National Enteric Disease Surveillance : Shigella surveillance overview
Corporate Authors:National Center for Emerging and Zoonotic Infectious Diseases (U.S.). Division of Foodborne Waterborne, and Environmental Diseases.
Description:Shigella is estimated to cause nearly half a million illnesses each year in the United States, with more than 5,400 hospitalizations and 38 deaths. Shigella infections most often cause gastroenteritis, manifested by diarrhea, fever, and stomach cramps starting a day or two after exposure to the bacteria. The diarrhea is often bloody. The primary mode of transmission is from one person to another. Shigella infections may also be acquired from eating contaminated food or drinking, swimming in, or playing with contaminated water.
National Shigella surveillance data are collected through passive surveillance of laboratory-confirmed human Shigella infections. Clinical diagnostic laboratories submit Shigella isolates to state and territorial public health laboratories, where they are confirmed, speciated, and subtyped. Unusual or untypable isolates are forwarded to the National Shigella Reference Laboratory in the Enteric Diseases Laboratory Branch
(EDLB) at the Centers for Disease Control and Prevention (CDC); results are reported back to public health laboratories.
State and territorial public health laboratories report Shigella infections electronically to CDC through a variety of mechanisms. Data are collected into the Laboratory-based Enteric Disease Surveillance (LEDS) system. The Division of Foodborne, Waterborne, and Environmental Diseases (DFWED) in the National Center for Emerging and Zoonotic Infectious Diseases maintains national Shigella surveillance in LEDS. The annual summaries of these data are the national source of species and subtype information for Shigella.
Isolates are reported by state and represent the state where laboratory confirmation and subtyping occurred; the reporting state may not be the same as the state of residence of the ill person. Reports include basic demographic information on the patient, and the species, subtype, and specimen source for the isolate. Duplicate records are deleted. Reporting rates vary by state and year. Not all isolates are forwarded or reported to state public health laboratories and are therefore not all are reported to national-level surveillance. The national Shigella surveillance data are dynamic; data from previous years may change as isolate reports are added or corrected.
Although all Shigella infections are nationally notifiable, for several reasons many cases are likely not recognized. Not all persons ill with Shigella infection seek medical care, healthcare providers may not obtain a specimen for laboratory diagnosis, or the clinical diagnostic laboratory may not perform the necessary diagnostic tests. The numbers of isolates with incomplete and unknown species and subtype data vary by state and year.
Recommended citation: Centers for Disease Control and Prevention (CDC). National Shigella Surveillance Overview. Atlanta, Georgia: US Department of Health and Human Services, CDC, 2011.
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