Korean J Pediatr Infect Dis.  2006 May;13(1):71-77. 10.14776/kjpid.2006.13.1.71.

Outbreak of Shigellosis Occurred in a Preschool and Two Elemetary Schools in Mapo-Gu, Seoul

• Park TS
• Lee HJ
• Kim SY
• Lee DW
• Kim JY
• Baik JN
• Park YM
• Park MS
• Lee BK

• KMID: 2440000
• DOI: http://doi.org/10.14776/kjpid.2006.13.1.71

Abstract

PURPOSE
Shigellosis is still an important cause of acute food-borne diarrheal diseases throughout the world. We investigated the transmission routes and clinical course through the outbreak of shigellosis in Mapo-Gu, Seoul.
METHODS
From October 7th to November 19th in 2005, Mapo-Gu public health center had referred 32 patients with confirmed or suspected shigellosis to the National Medical Center. We had investigated source of infection, epidemiology, laboratory findings, and clinical course of the cases occurred during this outbreak.
RESULTS
Among 32 patients, 24 patients had been confirmed with shigellosis, 8 patients had been diagnosed with suspected shigellosis. They ranged in age from 5 months to 12 years old and their mean age was 6.5 years. The clinical manifestations were as follows; diarrhea, fever, abdominal pain and asymptomatic condition. Symptoms had sustained for 3.7 days on the average. S. sonnei were cultured by rectal swab and founded to be resistant to ampicillin and TMP/SMX except to 3rd generation cephalosporin. After treatment with antibiotics such as cefixime and ceftriaxone or imipenem and conservative treatment with electrolyte and fluid replacement for 5~7 days, Stool cultures of the rectal swab grew no Shigella in these cases except 3 cases.
CONCLUSION
An outbreak of shigellosis had occurred in a preschool and elementary school children. From the same results of antimicrobial susceptibility and pulsed-field gel electrophoresis patterns in this study, we suggest that the outbreak of shigellosis in this report had been originated from a single strain. According to all negative results about suspected food and water cultures, we couldn't find out source of infection. Through materials offerred by Mapo-Gu Public Health Center, we presumed the trasmission routes probably were person-to-person.

Keyword

Shigella sonnei; outbreak; 3rd generation Cephalosporin

MeSH Terms

Abdominal Pain
Ampicillin
Anti-Bacterial Agents
Asymptomatic Diseases
Cefixime
Ceftriaxone
Child
Diarrhea
Dysentery, Bacillary*
Electrophoresis, Gel, Pulsed-Field
Epidemiology
Fever
Humans
Imipenem
Public Health
Seoul*
Shigella
Shigella sonnei
Water
Ampicillin
Anti-Bacterial Agents
Cefixime
Ceftriaxone
Imipenem
Water