ABSTRACT
An outbreak of Shiga bacillus (Shigella dysenteriae type 1) infection has been detected for the first time in South Africa. Forty-eight cases of this epidemic that presented to a referral hospital were clinically evaluated. Patients presented with dysentery from all age groups and 16 (33%) were admitted to hospital. There were two geographical regions where 32 (67%) of the patients resided. The isolates were demonstrated to be pathogenic by in vitro testing for invasion and toxin production, and were found to be resistant to first line antibiotics that have been used for the treatment of shigellosis i.e. ampicillin, cotrimoxazole, tetracycline and chloramphenicol. However, they were susceptible to nalidixic acid, ceftriaxone and ciprofloxacin. Urgent, public health measures are needed to prevent further spread of this epidemic.
Subject(s)
Disease Outbreaks , Dysentery, Bacillary/epidemiology , Shigella dysenteriae , Adolescent , Adult , Aged , Animals , Bacterial Toxins/toxicity , Child , Child, Preschool , Chlorocebus aethiops , Dysentery, Bacillary/diagnosis , Dysentery, Bacillary/transmission , Female , HeLa Cells , Humans , Infant , Male , Microbial Sensitivity Tests , Middle Aged , Shiga Toxins , South Africa/epidemiology , Vero CellsABSTRACT
Since its first isolation in South Africa in 1994, Shigella dysenteriae type 1 has now spread to cause an epidemic outbreak in Natal Kwazulu, resulting in a steep rise in admissions for dysentery and the haemolytic uraemic syndrome in children. We report on the epidemic as it has evolved so far. A large outbreak is to be expected in South Africa in view of large scale poverty, lack of housing, and adequate water and sanitation, unless urgent public health measures are taken.
