Shigellosis
Surveillance
CDC currently has six surveillance systems for obtaining information about Shigella. They serve different purposes and provide information on various features of the organism's epidemiology, such as number of outbreaks, antimicrobial-resistant infections, or subtypes.
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Public Health Laboratory Information System (PHLIS)
PHLIS is a passive, laboratory-based surveillance system that collects data about many infections, including Shigella. Reporting is limited to illnesses that are confirmed by culture and verified at the state public health laboratory. After verification, information about the infection is reported electronically to CDC by the state http://www.cdc.gov/ncidod/dbmd/phlisdata.
Annual summaries of the PHLIS Shigella surveillance data can be found at http://www.cdc.gov/ncidod/dbmd/phlisdata/shigella.htm.
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National Electronic Telecommunications System for Surveillance (NETSS)
NETSS is a passive, physician-based surveillance system that captures both laboratory-confirmed and clinically suspected cases of all nationally notifiable diseases, including Shigella. The number of illnesses reported through NETSS tends to be higher than the number reported through PHLIS because NETSS does not require confirmation by the state public health laboratory. More information on NETSS can be found at http://www.cdc.gov/epo/dphsi/netss.htm.
Shigella infections and other surveillance data collected by NETSS is published weekly in the CDC Morbidity and Mortality Report (MMWR) and can be found at http://www.cdc.gov/mmwr.
The MMWR also publishes an annual summary of the NETSS Shigella surveillance data; this information can be found at http://www.cdc.gov/mmwr/summary.html.
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FoodNet
The Foodborne Diseases Active Surveillance Network (FoodNet) is an active surveillance system for identifying and characterizing culture-confirmed infections that may be foodborne, including Shigella. FoodNet workers regularly contact more than 300 laboratories for confirmed cases of foodborne infections in several states encompassing a population of more than 25 million persons. In addition to monitoring the number of Shigella infections, investigators monitor laboratory techniques for isolation of bacteria, perform case-control studies of ill persons to determine foods associated with illness, and administer questionnaires to people living in FoodNet sites to better understand trends in the eating habits of Americans. Annual FoodNet reports that include data about Shigella can be found at http://www.cdc.gov/foodnet/reports.htm.
More information on FoodNet can be found at http://www.cdc.gov/foodnet/.
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National Molecular Subtyping Network for Foodborne Diseases Surveillance (PulseNet )
PulseNet is a national network of public health laboratories that perform pulsed-field gel electrophoresis (PFGE), a type of DNA "fingerprinting", on certain foodborne bacteria, including Shigella. PFGE "fingerprint" patterns are submitted electronically to CDC and can be compared rapidly with others in a large database. This system can help determine if individual infections are related or if an outbreak is occurring. PulseNet is not a surveillance system itself but a laboratory subtyping method used in surveillance.
More information on PulseNet can be found at http://www.cdc.gov/pulsenet.
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National Antimicrobial Resistance Monitoring System (NARMS)
NARMS is a passive surveillance system that monitors antimicrobial resistance of Shigella and selected other bacteria that cause human illness. NARMS is a collaboration between CDC, 16 state and local health departments, the Food and Drug Administration (FDA), and the United States Agricultural Department (USDA). More information on NARMS can be found at http://www.cdc.gov/narms.
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Foodborne Outbreak Detection Unit
CDC monitors outbreaks of foodborne disease, including outbreaks caused by Shigella. Each year, state and territorial epidemiologists voluntarily (passively) report the results of outbreak investigations to CDC. While outbreaks account for a small percentage of the total number of illnesses that occur each year, these investigations provide valuable information about sources of foodborne infection and often highlight important prevention opportunities. The latest summaries of foodborne outbreaks can be found at http://www.cdc.gov/mmwr/preview/mmwrhtml/ss4901a1.htm. |
MMWR Articles
Outbreak of Gastroenteritis Associated with an Interactive Water Fountain at a Beachside Park - Florida, 1999. MMWR June 30, 2000 / 49(25);565-8
Outbreaks of Shigella sonnei infection associated with eating fresh parsley - United States and Canada, July - August 1998. MMWR April 16, 1999 / 48(14);285-9
Shigella sonnei Outbreak Associated with Contaminated Drinking Water - Island Park, Idaho, August 1995
MMWR March 22, 1996 / Vol. 45 / No. 11
Links
CDC Safe Water System FoodNet
Laboratory Methods for the Diagnosis of Epidemic Dysentery and Cholera
PHLIS Data
References
Shane A, Crump J, Tucker N, Painter J, Mintz E. Sharing Shigella: risk factors and costs of a multi-community outbreak of shigellosis. Archives Pediatrics and Adolescent Med 2003; 157 601-603.
Sobel J, Cameron DN, Ismail J, et al. A prolonged outbreak of Shigella sonnei infections in traditionally observant Jewish communities in North America caused by a molecularly distinct bacterial subtype. J Infect Dis 1998; 177: 1405-1408.
Ries AA, Wells JG, Olivola D, et al. Epidemic Shigella dysenteriae type 1 in Burundi: panresistance and implications for prevention. J Infect Dis 1994; 169: 1035-1041.
Lee LA, Shapiro CN, Hargrett-Bean N, Tauxe RV. Hyperendemic shigellosis in the United States: a review of surveillance data for 1967-1988. J Infect Dis 1991; 164: 894-900.
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