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Shigella dysenteriae type 1 infections in US travellers to Mexico, 1988
J Parsonnet1, K D Greene, A R Gerber
1Enteric Diseases Branch, Centers for Disease Control, Atlanta, Georgia.
Abstract:
In 1988, the number of Shigella dysenteriae type 1 (Sd1) infections reported in the USA increased five-fold over the annual mean from the previous decade. 44 (94%) of 47 interviewed patients reported recent travel to Mexico; 33 (75%) of these had been tourists to the Yucatan peninsula. 27 patients who had travelled to Mexico were admitted to hospital, of whom 2 had a haemolytic uraemic syndrome; none died. The antimicrobial resistance pattern and plasmid profile of the Yucatan strain were similar to those of the 1969-72 pandemic strain. Antimicrobial resistances and plasmid profiles were different in sporadic Western hemisphere strains. This is the first outbreak of Sd1 among US tourists and it is the largest known outbreak in the Western hemisphere since the early 1970s. The dominant Sd1 strain is similar to that which caused the catastrophic 1969-72 pandemic. Surveillance and control measures have been instituted in the Yucatan peninsula.
Insights
A Shigella dysenteriae type 1 (Sd1) outbreak occurred in US tourists returning from Mexico. The Yucatan strain matched the 1969-72 pandemic strain, prompting control measures.
Area of Science:
- Microbiology
- Infectious Diseases
- Epidemiology
Background:
- Shigella dysenteriae type 1 (Sd1) causes dysentery and can lead to severe complications.
- Global surveillance is crucial for tracking infectious disease outbreaks and antimicrobial resistance.
Observation:
- A significant five-fold increase in reported US Shigella dysenteriae type 1 infections occurred in 1988.
- Most cases were linked to travel to Mexico, particularly the Yucatan peninsula.
Findings:
- The dominant Sd1 strain identified in US tourists exhibited antimicrobial resistance and plasmid profiles similar to the 1969-72 pandemic strain.
- This outbreak represents the largest Western Hemisphere emergence of Sd1 since the early 1970s and the first documented among US tourists.
Implications:
- The findings highlight the potential for re-emergence of highly virulent Sd1 strains.
- Enhanced surveillance and control measures in tourist destinations like the Yucatan peninsula are critical for preventing future outbreaks.