Shigella dysenteriae serotype 1 in west Africa: intervention strategy for an outbreak in Sierra Leone.

Journal article

In November 1999, a Médecins Sans Frontières team based in the southeastern part of Sierra Leone reported an increased number of cases of bloody diarrhoea. Shigella dysenteriae serotype 1 (Sd1) was isolated in the early cases. A total of 4218 cases of dysentery were reported in Kenema district from December, 1999, to March, 2000. The overall attack rate was 7.5%. The attack rate was higher among children younger than 5 years than in the rest of the population (11.2% vs 6.8%; relative risk=1.6; 95% CI 1.5-1.8). The case fatality was 3.1%, also higher for children younger than 5 years (6.1% vs 2.1%; relative risk=2.9; 95% CI 2.1-4.1]). Among 583 patients regarded at increased risk of death who were treated with ciprofloxacin in isolation centres, case fatality was 0.9%. A 5-day ciprofloxacin regimen, targeted to the most severe cases of bloody diarrhoea, was highly effective. This is the first time a large outbreak caused by Sd1 has been reported in west Africa.

Authors: Guerin, P; Brasher, C; Baron, E; Mic, D; Grimont, F

• Publication status: Published
• Journal: Lancet
• Volume: 362
• Issue: 9385
• Pages: 705-706
• Publication date: 2003-08-01
• DOI: 10.1016/s0140-6736(03)14227-4
• EISSN: 1474-547X
• ISSN: 0140-6736
• Language: English
• Keywords: Ciprofloxacin; Anti-Infective Agents; Serotyping; Sierra Leone; Shigella dysenteriae; Disease Outbreaks; Humans; Dysentery, Bacillary