Recent trends in the epidemiology of shigellosis in Israel

Abstract

We provide an update on the epidemiology of shigellosis in Israel using data generated by a sentinel laboratory-based surveillance network for the period 1998-2012. The average annual incidence of culture-proven shigellosis was 97/100 000. We estimated that each case of shigellosis accounted for 25 cases in the community indicating the high burden of disease. Orthodox Jewish communities, living in highly crowded conditions and with a high number of children aged <5 years were the epicentre of country-wide biennial propagated epidemics of S. sonnei shigellosis. S. flexneri was the leading Shigella serogroup in Israeli Arabs. S. flexneri 2a and S. flexneri 6 alternated as the most common serotypes. Both S. sonnei and S. flexneri isolates showed high rates of resistance to ampicillin and trimethoprim/sulfamethoxazole and very low rates of resistance to quinolones and third-generation cephalosporins. Shigellosis due to S. sonnei conferred 81% (95% confidence interval 69-89) protection against the homologous Shigella serotype when epidemic exposure re-occurred 2 years later. These data are of value in the process of Shigella vaccine development.

Travel- and Community-Based Transmission of Multidrug-ResistantShigellasonneiLineage among International Orthodox Jewish Communities

“…As described by Cohen et al (19), 90% of the S. sonnei shigellosis isolates collected in Israel are from Jewish patients, and the isolates from Israel sequenced in this study were primarily (n = 200, 90%) derived from OJCs (online Technical Appendix 2 Table 1, http://wwwnc.cdc.gov/EID/article/22/9/15-1953-Techapp2.pdf).…”

“…The 221 samples of S. sonnei in Israel were collected during 1992-2014 in local hospital and health maintenance organization laboratories, including the national sentinel laboratory-based surveillance program (19). As described by Cohen et al (19), 90% of the S. sonnei shigellosis isolates collected in Israel are from Jewish patients, and the isolates from Israel sequenced in this study were primarily (n = 200, 90%) derived from OJCs (online Technical Appendix 2 Table 1, http://wwwnc.cdc.gov/EID/article/22/9/15-1953-Techapp2.pdf).…”

“…One such risk group for S. sonnei is Orthodox Jewish communities (OJCs) (5). These communities are highly susceptible to shigellosis because of densely populated living conditions, high numbers of young children per family, and intracommunity transfer facilitated by large holiday gatherings (18)(19)(20). S. sonnei shigellosis is highly endemic to Israel; its incidence there since the early 1990s has primarily been driven by biennial epidemics within OJCs in Israel (primarily in the 0-4-year age group, in whom the incidence is ≈7 cases/1,000 population/y [19]).…”

“…These communities are highly susceptible to shigellosis because of densely populated living conditions, high numbers of young children per family, and intracommunity transfer facilitated by large holiday gatherings (18)(19)(20). S. sonnei shigellosis is highly endemic to Israel; its incidence there since the early 1990s has primarily been driven by biennial epidemics within OJCs in Israel (primarily in the 0-4-year age group, in whom the incidence is ≈7 cases/1,000 population/y [19]). In addition to incidence in OJCs in Israel, outbreaks ranging in size from 27 culture-confirmed cases to >13,000 cases of S. sonnei shigellosis have been reported in OJCs in Europe and North America (18,(20)(21)(22)(23)(24).…”

Alteration of blood cytokine content at shigellosis in children with helicobacter infection

“…Along with IL-1, TNFα induces the synthesis of acute phase proteins by the cells of mononuclear phagocyte system of the liver. The role of TNFα and IL-1β in the development of fever as pyrogens, which through the bloodstream cross the blood-brain barrier and interact with neurons of the hypothalamus thermoregulation center, has been proved [10,11].…”