Epidemic dysentery in western Kenya

This paper describes the epidemiology of a probable Shigella dysenteriae type 1 dysentery epidemic in western Kenya. A retrospective record review over 2 years of all cases of dysentery, amoebiasis and diarrhoea was carried out in 13 healthcare facilities in the Rarieda Division of Nyanza province. Of the 3301 cases recorded, 2191 were dysentery, giving a cumulative 2 years incidence rate for dysentery of 4%. The epidemic began in December 1994 and peaked in February 1995, coinciding with the very dry season. One location in the area had an overall attack rate of 9.3%, double that of other locations. Highest rates were in children aged < 5 years and in persons > 15 years old. S. dysenteriae type 1, with its increasing multiantibiotic resistance, is a continuing threat to the health of people in this region; this area may be suitable for intensive, prospective surveillance as a prelude to a Shigella vaccine trial.