A prolonged outbreak of Shigella sonnei infections in traditionally observant Jewish communities in North America caused by a molecularly distinct bacterial subtype.
During 1994-1996, Shigella sonnei outbreaks occurred in 8 North American traditionally observant Jewish communities. These communities remain relatively separate from neighboring populations while maintaining close contact by travel with coreligionists in other cities. Epidemiologic investigations suggested community-to-community transmission via travel. Outbreak-related and control isolates of S. sonnei from each city were subtyped by pulsed-field gel electrophoresis (PFGE) to confirm an epidemiologic linkage between outbreaks. Forty-three (94%) of 46 outbreak-related isolates had closely related PFGE patterns, constituting a single subtype; 33 (94%) of 35 control isolates demonstrated unrelated PFGE patterns. Several patterns differing by < or = 3 bands were identified within the outbreak subtype; one of these accounted for 65% of outbreak isolates. Hence, a single subtype of S. sonnei caused an international outbreak involving 8 traditionally observant Jewish communities, but not neighboring populations, over a 2-year period, suggesting sustained propagation of the epidemic strain between communities.
Sobel
J
J
Foodborne and Diarrheal Diseases Branch, Division of Bacterial and Mycotic Diseases, National Center for Infectious Diseases, Centers for Disease Control and Prevention, Atlanta, Georgia 30333, USA. qzs32@cdc.gov
Cameron
D N
DN
Ismail
J
J
Strockbine
N
N
Williams
M
M
Diaz
P S
PS
Westley
B
B
Rittmann
M
M
DiCristina
J
J
Ragazzoni
H
H
Tauxe
R V
RV
Mintz
E D
ED
D004269:DNA, Bacterial / Q000302:isolation & purification; D004196:Disease Outbreaks; D004405:Dysentery, Bacillary / Q000453:epidemiology* / Q000635:transmission; D016521:Electrophoresis, Gel, Pulsed-Field; D006801:Humans; D007585:Jews; D007599:Judaism; D008826:Microbial Sensitivity Tests; D009656:North America / Q000453:epidemiology; D012764:Shigella sonnei / Q000145:classification / Q000302:isolation & purification
D004269:DNA, Bacterial