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Journal of Preventive Medicine and Public Health 2005;38(2): 182-188.
Epidemiologic Investigation on Sporadic Occurrence of Shigellosis in a Subcounty of Cheongwon County in Chungbuk Province in 2003.
Yong Jae Lee, Ue Kyoung Hwang, Jong Suk Kim, Jun Young Kim, Ja Seol Koo, Bok Kwon Lee, Jong Won Kang
1Division of Epidemic Intelligence Service, Korea Center for Disease Control and Prevention, Korea.
2Department of Family Medicine, Seoul Paik Hospital, Inje University College of Medicine, Korea.
3Department of Microbiology, Chungbuk Institute of Health and Environment Research, Korea.
4Division of Enteric Infections, Department of Bacteriology, National Institute of Health, Korea.
5Division of Bioterrorism Preparedness and Response, Korea Center for Disease Control and Prevention, Korea.
6Department of Preventive Medicine, College of Medicine, Chungbuk National University, Korea. jwkang@pm.cbu.ac.kr
OBJECTIVES: This study was undertaken to investigate the source of infection and mode of transmission of shigellosis, which occurred sporadically among residents and students in a subcounty of Cheongwon county, Chungbuk province, Korea, from June 4 to July 3 2003. METHODS: 692 subjects completed a questionnaire and provided a swab for microbiological examinations, and 7 environmental specimens were examined for bacterial organisms. PFGE (pulsed-field gel electrophoresis) and fingerprinting were performed to find the genetic relationship among the temporally associated sporadic isolates. RESULTS: A total of 29 patients had symptoms consistent with the case definition, with 13 confirmed and 16 suspected cases. The frequency of diarrhea was 6 times or more a day (80.8%), with a duration of 1 to 4 days (88.5%) in most cases. The most common symptoms accompanying the diarrhea were fever (80.9%) followed by abdominal pain (76.9%), headache (65.4%), chill (61.5%), vomiting (46.2%) and tenesmus (15.4%). The epidemic curve was characteristic of a person-to-person transmission. The PFGE and fingerprinting demonstrated identical or similar DNA patterns among the 3 Shigella sonnei isolates (A51, A53 and A61 types) found in this outbreak. CONCLUSION: A genetically identical strain of S. sonnei was estimated to be the cause of this outbreak, and the mode of transmission was most likely person-to-person.
Key words: Epidemiology; Transmission; Shigellosis; Pulsed-field gel electrophoresis
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