Prospective cohort studies of shigellosis during military field training

Epidemiological and clinical features of shigellosis occurring among cohorts of Israeli recruits followed-up for 3-6 months during the summer field training of years 1993-1997 were studied. The incidence rate of culture-proven shigellosis was the highest (78 cases per 1,000 recruits) in 1996 and the lowest (13 cases per 1,000 recruits) in 1995. Shigella sonnei (152 isolates) and Shigella flexneri (151 isolates) were the most common species. Fifty percent of the patients with shigellosis had fever (>37.5 degrees C), compared to only 18% of the subjects with other diarrheal diseases (P < 0.001). The duration of illness was longer among subjects with shigellosis than among those with other diarrheal diseases (P < 0.001). Illness due to Shigella flexneri was more severe than illness caused by Shigella sonnei.