Outbreak of Shigella sonnei in Montréal’s ultra-Orthodox Jewish community, 2015

Abstract

An outbreak of Shigella sonnei that occurred in the ultra-Orthodox Jewish community (UOJC) was the subject of an investigation and response by the Montréal Regional Public Health Department, who collaborated with several health and community partners. A total of 27 confirmed cases were reported in this outbreak, which lasted from February to June 2015. The epidemic curve was compatible with a point source with secondary person-to-person transmission. In 11 of the 27 cases, pulsed-field gel electrophoresis (PFGE) analysis of strains found a single PFGE pattern newly identified in Quebec. Almost all strains tested showed resistance to ampicillin and trimethoprim-sulfamethoxazole (TMP/SMX). All the cases resided in centre west Montréal. Most of the cases were under 5 years old and attended a daycare centre, an environment recognized to be conducive to the transmission of enteric diseases. The Montréal Regional Public Health Department sent timely information to families, daycare and school stakeholders, community partners and synagogues in the UOJC, which helped reduce the transmission of shigellosis in the community.

Evaluation of whole-genome sequencing-based subtyping methods for the surveillance of Shigella spp. and the confounding effect of mobile genetic elements in long-term outbreaks

“…are facultative intracellular pathogens transmitted solely through the faecal-oral route and are the causative agents of shigellosis. While the rate of reported shigellosis cases in Canada has been steadily decreasing over time [2], Shigella flexneri and Shigella sonnei cases in large cities have become prevalent due to extensive sexual transmission networks involving men who have sex with men (MSM) [3][4][5][6][7], in addition to periodic food-, water-and travel-associated outbreaks in the general population [8][9][10][11][12]. Similar MSM-related outbreaks have also been documented globally and have been described as potential public health concerns due to their widespread resistances to antimicrobial treatments [13][14][15][16][17][18], occurrence of life-threatening invasive infections in patients co-infected with HIV [5,6] and potential to spill into other at-risk communities.…”

Cardiac and Other Presentation and Clinical Outcomes of COVID-19 Pandemic among Different Ethnic and Religious Populations in the city of Jerusalem

“…Interestingly, similar trends of high rate and severity of morbidity were reported among other ultraorthodox neighborhoods in Israel and in New York City Approximately one-half of the cases (2,202) occurred in Jerusalem District, primarily in unvaccinated children in Orthodox Jewish communities [30]. In February 2015, an outbreak of Shigella sonnei occurred in the Ultra-Orthodox Jewish community in Montréal while in December 2014, similar outbreak affecting two similar communities occurred in New York City [31,32]. Interestingly, although the Arabs patients suffered more from co-morbidities, the four major presenting symptoms (fever, cough, dyspnea and fatigue) and length of stay were more prominent among Jews patients.…”

Cardiac and Other Presentation and Clinical Outcomes of COVID-19 Pandemic among Different Ethnic and Religious Populations in The City of Jerusalem

“…Approximately one-half of the cases (2,202) occurred in Jerusalem District, primarily in unvaccinated children in Orthodox Jewish communities (31). In February 2015, an outbreak of Shigella sonnei occurred in the Ultra-Orthodox Jewish community in Montréal while in December 2014, similar outbreak affecting two similar communities occurred in New York City (32,33). Interestingly, although the Arabs patients suffered more from co-morbidities, the four major presenting symptoms (fever, cough, dyspnea and fatigue) and length of stay were more prominent among Jews patients.…”