Antimicrobial-resistant epidemic Shigella dysenteriae type 1 in Zambia: modes of transmission.
To determine the modes of transmission of an epidemic caused by Shigella dysenteriae type I (Sd1) in Zambia, a case-control study was conducted. Case-patients were more likely to have recent contact with a person with dysentery (P = .03) and to have a family member with preceding dysentery (P = .01). Case households were more likely to share their latrine (P = .06). Stored drinking water was obtained by hand-dipping a cup into wide-mouthed vessels or by pouring from narrow-mouthed vessels; case households were more likely to obtain drinking water only by hand-dipping (P = .03). Case-patients were more likely to have eaten relish (a cooked meat or vegetable dish; P = .03) purchased from a vendor. Evidence from this study suggests that Sd1 was transmitted by person-to-person spread, by water stored in vessels that permitted hand-dipping, and by prepared foods sold by vendors. Preventive measures should be directed at these risk factors.
Foodborne and Diarrheal Diseases Branch, Centers for Disease Control and Prevention, Atlanta, GA 30333.
J
J
Tuttle
A A
AA
Ries
R M
RM
Chimba
C U
CU
Perera
N H
NH
Bean
P M
PM
Griffin
D000293:Adolescent; D000328:Adult; D000900:Anti-Bacterial Agents / Q000494:pharmacology*; D016022:Case-Control Studies; D002648:Child; D002675:Child, Preschool; D004196:Disease Outbreaks; D004352:Drug Resistance, Microbial; D004405:Dysentery, Bacillary / Q000453:epidemiology* / Q000401:mortality / Q000635:transmission; D005243:Feces / Q000382:microbiology; D005260:Female; D006801:Humans; D008297:Male; D008826:Microbial Sensitivity Tests; D008875:Middle Aged; D012307:Risk Factors; D012762:Shigella dysenteriae / Q000187:drug effects* / Q000472:pathogenicity; D015024:Zambia / Q000453:epidemiology
D000900:Anti-Bacterial Agents