Communications

  https://www.nature.com/articles/s41467-023-43345-5

  South Africa has a high incidence (2.7 hospitalisations/100,000 persons per year) of shigellosis, caused predominantly by S. flexneri and S. sonnei, discovered through routine, national shigellosis surveillance, enabling detailed examination of the national epidemiology of serotypes from both globally important serogroups within SSA. […] In this study, we use WGSA to examine the epidemiology, ecology, and accessory genome dynamics of shigellosis in the sub-Saharan nation of South Africa using isolates collected as part of the national surveillance between 2011 and 2015. […] We used reported case numbers from the annual surveillance reports by the Group for Enteric, Respiratory and Meningeal Diseases Surveillance in South Africa (GERMS-SA) to characterise the epidemiology of shigellosis in the country.

• #26 Shigellosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482337/

  Shigellosis occurs globally but is most common in resource-poor countries and has a propensity for endemicity and outbreaks. […] The estimated annual global incidence of shigellosis is 188 million cases; approximately 164,000 cases result in death. […] In high-income countries, the transmission of Shigella is mostly via the fecal-oral route or by direct person-to-person contact, including sexual contact. […] In low- and middle-income countries, transmission via the fecal-oral route is most commonly from contaminated food or water. […] Shigellae is the most common cause of dysentery in children aged 6 months to 5 years. […] The second-most common etiologic agent is S sonnei. […] Shigellosis outbreaks occur whenever war or natural disasters result in unhygienic living conditions, overcrowding, and poor sanitation. […] Rising temperatures also remarkably increase the risk of diarrheal diseases such as shigellosis. […] There is no gender or ethnic predilection for shigellosis.

• #27 Shigellosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/182767-overview

  Shigellosis occurs worldwide, and it tends to occur whenever war, natural calamities (eg, earthquakes, floods), or unhygienic living conditions result in overcrowding and poor sanitation. […] Globally, S sonnei is the second most common infectious species of shigellosis in low- and middle-income countries. […] Worldwide, disease from Shigella species causes an estimated 700,000 deaths and 165 million cases of diarrhea annually. […] Shigellosis is most common in children aged 6 months to 5 years.

• #28 WHO EMRO | Shigella dysentery and shigella infections | Volume 2, issue 1 | EMHJ volume 2, 1996

  https://www.emro.who.int/emhj-volume-2-1996/volume-2-issue-1/article14.html

  According to current estimates, over two thirds of all episodes of shigellosis and four fifths of all deaths from shigellosis occur in children under five years old. […] The WHO case definition of dysentery recommended for surveillance and reporting purposes is diarrhoea with visible blood in the stool („bloody diarrhoea”). […] To detect outbreaks of shigellosis, recording, reporting and analysis of all cases of bloody diarrhoea need to be done at health facilities. […] It is also considered to have limited practical value, because results become available long after the treatment has started, and false negative cultures are common. […] Each country aiming to ensure preparedness for an Sd1 epidemic should have effective disease surveillance systems, trained health professionals, reliably supplied health facilities and ongoing health education activities. […] Establishing an interministerial committee to plan and coordinate response to epidemics, including dysentery.

• #29 Shigella-Shigellosis

  https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs/community_epidemiology/dc/Shigella.html

  Shigella can easily spread from person to person and make people sick. There are about 450,000 infections in the U.S. each year. […] Those with lower immune systems, young children, men who have sex with men, and international travels can be at a high risk of catching Shigella. […] Shigella germs spread easily from one person to another it only takes a small amount of Shigella germs to make someone sick (too small to see). […] Healthcare providers can order laboratory tests to find Shigella bacteria in the stool of a sick person. […] Most people with shigellosis will get better within 5 to 7 days without medical treatment. However, Shigella bacteria can cause more severe illness in infants, older adults, or people with weakened immune systems. […] Contact your healthcare provider if you, or someone you know, has blood or prolonged diarrhea (diarrhea lasting more than 3 days) or severe stomach cramping or tenderness, especially if you also have a fever or feel very sick.

• #30 Shigellosis | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/shigellosis

  Shigellosis has a worldwide distribution, with approximately 125 million illnesses and 14,000 deaths reported annually throughout the world. […] In the United States, there are an estimated 500,000 cases of shigellosis every year, making it the third most common bacterial enteric disease. […] Outbreaks most often occur in child care centers, among men who have sex with men, and in jails. […] The Council of State and Territorial Epidemiologists (CSTE) surveillance case definitions for Shigellosis can be found at: https://ndc.services.cdc.gov/conditions/shigellosis/. […] CSTE case definitions should not affect the investigation or reporting of a case that fulfills the criteria in this chapter.

• #31 Shigellosis – Disease Surveillance Epidemiology Program – MeCDC; DHHS Maine

  https://www.maine.gov/dhhs/mecdc/infectious-disease/epi/disease/shigellosis.shtml

  DHHS MeCDC Disease Surveillance Epidemiology Diseases Shigellosis […] Many shigellosis outbreaks occur in childcare or school settings, and children younger than 5 years old are the most likely to be infected. Travelers, men who have sex with men, people experiencing homelessness, and those with weakened immune systems are also at increased risk for shigellosis. […] US CDC Shigella Surveillance […] Maine Shigellosis Surveillance Reports 2019 | 2020 | 2021 | 2022 | 2023 (PDF)

• #32 The changing epidemiology of shigellosis in Australia, 2001–2019 | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0010450

  Shigellosis is an increasing cause of gastroenteritis in Australia, with prolonged outbreaks reported in remote Aboriginal and Torres Strait Islander (hereafter First Nations) communities and among men who have sex with men (MSM) in major cities. […] Between 2001 and 2019, Australian states and territories reported 18,363 shigellosis cases to the National Notifiable Diseases Surveillance System (NNDSS), of which age, sex and organism information were available for 99% (18,327/18,363) of cases. […] Nationally, notification rates increased from 2001 to 2019 with yearly notification rate ratios of 1.04 (95% CI 1.021.07) for S. boydii and 1.05 (95% CI 1.041.06) for S. sonnei. […] First Nations Australians were disproportionately affected by shigellosis, with the notification rate in this population peaking in 2018 at 92.1 cases per 100,000 population.

• #33 Shigellosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482337/

  Shigellosis occurs globally but is most common in resource-poor countries and has a propensity for endemicity and outbreaks. […] The estimated annual global incidence of shigellosis is 188 million cases; approximately 164,000 cases result in death. […] In high-income countries, the transmission of Shigella is mostly via the fecal-oral route or by direct person-to-person contact, including sexual contact. […] In low- and middle-income countries, transmission via the fecal-oral route is most commonly from contaminated food or water. […] Shigellae is the most common cause of dysentery in children aged 6 months to 5 years. […] The second-most common etiologic agent is S sonnei. […] Shigellosis outbreaks occur whenever war or natural disasters result in unhygienic living conditions, overcrowding, and poor sanitation. […] Rising temperatures also remarkably increase the risk of diarrheal diseases such as shigellosis. […] There is no gender or ethnic predilection for shigellosis.

• #34 Shigellosis: Practice Essentials, Background, Pathophysiology

  https://emedicine.medscape.com/article/182767-overview

  Shigellosis occurs worldwide, and it tends to occur whenever war, natural calamities (eg, earthquakes, floods), or unhygienic living conditions result in overcrowding and poor sanitation. […] Globally, S sonnei is the second most common infectious species of shigellosis in low- and middle-income countries. […] Worldwide, disease from Shigella species causes an estimated 700,000 deaths and 165 million cases of diarrhea annually. […] Shigellosis is most common in children aged 6 months to 5 years.

• #35 Shigellosis – StatPearls – NCBI Bookshelf

  https://www.ncbi.nlm.nih.gov/books/NBK482337/

  Shigellosis occurs globally but is most common in resource-poor countries and has a propensity for endemicity and outbreaks. […] The estimated annual global incidence of shigellosis is 188 million cases; approximately 164,000 cases result in death. […] In high-income countries, the transmission of Shigella is mostly via the fecal-oral route or by direct person-to-person contact, including sexual contact. […] In low- and middle-income countries, transmission via the fecal-oral route is most commonly from contaminated food or water. […] Shigellae is the most common cause of dysentery in children aged 6 months to 5 years. […] The second-most common etiologic agent is S sonnei. […] Shigellosis outbreaks occur whenever war or natural disasters result in unhygienic living conditions, overcrowding, and poor sanitation. […] Rising temperatures also remarkably increase the risk of diarrheal diseases such as shigellosis. […] There is no gender or ethnic predilection for shigellosis.

• #36 WHO EMRO | Shigella dysentery and shigella infections | Volume 2, issue 1 | EMHJ volume 2, 1996

  https://www.emro.who.int/emhj-volume-2-1996/volume-2-issue-1/article14.html

  In the Eastern Mediterranean Region, dysentery is recognized as one of the major causes of persistent diarrhoea and malnutrition. The latest estimates amount to about a million total shigella cases annually with approximately 40 000 deaths (an average of 4% case fatality rate). […] Bacillary dysentery is becoming one of the leading causes of diarrhoea morbidity and mortality in children under five years of age. In some settings, up to 50% of all diarrhoea deaths can be attributed to bacillary dysentery. […] The latest regional estimates are a million total shigella cases annually with approximately 40 000 deaths (an average 4% case fatality rate). […] In most countries in the Eastern Mediterranean Region shigellosis is most prevalent in densely populated areas with unsafe or insufficient water supplies and inadequate sanitation.

• #37 WHO EMRO | Shigella dysentery and shigella infections | Volume 2, issue 1 | EMHJ volume 2, 1996

  https://www.emro.who.int/emhj-volume-2-1996/volume-2-issue-1/article14.html

  In the Eastern Mediterranean Region, dysentery is recognized as one of the major causes of persistent diarrhoea and malnutrition. The latest estimates amount to about a million total shigella cases annually with approximately 40 000 deaths (an average of 4% case fatality rate). […] Bacillary dysentery is becoming one of the leading causes of diarrhoea morbidity and mortality in children under five years of age. In some settings, up to 50% of all diarrhoea deaths can be attributed to bacillary dysentery. […] The latest regional estimates are a million total shigella cases annually with approximately 40 000 deaths (an average 4% case fatality rate). […] In most countries in the Eastern Mediterranean Region shigellosis is most prevalent in densely populated areas with unsafe or insufficient water supplies and inadequate sanitation.

• #38 WHO EMRO | Shigella dysentery and shigella infections | Volume 2, issue 1 | EMHJ volume 2, 1996

  https://www.emro.who.int/emhj-volume-2-1996/volume-2-issue-1/article14.html

  In the Eastern Mediterranean Region, dysentery is recognized as one of the major causes of persistent diarrhoea and malnutrition. The latest estimates amount to about a million total shigella cases annually with approximately 40 000 deaths (an average of 4% case fatality rate). […] Bacillary dysentery is becoming one of the leading causes of diarrhoea morbidity and mortality in children under five years of age. In some settings, up to 50% of all diarrhoea deaths can be attributed to bacillary dysentery. […] The latest regional estimates are a million total shigella cases annually with approximately 40 000 deaths (an average 4% case fatality rate). […] In most countries in the Eastern Mediterranean Region shigellosis is most prevalent in densely populated areas with unsafe or insufficient water supplies and inadequate sanitation.

• #39 The Incidence of Shigella Infection | Marler Clark

  https://marlerclark.com/foodborne-illnesses/shigella/shigella-incidence

  The number of shigellosis cases reported annually to the Centers for Disease Control and Prevention (CDC) has varied over the past several years. National surveillance for Shigella infections is done through testing at state and territorial laboratories, the data from which is then collected in the Laboratory-based Enteric Disease Surveillance (LEDS) system. According to recent LEDS reports, Shigella infections decreased from over 14,000 isolates reported in 2008 to all-time lows of 7,000-8,000 isolates reported annually in 2011-2013. […] In a systematic review of global shigellosis cases from 1990 to 2016, researchers demonstrated that, while the burden of diarrhea attributable to Shigella and enterohemorrhagic E. coli was decreasing, these foodborne illnesses remained a substantial cause of mortality and disability globally.

• #40 Shigella Infection: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/968773-overview

  In 2013, the average annual incidence of shigellosis in the United States was 4.82 cases per 100,000 individuals. State public health laboratories reported 7746 laboratory confirmed Shigella infections to the CDC in 2012. Of the 7,746 laboratory confirmed isolates, 6867 were identified to species level. Distribution by species was similar to previous years, with S sonnei accounting for the largest percentage of infections (75%), followed by S flexneri (12%), S boydii (0.8%), and S dysenteriae (0.3%). The reporting jurisdictions with the highest incidence rates were Nebraska (13.2 %), New Jersey (7.6%), and Minnesota (7.1%). The highest incidence per 100,000 population for shigellosis (27.77 cases) was among children younger than 5 years. […] Worldwide, the incidence of shigellosis is estimated to be 164.7 million cases per year, of which 163.2 million were in developing countries, where 1.1 million deaths occurred. About 60% of all episodes and 61% of all deaths attributable to shigellosis involved children younger than 5 years. Shigella infection is the leading cause globally of moderate to severe diarrhea in children younger than 5 years. The incidence in developing countries may be 20 times greater than that in developed countries. […] According to recent CDC reports, Shigella infection accounted for 28% of all the enteric bacterial infections. Children younger than 5 years had 7% of total reported cases, a rate indicating a disproportionate disease burden in this population.

• #41 Shigellosis

  https://dph.illinois.gov/topics-services/diseases-and-conditions/diseases-a-z-list/diseases/shigellosis.html

  Every year, about 18,000 laboratory confirmed cases of shigellosis are reported in the United States; 1,300 in Illinois. Because many milder cases are not diagnosed or reported, the actual number of infections may be 20 times greater. […] Shigellosis is particularly common and causes recurrent problems in settings where hygiene is poor and can sometimes sweep through entire communities. […] In the developing world, shigellosis is far more common and is present in most communities most of the time.

• #42 Shigellosis (Shigella Infection) | Texas DSHS

  https://www.dshs.texas.gov/foodborne-illness/shigellosis-shigella-infection

  From 2014-2018, the average number of cases of shigellosis reported in Texas had been 3,126 cases per year (ranging from 1,357 to 5,623). The number of shigellosis cases reported in Texas decreased from a peak of 5,623 cases reported in 2015 to 1,357 cases in 2018. However, the number of cases reported in 2019 tripled to 4,042. Approximately two-thirds, (66%) of cases reported in 2019 are between the ages of 0-19 years old with the majority of cases (58%) between the ages of 1-9 years old. […] Report Shigellosis within one week.

• #43 Shigella Infection: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/968773-overview

  In 2013, the average annual incidence of shigellosis in the United States was 4.82 cases per 100,000 individuals. State public health laboratories reported 7746 laboratory confirmed Shigella infections to the CDC in 2012. Of the 7,746 laboratory confirmed isolates, 6867 were identified to species level. Distribution by species was similar to previous years, with S sonnei accounting for the largest percentage of infections (75%), followed by S flexneri (12%), S boydii (0.8%), and S dysenteriae (0.3%). The reporting jurisdictions with the highest incidence rates were Nebraska (13.2 %), New Jersey (7.6%), and Minnesota (7.1%). The highest incidence per 100,000 population for shigellosis (27.77 cases) was among children younger than 5 years. […] Worldwide, the incidence of shigellosis is estimated to be 164.7 million cases per year, of which 163.2 million were in developing countries, where 1.1 million deaths occurred. About 60% of all episodes and 61% of all deaths attributable to shigellosis involved children younger than 5 years. Shigella infection is the leading cause globally of moderate to severe diarrhea in children younger than 5 years. The incidence in developing countries may be 20 times greater than that in developed countries. […] According to recent CDC reports, Shigella infection accounted for 28% of all the enteric bacterial infections. Children younger than 5 years had 7% of total reported cases, a rate indicating a disproportionate disease burden in this population.

• #44 Shigella Infection: Practice Essentials, Pathophysiology, Etiology

  https://emedicine.medscape.com/article/968773-overview

  In 2013, the average annual incidence of shigellosis in the United States was 4.82 cases per 100,000 individuals. State public health laboratories reported 7746 laboratory confirmed Shigella infections to the CDC in 2012. Of the 7,746 laboratory confirmed isolates, 6867 were identified to species level. Distribution by species was similar to previous years, with S sonnei accounting for the largest percentage of infections (75%), followed by S flexneri (12%), S boydii (0.8%), and S dysenteriae (0.3%). The reporting jurisdictions with the highest incidence rates were Nebraska (13.2 %), New Jersey (7.6%), and Minnesota (7.1%). The highest incidence per 100,000 population for shigellosis (27.77 cases) was among children younger than 5 years. […] Worldwide, the incidence of shigellosis is estimated to be 164.7 million cases per year, of which 163.2 million were in developing countries, where 1.1 million deaths occurred. About 60% of all episodes and 61% of all deaths attributable to shigellosis involved children younger than 5 years. Shigella infection is the leading cause globally of moderate to severe diarrhea in children younger than 5 years. The incidence in developing countries may be 20 times greater than that in developed countries. […] According to recent CDC reports, Shigella infection accounted for 28% of all the enteric bacterial infections. Children younger than 5 years had 7% of total reported cases, a rate indicating a disproportionate disease burden in this population.

• #45 Shigellosis (Shigella Infection) | Texas DSHS

  https://www.dshs.texas.gov/foodborne-illness/shigellosis-shigella-infection

  From 2014-2018, the average number of cases of shigellosis reported in Texas had been 3,126 cases per year (ranging from 1,357 to 5,623). The number of shigellosis cases reported in Texas decreased from a peak of 5,623 cases reported in 2015 to 1,357 cases in 2018. However, the number of cases reported in 2019 tripled to 4,042. Approximately two-thirds, (66%) of cases reported in 2019 are between the ages of 0-19 years old with the majority of cases (58%) between the ages of 1-9 years old. […] Report Shigellosis within one week.

• #46 The changing epidemiology of shigellosis in Australia, 2001–2019 | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0010450

  The relative importance of Shigella species in Australia varied by jurisdiction, with western jurisdictions, particularly the Northern Territory (NT) having higher rates across all years. […] In Australia, notification rates of shigellosis were higher in First Nations Australians than the non-Indigenous population, which was consistent throughout the period of surveillance. […] The study observed a considerable increase in untyped Shigella in recent years which coincided with an increased use of CIDT.

• #47 The changing epidemiology of shigellosis in Australia, 2001–2019 | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0010450

  The relative importance of Shigella species in Australia varied by jurisdiction, with western jurisdictions, particularly the Northern Territory (NT) having higher rates across all years. […] In Australia, notification rates of shigellosis were higher in First Nations Australians than the non-Indigenous population, which was consistent throughout the period of surveillance. […] The study observed a considerable increase in untyped Shigella in recent years which coincided with an increased use of CIDT.

• #48 Shigella-Shigellosis

  https://www.sandiegocounty.gov/content/sdc/hhsa/programs/phs/community_epidemiology/dc/Shigella.html

  Shigella can easily spread from person to person and make people sick. There are about 450,000 infections in the U.S. each year. […] Those with lower immune systems, young children, men who have sex with men, and international travels can be at a high risk of catching Shigella. […] Shigella germs spread easily from one person to another it only takes a small amount of Shigella germs to make someone sick (too small to see). […] Healthcare providers can order laboratory tests to find Shigella bacteria in the stool of a sick person. […] Most people with shigellosis will get better within 5 to 7 days without medical treatment. However, Shigella bacteria can cause more severe illness in infants, older adults, or people with weakened immune systems. […] Contact your healthcare provider if you, or someone you know, has blood or prolonged diarrhea (diarrhea lasting more than 3 days) or severe stomach cramping or tenderness, especially if you also have a fever or feel very sick.

• #49 Shigella spp.: Infectious substances pathogen safety data sheet – Canada.ca

  https://www.canada.ca/en/public-health/services/laboratory-biosafety-biosecurity/pathogen-safety-data-sheets-risk-assessment/shigella.html

  Drug resistant S. sonnei has also emerged in Europe, resulting in a 5-fold increase in cases of gastrointestinal infections among Men who have Sex with Men (MSM). Due to the dissemination of this bacterium in Europe, the WHO Regional Office for Europe released an alert in March of 2022. Shigellosis outbreaks have been reported in daycare centers and residential institutions in developed areas, as well as in MSM. Outbreaks are also commonly caused by contaminated food or water; however, in developed countries, the likelihood of shigellosis outbreaks due to contaminated water are low. Poor sanitation and hygiene increase the probability of transmission. Globally, the overall incidence of shigellosis is approximately 188 million cases globally per year, resulting in 1 million deaths. Populations that are more likely to develop the disease, or experience more severe disease, include the elderly, very young individuals, and immunocompromised individuals. Increasing age is associated with decreasing prevalence and severity. Persons living in developing countries, international travellers, migrant workers, custodial service workers, children in daycare centers, certain First Nation reserves, MSM, and HIV-infected patients are also considered high-risk groups. […] Infection from Shigella spp. can be identified by monitoring for symptoms. Serological testing of stool isolates can distinguish and confirm serogroups. Nucleic acid based diagnostic assays are common for the detections of enteric pathogens.

• #50 WHO EMRO | Shigella dysentery and shigella infections | Volume 2, issue 1 | EMHJ volume 2, 1996

  https://www.emro.who.int/emhj-volume-2-1996/volume-2-issue-1/article14.html

  According to current estimates, over two thirds of all episodes of shigellosis and four fifths of all deaths from shigellosis occur in children under five years old. […] The WHO case definition of dysentery recommended for surveillance and reporting purposes is diarrhoea with visible blood in the stool („bloody diarrhoea”). […] To detect outbreaks of shigellosis, recording, reporting and analysis of all cases of bloody diarrhoea need to be done at health facilities. […] It is also considered to have limited practical value, because results become available long after the treatment has started, and false negative cultures are common. […] Each country aiming to ensure preparedness for an Sd1 epidemic should have effective disease surveillance systems, trained health professionals, reliably supplied health facilities and ongoing health education activities. […] Establishing an interministerial committee to plan and coordinate response to epidemics, including dysentery.

• #51 WHO EMRO | Shigella dysentery and shigella infections | Volume 2, issue 1 | EMHJ volume 2, 1996

  https://www.emro.who.int/emhj-volume-2-1996/volume-2-issue-1/article14.html

  According to current estimates, over two thirds of all episodes of shigellosis and four fifths of all deaths from shigellosis occur in children under five years old. […] The WHO case definition of dysentery recommended for surveillance and reporting purposes is diarrhoea with visible blood in the stool („bloody diarrhoea”). […] To detect outbreaks of shigellosis, recording, reporting and analysis of all cases of bloody diarrhoea need to be done at health facilities. […] It is also considered to have limited practical value, because results become available long after the treatment has started, and false negative cultures are common. […] Each country aiming to ensure preparedness for an Sd1 epidemic should have effective disease surveillance systems, trained health professionals, reliably supplied health facilities and ongoing health education activities. […] Establishing an interministerial committee to plan and coordinate response to epidemics, including dysentery.

• #52 The changing epidemiology of shigellosis in Australia, 2001–2019 | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0010450

  Over the study period, we also observed a shift in the testing method used to diagnose shigellosis, with culture independent diagnostic testing (CIDT) increasing from 2014; this also coincided with an increase in notifications of untyped Shigella. […] Our study findings also highlight the implications of culture independent testing on shigellosis surveillance, particularly a reduction in the availability of species level information. […] Shigellosis is caused by gram-negative Shigella spp. bacteria, which is primarily transmitted through the faecal-oral route by direct or indirect contact with faecal matter. […] Shigella have a low infectious dose between 10 to 100 organisms, and the clinical presentations of infection can vary from mild watery diarrhoea to severe dysentery (bloody diarrhoea) compounded by systemic complications such as electrolyte imbalance, seizures, fever, nausea and haemolytic uraemic syndrome.

• #53 The changing epidemiology of shigellosis in Australia, 2001–2019 | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0010450

  Over the study period, we also observed a shift in the testing method used to diagnose shigellosis, with culture independent diagnostic testing (CIDT) increasing from 2014; this also coincided with an increase in notifications of untyped Shigella. […] Our study findings also highlight the implications of culture independent testing on shigellosis surveillance, particularly a reduction in the availability of species level information. […] Shigellosis is caused by gram-negative Shigella spp. bacteria, which is primarily transmitted through the faecal-oral route by direct or indirect contact with faecal matter. […] Shigella have a low infectious dose between 10 to 100 organisms, and the clinical presentations of infection can vary from mild watery diarrhoea to severe dysentery (bloody diarrhoea) compounded by systemic complications such as electrolyte imbalance, seizures, fever, nausea and haemolytic uraemic syndrome.

• #54 The changing epidemiology of shigellosis in Australia, 2001–2019 | PLOS Neglected Tropical Diseases

  https://journals.plos.org/plosntds/article?id=10.1371/journal.pntd.0010450

  The relative importance of Shigella species in Australia varied by jurisdiction, with western jurisdictions, particularly the Northern Territory (NT) having higher rates across all years. […] In Australia, notification rates of shigellosis were higher in First Nations Australians than the non-Indigenous population, which was consistent throughout the period of surveillance. […] The study observed a considerable increase in untyped Shigella in recent years which coincided with an increased use of CIDT.

• #55 RIDRM Shigellosis

  https://portal.ct.gov/dph/epidemiology-and-emerging-infections/ridrm-shigellosis

  Shigellosis is a diarrheal illness caused by a group of bacteria called Shigella. […] Shigellosis is physician reportable by mail within 12 hours of recognition or strong suspicion to both the Connecticut Department of Public Health (DPH) and the local health department (LHD). […] Isolates of Shigella must be submitted to the DPH State Public Health Laboratory for confirmation and should include the serogroup/species. […] If the case is in a high-risk occupation or setting, the LHD will implement control measures. […] DPH will interview the case to collect clinical and risk factor information and to identify individuals in high-risk occupations or settings. […] Individuals with laboratory-confirmed infection should be restricted from direct patient care until diarrhea ceases and two consecutive negative stool cultures spaced at least 24 hours apart are obtained.

• #56 RIDRM Shigellosis

  https://portal.ct.gov/dph/epidemiology-and-emerging-infections/ridrm-shigellosis

  Shigellosis is a diarrheal illness caused by a group of bacteria called Shigella. […] Shigellosis is physician reportable by mail within 12 hours of recognition or strong suspicion to both the Connecticut Department of Public Health (DPH) and the local health department (LHD). […] Isolates of Shigella must be submitted to the DPH State Public Health Laboratory for confirmation and should include the serogroup/species. […] If the case is in a high-risk occupation or setting, the LHD will implement control measures. […] DPH will interview the case to collect clinical and risk factor information and to identify individuals in high-risk occupations or settings. […] Individuals with laboratory-confirmed infection should be restricted from direct patient care until diarrhea ceases and two consecutive negative stool cultures spaced at least 24 hours apart are obtained.

• #57 Shigella | Georgia Department of Public Health

  https://dph.georgia.gov/epidemiology/acute-disease-epidemiology/foodborne-and-waterborne-diseases/shigella

  Shigellosis is a bacterial infection affecting the intestinal tract. Most cases are seen in the summer and early fall and occur as single cases or in association with outbreaks. Shigella case numbers can vary from year to year, in a cyclical pattern over 5-6 years. […] Shigella germs are found in the stool of people who are sick with shigellosis and for up to two weeks after the diarrhea has gone away. Shigella is extremely contagious, and a small amount can make someone sick. Shigella bacteria can be found in contaminated food and water, or surfaces contaminated with feces from infected humans. […] Shigellosis is a reportable disease in Georgia. All laboratory positive results are reportable to the Georgia Department of Public Health. […] Traveling to developing countries increases the likelihood of getting shigellosis and getting a type of shigella that is more difficult to treat.

• #58 Shigella

  https://www.nmhealth.org/about/erd/ideb/eip/foodnet/shigella/

  Shigellosis is an infection caused by the Shigella group of bacteria. […] Shigella bacteria are passed from the stool of an infected person to the mouth of another, also called the oral-fecal route of transmission. […] Children in child care settings and people living in crowded conditions are at increased risk of infection. […] Shigellosis can sometimes spread quickly through entire communities, primarily through person-to-person transmission, causing what is known as a community-wide outbreak. […] Active, population-based surveillance for Shigella has been conducted throughout New Mexico since 2004 as part of the New Mexico Emerging Infections Program (NMEIP ) FoodNet system. […] Through this surveillance system New Mexico FoodNet is able to examine and describe Shigella infections in the state.

• #59 Shigella

  https://www.nmhealth.org/about/erd/ideb/eip/foodnet/shigella/

  Shigellosis is an infection caused by the Shigella group of bacteria. […] Shigella bacteria are passed from the stool of an infected person to the mouth of another, also called the oral-fecal route of transmission. […] Children in child care settings and people living in crowded conditions are at increased risk of infection. […] Shigellosis can sometimes spread quickly through entire communities, primarily through person-to-person transmission, causing what is known as a community-wide outbreak. […] Active, population-based surveillance for Shigella has been conducted throughout New Mexico since 2004 as part of the New Mexico Emerging Infections Program (NMEIP ) FoodNet system. […] Through this surveillance system New Mexico FoodNet is able to examine and describe Shigella infections in the state.

• #60 Shigellosis

  https://www.health.vic.gov.au/infectious-diseases/shigellosis

  Shigellosis must be notified by medical practitioners and pathology services in writing within 5 days of diagnosis. […] Shigella infection occurs worldwide, although the incidence of specific serotypes varies by country; antimicrobial resistance in Shigella isolates from returned travellers is increasing. […] Notifications of shigellosis in Victoria have increased substantially since 2014. […] Two or more related cases should be considered indicative of an outbreak and require investigation. […] The diagnosis should be considered in symptomatic contacts.

• #61 Shigellosis

  https://www.health.vic.gov.au/infectious-diseases/shigellosis

  Shigellosis must be notified by medical practitioners and pathology services in writing within 5 days of diagnosis. […] Shigella infection occurs worldwide, although the incidence of specific serotypes varies by country; antimicrobial resistance in Shigella isolates from returned travellers is increasing. […] Notifications of shigellosis in Victoria have increased substantially since 2014. […] Two or more related cases should be considered indicative of an outbreak and require investigation. […] The diagnosis should be considered in symptomatic contacts.

• #62

  https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON364

  The World Health Organisation (WHO) was notified on 4 February 2022 of an unusually high number of cases of extensively drug-resistant (XDR) Shigella sonnei which have been reported in the United Kingdom of Great Britain and Northern Ireland and several other countries in the WHO European Region since late 2021. […] Multi-drug resistant (MDR) and XDR shigellosis is a public health concern since treatment options are very limited for moderate to severe cases. […] As of 17 March 2022, at least nine additional countries in the European Region have reported cases of S. sonnei, including some cases infected with XDR S. sonnei. […] Shigellosis is a gastrointestinal infection caused by one of four species of Shigella bacteria, including S. sonnei. […] It is estimated to cause at least 80 million cases of bloody diarrhoea and 700 000 deaths.

• #63

  https://www.who.int/emergencies/disease-outbreak-news/item/2022-DON364

  The World Health Organisation (WHO) was notified on 4 February 2022 of an unusually high number of cases of extensively drug-resistant (XDR) Shigella sonnei which have been reported in the United Kingdom of Great Britain and Northern Ireland and several other countries in the WHO European Region since late 2021. […] Multi-drug resistant (MDR) and XDR shigellosis is a public health concern since treatment options are very limited for moderate to severe cases. […] As of 17 March 2022, at least nine additional countries in the European Region have reported cases of S. sonnei, including some cases infected with XDR S. sonnei. […] Shigellosis is a gastrointestinal infection caused by one of four species of Shigella bacteria, including S. sonnei. […] It is estimated to cause at least 80 million cases of bloody diarrhoea and 700 000 deaths.

• #64 Shigella

  https://www.nmhealth.org/about/erd/ideb/eip/foodnet/shigella/

  Shigellosis is an infection caused by the Shigella group of bacteria. […] Shigella bacteria are passed from the stool of an infected person to the mouth of another, also called the oral-fecal route of transmission. […] Children in child care settings and people living in crowded conditions are at increased risk of infection. […] Shigellosis can sometimes spread quickly through entire communities, primarily through person-to-person transmission, causing what is known as a community-wide outbreak. […] Active, population-based surveillance for Shigella has been conducted throughout New Mexico since 2004 as part of the New Mexico Emerging Infections Program (NMEIP ) FoodNet system. […] Through this surveillance system New Mexico FoodNet is able to examine and describe Shigella infections in the state.

• #65 Shigella

  https://www.nmhealth.org/about/erd/ideb/eip/foodnet/shigella/

  During 2022, there were 246 confirmed and probable cases of Shigella identified in New Mexico, an overall rate of 11.6 per 100,000 population. […] The annual infection rate in New Mexico is cyclical and yearly rates trend higher than other FoodNet states. […] Data are from New Mexico FoodNET cases and may slightly differ from those reported to the National Notifiable Diseases Surveillance System (NNDSS).

• #66

  https://hip.phila.gov/disease-control/diseasesconditions/shigella/

  Increase in Shigella Cases in Philadelphia […] An increase in shigella cases has been observed in Philadelphia over the last month. Cases have been reported among people experiencing homelessness and opioid use disorder. Shigellosis is a reportable condition in Philadelphia. Providers who use culture-independent diagnostic test (CIDT) instead of culture for diagnosis should request reflex culture when CIDT is positive. […] Cases in Philadelphia have increased in the last month. There have been 21 cases identified among adults and 4 cases identified among children since October 1, 2023. Investigations are ongoing, however preliminary investigations suggest that some individuals testing positive are experiencing homelessness or opioid use disorder. Among the cases, different species and serovars have been identified indicating that more than one cluster is possibly occurring. Nationwide, cases are being reported frequently among people experiencing homelessness, as well as gay, bisexual, and other men who have sex with men.

• #67 Suspected Local Transmission of Extensively Drug-Resistant (XDR) Shigellosis in King County – King County, Washington

  https://kingcounty.gov/en/dept/dph/health-safety/disease-illness/health-advisories/2024/april-5

  Be aware of four cases of extensively drug-resistant (XDR) shigellosis detected in King County during 20232024 with suspected local transmission. […] Public Health Seattle King County (Public Health) has identified five cases of XDR Shigella in King County since 2020. Four cases of XDR Shigella in King County residents were reported during November 2023 and March 2024. […] The Centers for Disease Control and Prevention (CDC) National Antimicrobial Resistance Monitoring System (NARMS) has been monitoring an increase of extensively drug-resistant (XDR) Shigella infections (shigellosis) in the United States. In 2022, about 5% of Shigella infections reported to CDC were caused by XDR strains compared to 0% in 2015. […] The CDC defines XDR Shigella bacteria as strains that are resistant to all commonly recommended empiric and alternative antibiotics azithromycin, ciprofloxacin, ceftriaxone, trimethoprim-sulfamethoxazole (TMP-SMX), and ampicillin.

• #68 Shigellosis | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/shigellosis

  Shigellosis has a worldwide distribution, with approximately 125 million illnesses and 14,000 deaths reported annually throughout the world. […] In the United States, there are an estimated 500,000 cases of shigellosis every year, making it the third most common bacterial enteric disease. […] Outbreaks most often occur in child care centers, among men who have sex with men, and in jails. […] The Council of State and Territorial Epidemiologists (CSTE) surveillance case definitions for Shigellosis can be found at: https://ndc.services.cdc.gov/conditions/shigellosis/. […] CSTE case definitions should not affect the investigation or reporting of a case that fulfills the criteria in this chapter.

• #69 Shigellosis Fact Sheet

  https://www.health.ny.gov/diseases/communicable/shigellosis/fact_sheet.htm

  Shigellosis is a fairly common disease; there are an estimated 450,000 infections in the United States each year. […] Large outbreaks of shigellosis have occurred in communities which often begin in childcare settings or schools and spread throughout households and the community during social gatherings. […] Outbreaks have also occurred among gay or bisexual men and other men who have sex with men. […] Shigella is found in the intestinal tract (bowels) of infected people and is shed in their feces (poop). […] Shigella bacteria are present in the feces of infected persons while they are sick and for up to a week or two after they no longer feel ill. […] Most infected people may return to work or school when their diarrhea (loose stool/poop) has stopped, provided that they carefully wash their hands with soap and water after using the bathroom. […] People with shigellosis should avoid sexual contact until at least two weeks after diarrhea resolves.

• #70 Shigellosis Fact Sheet

  https://www.health.ny.gov/diseases/communicable/shigellosis/fact_sheet.htm

  Shigellosis is a fairly common disease; there are an estimated 450,000 infections in the United States each year. […] Large outbreaks of shigellosis have occurred in communities which often begin in childcare settings or schools and spread throughout households and the community during social gatherings. […] Outbreaks have also occurred among gay or bisexual men and other men who have sex with men. […] Shigella is found in the intestinal tract (bowels) of infected people and is shed in their feces (poop). […] Shigella bacteria are present in the feces of infected persons while they are sick and for up to a week or two after they no longer feel ill. […] Most infected people may return to work or school when their diarrhea (loose stool/poop) has stopped, provided that they carefully wash their hands with soap and water after using the bathroom. […] People with shigellosis should avoid sexual contact until at least two weeks after diarrhea resolves.

• #71

  https://www.gov.uk/government/publications/non-travel-associated-shigella-infections/sexually-transmitted-shigella-spp-in-england-2016-to-2023

  Shigella spp. (S. dysenteriae, S. flexneri, S. boydii and S. sonnei) are bacterial enteric pathogens, transmitted through faecal-oral contact, which can cause dysentery. […] However, in England shigellosis is increasingly acquired domestically by men who have sex with men (MSM). […] Throughout this report, adult men not reporting travel, or where travel is unknown, are assumed to most likely have acquired their infection through sexual transmission and are described as presumptive MSM. […] The key observations from this report are that: following the COVID-19 pandemic, reported diagnoses of Shigella spp. related to both travel and presumed sexual transmission increased and returned to pre-pandemic 2019 levels, and have substantially exceeded pre-pandemic levels among presumptive MSM.

• #72

  https://www.gov.uk/government/publications/non-travel-associated-shigella-infections/sexually-transmitted-shigella-spp-in-england-2016-to-2023

  In 2023, most diagnoses of Shigella spp. were seen in London (46%), Greater Manchester (7%) and Surrey and Sussex (8%); this reflects variations in the population of MSM across the country. […] Cases of sexually transmitted S. sonnei increased substantially from Q3 2021 onwards, 230 and 432 diagnoses being reported in 2022 and 2023 respectively; notable within this increase was the re-emergence of a S. sonnei CipR.MSM5 (Clade 5) outbreak strain in late 2021, which subsequently became extensively drug-resistant (XDR). […] Very high levels of antimicrobial resistance among Shigella spp. isolates continue to be a significant public health concern; the increase in XDR in S. sonnei isolates with resistance to ceftriaxone (a key second-line treatment for shigellosis) is being monitored to ensure that present cases of shigellosis are treated effectively and that antimicrobial treatment continues to be effective.

• #73 Shigellosis in Nepal: 13 years review of nationwide surveillance | Journal of Health, Population and Nutrition | Full Text

  https://jhpn.biomedcentral.com/articles/10.1186/s41043-016-0073-x

  The present study, covering 13 years surveillance (2003-2015), demonstrates the changing serotype and trend of antimicrobial resistance of Shigella isolates in Nepal. […] Treatment of shigellosis depends on appropriate antimicrobial therapy. A variety of antibiotics are effective for treatment of shigellosis, although options are becoming limited due to globally emerging drug resistance. […] With increasing resistance to first-line agents along with ciprofloxacin, only ceftriaxone remains the drug of choice; however, increasing MDR along with resistance to third-generation cephalosporins as last resort creates an alarming situation warranting proper usage of antimicrobial agents and its continuous monitoring.

• #74

  https://journals.lww.com/ijmr/fulltext/2016/43050/shigellosis__epidemiology_in_india.6.aspx

  The emergence of MDR Shigella has been reported from all over the world, including the USA, Iran, China, Indonesia, Vietnam, Bangladesh and India. […] The finding of a high prevalence of ESBL producing genes like blaCTX-M-15 which spread by horizontal transfer and/or mobilization of genetic mobile elements by orofaecal route, has serious implications in terms of further spread of resistance to third generation cephalosporins to other regions. […] Thus, there is a widespread emergence of MDR Shigella in the face of rampant injudicious antimicrobial use which reinforces the need for continuous surveillance of antimicrobial resistance determinants across the country to know the molecular epidemiology of resistance, which is further essential for implementing timely intervention steps to control the disease as well as spread of these resistance genes to other parts of the world.

• #75

  https://journals.lww.com/ijmr/fulltext/2016/43050/shigellosis__epidemiology_in_india.6.aspx

  The emergence of MDR Shigella has been reported from all over the world, including the USA, Iran, China, Indonesia, Vietnam, Bangladesh and India. […] The finding of a high prevalence of ESBL producing genes like blaCTX-M-15 which spread by horizontal transfer and/or mobilization of genetic mobile elements by orofaecal route, has serious implications in terms of further spread of resistance to third generation cephalosporins to other regions. […] Thus, there is a widespread emergence of MDR Shigella in the face of rampant injudicious antimicrobial use which reinforces the need for continuous surveillance of antimicrobial resistance determinants across the country to know the molecular epidemiology of resistance, which is further essential for implementing timely intervention steps to control the disease as well as spread of these resistance genes to other parts of the world.

• #76 Suspected Local Transmission of Extensively Drug-Resistant (XDR) Shigellosis in King County – King County, Washington

  https://kingcounty.gov/en/dept/dph/health-safety/disease-illness/health-advisories/2024/april-5

  Be aware of four cases of extensively drug-resistant (XDR) shigellosis detected in King County during 20232024 with suspected local transmission. […] Public Health Seattle King County (Public Health) has identified five cases of XDR Shigella in King County since 2020. Four cases of XDR Shigella in King County residents were reported during November 2023 and March 2024. […] The Centers for Disease Control and Prevention (CDC) National Antimicrobial Resistance Monitoring System (NARMS) has been monitoring an increase of extensively drug-resistant (XDR) Shigella infections (shigellosis) in the United States. In 2022, about 5% of Shigella infections reported to CDC were caused by XDR strains compared to 0% in 2015. […] The CDC defines XDR Shigella bacteria as strains that are resistant to all commonly recommended empiric and alternative antibiotics azithromycin, ciprofloxacin, ceftriaxone, trimethoprim-sulfamethoxazole (TMP-SMX), and ampicillin.

• #77 Increase in extensively drug-resistant (XDR) shigellosis in the United States – King County, Washington

  https://kingcounty.gov/en/dept/dph/health-safety/disease-illness/health-advisories/2023/9-march

  Be aware that the Centers for Disease Control and Prevention (CDC) has been monitoring an increase in extensively drug-resistant (XDR) Shigella infections (shigellosis) reported through national surveillance systems. […] The Centers for Disease Control and Prevention (CDC) National Antimicrobial Resistance Monitoring System (NARMS) has been monitoring an increase of extensively drug-resistant (XDR) Shigella infections (shigellosis) in the United States. In 2022, about 5% of Shigella infections reported to CDC were caused by XDR strains compared to with 0% in 2015. […] Currently, Public Health has seen a marked increase in reported Shigella infections among King County residents, investigating a total of 156 reported cases since November 2022. […] Shigella is easily spread person-to-person through the fecal-oral route and through sexual contact, especially in situations with limited access to hygiene facilities.

• #78 Suspected Local Transmission of Extensively Drug-Resistant (XDR) Shigellosis in King County – King County, Washington

  https://kingcounty.gov/en/dept/dph/health-safety/disease-illness/health-advisories/2024/april-5

  Be aware of four cases of extensively drug-resistant (XDR) shigellosis detected in King County during 20232024 with suspected local transmission. […] Public Health Seattle King County (Public Health) has identified five cases of XDR Shigella in King County since 2020. Four cases of XDR Shigella in King County residents were reported during November 2023 and March 2024. […] The Centers for Disease Control and Prevention (CDC) National Antimicrobial Resistance Monitoring System (NARMS) has been monitoring an increase of extensively drug-resistant (XDR) Shigella infections (shigellosis) in the United States. In 2022, about 5% of Shigella infections reported to CDC were caused by XDR strains compared to 0% in 2015. […] The CDC defines XDR Shigella bacteria as strains that are resistant to all commonly recommended empiric and alternative antibiotics azithromycin, ciprofloxacin, ceftriaxone, trimethoprim-sulfamethoxazole (TMP-SMX), and ampicillin.

• #79

  https://www.gov.uk/government/publications/non-travel-associated-shigella-infections/sexually-transmitted-shigella-spp-in-england-2016-to-2023

  In 2023, most diagnoses of Shigella spp. were seen in London (46%), Greater Manchester (7%) and Surrey and Sussex (8%); this reflects variations in the population of MSM across the country. […] Cases of sexually transmitted S. sonnei increased substantially from Q3 2021 onwards, 230 and 432 diagnoses being reported in 2022 and 2023 respectively; notable within this increase was the re-emergence of a S. sonnei CipR.MSM5 (Clade 5) outbreak strain in late 2021, which subsequently became extensively drug-resistant (XDR). […] Very high levels of antimicrobial resistance among Shigella spp. isolates continue to be a significant public health concern; the increase in XDR in S. sonnei isolates with resistance to ceftriaxone (a key second-line treatment for shigellosis) is being monitored to ensure that present cases of shigellosis are treated effectively and that antimicrobial treatment continues to be effective.

• #80

  https://www.gov.uk/government/publications/non-travel-associated-shigella-infections/sexually-transmitted-shigella-spp-in-england-2016-to-2023

  In 2023, most diagnoses of Shigella spp. were seen in London (46%), Greater Manchester (7%) and Surrey and Sussex (8%); this reflects variations in the population of MSM across the country. […] Cases of sexually transmitted S. sonnei increased substantially from Q3 2021 onwards, 230 and 432 diagnoses being reported in 2022 and 2023 respectively; notable within this increase was the re-emergence of a S. sonnei CipR.MSM5 (Clade 5) outbreak strain in late 2021, which subsequently became extensively drug-resistant (XDR). […] Very high levels of antimicrobial resistance among Shigella spp. isolates continue to be a significant public health concern; the increase in XDR in S. sonnei isolates with resistance to ceftriaxone (a key second-line treatment for shigellosis) is being monitored to ensure that present cases of shigellosis are treated effectively and that antimicrobial treatment continues to be effective.

• #81

  https://www.gov.uk/government/publications/non-travel-associated-shigella-infections/sexually-transmitted-shigella-spp-in-england-2016-to-2023

  Reported diagnoses among adult males not reporting travel or where travel history is unknown (presumptive MSM) have been consistently higher, and increasing at a faster rate compared to females, children, or males reporting recent travel. […] During this period around 75% of all shigella reports were presumed to be sexually transmitted, indicating that transmission between MSM persisted during the pandemic. […] The proportion has since declined but, in 2023, still accounted for as much as 51% of all diagnoses. […] Following the easing of COVID-19 restrictions from Q2 2021, both travel-associated and non-travel associated diagnoses increased. […] This was more pronounced among presumptive MSM, with diagnoses increasing by 280% between Q3 2021 and Q4 2023 (from 66 to 251). […] The proportion of isolates that are XDR continues to increase among S. flexneri and, particularly, S. sonnei isolates which raises concern that there are very few therapeutic options available for patients with complications. […] Diagnostic laboratories should continue to refer isolates from high risk populations so as to monitor emergence of pan-resistance.

• #82 Spatiotemporal variation in risk of Shigella infection in childhood: a global risk mapping and prediction model using individual participant data | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.08.04.22277641v1.full-text

  Diarrheal disease remains a leading cause of childhood illness and mortality and Shigella is a major etiological contributor for which a vaccine may soon be available. This study aimed to model the spatiotemporal variation in pediatric Shigella infection and map its predicted prevalence across low- and middle-income countries (LMICs). […] Shigella, a genus of gram-negative bacteria with 50 serotypes, infects over 163 million people annually in low- and middle-income countries (LMICs) and is responsible for over 212,000 diarrheal disease deaths. […] Vaccine development for Shigella has been hampered by biotechnical and financial limitations, but there are multiple candidate vaccines now in late stages of development. It is therefore becoming increasingly important to geographically map global Shigella infection risk to guide and inform prospective rollout efforts towards high-priority populations.

• #83 Spatiotemporal variation in risk of Shigella infection in childhood: a global risk mapping and prediction model using individual participant data | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.08.04.22277641v1.full-text

  The distribution of Shigella is more sensitive to climatological factors like temperature than previously recognized. Conditions in much of sub-Saharan Africa are particularly propitious for Shigella transmission, though hotspots also occur in South and Central America, the Ganges-Brahmaputra Delta, and New Guinea. These findings can inform prioritization of populations for future vaccine trials and campaigns. […] This study applied an IPD-MA approach to address this knowledge gap and is the first attempt to map Shigella prevalence at sub-unit level and across multiple continents. It is also the first to model the comparative effects of a large suite of covariates that vary on different scales, from the individual to the wider macroclimate, and, for several, include temporal variability at daily resolution.

• #84 Spatiotemporal variation in risk of Shigella infection in childhood: a global risk mapping and prediction model using individual participant data | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.08.04.22277641v1.full-text

  The findings reveal not only small-scale zones of potential elevated transmission risk, but also generalizable evidence about the relative influence of different drivers of Shigella transmission. Furthermore, the seasonal variability in infection risk within the same locations revealed by these findings may be relevant for diagnosis and treatment and for optimal timing of health system interventions. […] The results confirm that Shigella risk has a strong association with age the highest prevalence occurring in older children (24-59m) – and diarrhea symptom status, consistent with effects documented previously. While these control variables ranked highest in importance and effect size magnitude, they were closely followed by hydrometeorological variables including temperature, wind speed, relative humidity, and soil moisture. […] These findings should inform the design and selection of sites for forthcoming phase 3 Shigella vaccine trials, and populations living in these hotspots should be considered high priority for eventual vaccine rollout campaigns.

• #85 Spatiotemporal variation in risk of Shigella infection in childhood: a global risk mapping and prediction model using individual participant data | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.08.04.22277641v1.full-text

  The findings reveal not only small-scale zones of potential elevated transmission risk, but also generalizable evidence about the relative influence of different drivers of Shigella transmission. Furthermore, the seasonal variability in infection risk within the same locations revealed by these findings may be relevant for diagnosis and treatment and for optimal timing of health system interventions. […] The results confirm that Shigella risk has a strong association with age the highest prevalence occurring in older children (24-59m) – and diarrhea symptom status, consistent with effects documented previously. While these control variables ranked highest in importance and effect size magnitude, they were closely followed by hydrometeorological variables including temperature, wind speed, relative humidity, and soil moisture. […] These findings should inform the design and selection of sites for forthcoming phase 3 Shigella vaccine trials, and populations living in these hotspots should be considered high priority for eventual vaccine rollout campaigns.

• #86 Spatiotemporal variation in risk of Shigella infection in childhood: a global risk mapping and prediction model using individual participant data | medRxiv

  https://www.medrxiv.org/content/10.1101/2022.08.04.22277641v1.full-text

  The distribution of Shigella is more sensitive to climatological factors like temperature than previously recognized. Conditions in much of sub-Saharan Africa are particularly propitious for Shigella transmission, though hotspots also occur in South and Central America, the Ganges-Brahmaputra Delta, and New Guinea. These findings can inform prioritization of populations for future vaccine trials and campaigns. […] This study applied an IPD-MA approach to address this knowledge gap and is the first attempt to map Shigella prevalence at sub-unit level and across multiple continents. It is also the first to model the comparative effects of a large suite of covariates that vary on different scales, from the individual to the wider macroclimate, and, for several, include temporal variability at daily resolution.

• #87

  https://journals.lww.com/ijmr/fulltext/2016/43050/shigellosis__epidemiology_in_india.6.aspx

  Shigellosis is one of the major causes of diarrhoea in India. The accurate estimates of morbidity and mortality due to shigellosis are lacking, though it is endemic in the country and has been reported to cause many outbreaks. […] The limited information available indicates Shigella to be an important food-borne pathogen in India. […] This calls for a continuous and strong surveillance of antibiotic resistance across the country for periodic updation of the local antibiograms. […] The prevention of shigellosis is desirable as it will substantially reduce the morbidity associated with diarrhoea in the country. […] This review is focused upon the epidemiology, disease burden and the therapeutic challenges of shigellosis in Indian perspective. […] Shigellosis occurs worldwide, in endemic and epidemic forms. Majority of cases are children 5 yr of age.

• #88 RIDRM Shigellosis

  https://portal.ct.gov/dph/epidemiology-and-emerging-infections/ridrm-shigellosis

  Attendees and/or staff with laboratory-confirmed infection should be excluded from day care until diarrhea ceases and two consecutive negative stool cultures spaced at least 24 hours apart are obtained. […] Improved sanitation and personal hygiene should be emphasized in day care settings. […] Proper hand washing by staff and children (especially after using the toilet or handling soiled diapers) should be stressed, as hand hygiene is the most important measure to decrease transmission. […] Household contacts with diarrhea and/or vomiting should be excluded from food handling, child daycare, and direct patient care until they are asymptomatic. Proper hand washing should be stressed.

• #89 RIDRM Shigellosis

  https://portal.ct.gov/dph/epidemiology-and-emerging-infections/ridrm-shigellosis

  Attendees and/or staff with laboratory-confirmed infection should be excluded from day care until diarrhea ceases and two consecutive negative stool cultures spaced at least 24 hours apart are obtained. […] Improved sanitation and personal hygiene should be emphasized in day care settings. […] Proper hand washing by staff and children (especially after using the toilet or handling soiled diapers) should be stressed, as hand hygiene is the most important measure to decrease transmission. […] Household contacts with diarrhea and/or vomiting should be excluded from food handling, child daycare, and direct patient care until they are asymptomatic. Proper hand washing should be stressed.

• #90 WHO EMRO | Shigella dysentery and shigella infections | Volume 2, issue 1 | EMHJ volume 2, 1996

  https://www.emro.who.int/emhj-volume-2-1996/volume-2-issue-1/article14.html

  According to current estimates, over two thirds of all episodes of shigellosis and four fifths of all deaths from shigellosis occur in children under five years old. […] The WHO case definition of dysentery recommended for surveillance and reporting purposes is diarrhoea with visible blood in the stool („bloody diarrhoea”). […] To detect outbreaks of shigellosis, recording, reporting and analysis of all cases of bloody diarrhoea need to be done at health facilities. […] It is also considered to have limited practical value, because results become available long after the treatment has started, and false negative cultures are common. […] Each country aiming to ensure preparedness for an Sd1 epidemic should have effective disease surveillance systems, trained health professionals, reliably supplied health facilities and ongoing health education activities. […] Establishing an interministerial committee to plan and coordinate response to epidemics, including dysentery.

• #91 WHO EMRO | Shigella dysentery and shigella infections | Volume 2, issue 1 | EMHJ volume 2, 1996

  https://www.emro.who.int/emhj-volume-2-1996/volume-2-issue-1/article14.html

  According to current estimates, over two thirds of all episodes of shigellosis and four fifths of all deaths from shigellosis occur in children under five years old. […] The WHO case definition of dysentery recommended for surveillance and reporting purposes is diarrhoea with visible blood in the stool („bloody diarrhoea”). […] To detect outbreaks of shigellosis, recording, reporting and analysis of all cases of bloody diarrhoea need to be done at health facilities. […] It is also considered to have limited practical value, because results become available long after the treatment has started, and false negative cultures are common. […] Each country aiming to ensure preparedness for an Sd1 epidemic should have effective disease surveillance systems, trained health professionals, reliably supplied health facilities and ongoing health education activities. […] Establishing an interministerial committee to plan and coordinate response to epidemics, including dysentery.

• #92 Controlling Spread of Shigellosis | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/shigellosis-0

  Children with Shigella infection who have diarrhea should be excluded until 48 hours after resolution of diarrhea or until 24 hours after treatment with antibiotics has started AND 24 hours after diarrhea stops. […] If the number of reported cases of shigellosis in your city/town seems higher than usual, or if an outbreak is suspected, more intensive investigation is warranted. Consult with your field epidemiologist in CADE for guidance on prevention and surveillance for additional cases.

• #93 Controlling Spread of Shigellosis | Health & Human Services

  https://hhs.iowa.gov/center-acute-disease-epidemiology/epi-manual/reportable-diseases/shigellosis-0

  Children with Shigella infection who have diarrhea should be excluded until 48 hours after resolution of diarrhea or until 24 hours after treatment with antibiotics has started AND 24 hours after diarrhea stops. […] If the number of reported cases of shigellosis in your city/town seems higher than usual, or if an outbreak is suspected, more intensive investigation is warranted. Consult with your field epidemiologist in CADE for guidance on prevention and surveillance for additional cases.

• #94 RIDRM Shigellosis

  https://portal.ct.gov/dph/epidemiology-and-emerging-infections/ridrm-shigellosis

  Shigellosis is a diarrheal illness caused by a group of bacteria called Shigella. […] Shigellosis is physician reportable by mail within 12 hours of recognition or strong suspicion to both the Connecticut Department of Public Health (DPH) and the local health department (LHD). […] Isolates of Shigella must be submitted to the DPH State Public Health Laboratory for confirmation and should include the serogroup/species. […] If the case is in a high-risk occupation or setting, the LHD will implement control measures. […] DPH will interview the case to collect clinical and risk factor information and to identify individuals in high-risk occupations or settings. […] Individuals with laboratory-confirmed infection should be restricted from direct patient care until diarrhea ceases and two consecutive negative stool cultures spaced at least 24 hours apart are obtained.

• #95 RIDRM Shigellosis

  https://portal.ct.gov/dph/epidemiology-and-emerging-infections/ridrm-shigellosis

  Attendees and/or staff with laboratory-confirmed infection should be excluded from day care until diarrhea ceases and two consecutive negative stool cultures spaced at least 24 hours apart are obtained. […] Improved sanitation and personal hygiene should be emphasized in day care settings. […] Proper hand washing by staff and children (especially after using the toilet or handling soiled diapers) should be stressed, as hand hygiene is the most important measure to decrease transmission. […] Household contacts with diarrhea and/or vomiting should be excluded from food handling, child daycare, and direct patient care until they are asymptomatic. Proper hand washing should be stressed.

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