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Epidemiologic Notes and Reports
Shigella dysenteriae Type 1 in Tourists to Cancun, Mexico
From January 1 to August 1, 1988, 17 cases of diarrheal disease
caused by Shigella dysenteriae type 1 (Shiga bacillus) were
reported to
CDC. Three cases were reported to CDC during the same period in
1987.
Fifteen of the patients with shigellosis had visited Cancun,
Mexico, andd
two had visited other areas in Mexico in the weeks before or during
onset of their illness. The patients had no common exposures in
hotels
or restaurants. Thirteen (76%) of the patients required
hospitalization ;
two patients developed hemolytic-uremic syndrome. Six isolates
tested
thus far at CDC were resistant to chloramphenicol and tetracycline;
two
isolates were also resistant to ampicillin and
trimethoprim-sulfamethoxazole. An epidemiologic and laboratory
investigation is under way in Mexico.
Reported by: J Sepulveda Amor, Director General de Epidemiologia,
Secretaria de Salud, Mexico. Enteric Diseases Br, Div of Bacterial
Diseases, Center for Infectious Diseases, CDC. Editorial Note
Editorial Note: The antimicrobial agents often taken
prophylactically
and therapeutically by travelers--trimethoprim-sulfamethoxazole and
tetracycline--may be ineffective against the S. dysenteriae type 1
strains for which sensitivity data are available. Physicians should
consider this diagnosis in persons with severe or bloody diarrheal
illness who have recently returned from Mexico, obtain appropriate
cultures, and report suspected cases of S. dysenteriae to local and
state public health authorities. Laboratories are requested to send
isolates of S. dysenteriae to appropriate public health
laboratories
for serotyping. Travelers to Cancun and other regions with
recognized
risk for travelers' diarrhea should follow CDC's recommendations
for
international travel (1).
Reference
CDC. Health information for international travel, 1988.
Atlanta: US
Department of Health and Human Services, Public Health Service,
1988; HHS publication no. (CDC)88-8280.
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