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Shigellosis -- United States, 1982

In 1982, 13,523 Shigella isolations from humans were reported to CDC. This represents a 9.9% decrease from the 15,006 isolations reported in 1981. The number of isolations has continued to decline from the 15,334 reported during the peak year, 1978 (Figure 1).

Shigella serotypes were reported for 12,818 of the 13,523 isolates and were distributed by serotype as follows: S. sonnei--8,228 (64.2%), S. flexneri--4,165 (32.5%), S. boydii--294 (2.3%), and S. dysenteriae--131 (1.0%). S. flexneri 1a, 1b, 2a, 3a, and 6 comprised 27.3% of all S. flexneri subtyped. When compared with 1981, reported S. boydii isolations decreased by 42.4%; S. dysenteriae, by 35.8%; and S. sonnei, by 12.7%. The number of S. isolates and were distributed by serotype as follows: S. sonnei--8,228 (64.2%), S. flexneri--4,165 (32.5%), S. boydii--294 (2.3%), and S. dysenteriae--131 (1.0%). S. flexneri 1a, 1b, 2a, 3a, and 6 comprised 27.3% of all S. flexneri subtyped. When compared with 1981, reported S. boydii isolations decreased by 42.4%; S. dysenteriae, by 35.8%; and S. sonnei, by 12.7%. The number of S. flexneri isolations remained relatively constant.

The decreases were not confined to one state or region. From 1981 to 1982, S. sonnei decreased notably in Florida (166 to 92), Georgia (349 to 135), Hawaii (128 to 46), Indiana (102 to 35), Louisiana (357 to 147), Missouri (128 to 35), and Virginia (889 to 81); S. boydii, in Arizona (38 to 16) and Texas (82 to 45); and S. dysenteriae, in California (129 to 71).

In the reported age distribution of persons from whom isolates were obtained, the age-specific attack rate was highest for 2-year-old children, markedly lower for older children, and slightly lower for adults, except for a slight increase for 20- to 29-year-olds (Figure 2). In the 20- to 29-year age groups, a slightly higher isolation rate was reported for females than for males. The isolation rates by sex were similar for the remaining age groups. The median ages of persons from whom isolates were reported were S. boydii--13 years, S. dysenteriae--24, S. flexneri--11, and S. sonnei--7.

Since shigellosis is a more important problem for some population groups than for others, data were tabulated separately for patients residing in certain institutions (e.g., nursing homes, facilities for the mentally ill, and other resident-care centers) and on American Indian reservations. Thirty-one percent of the reports included data on patient residence at the time of onset of illness. Of those specified, 1.2% lived in institutions and 2.7% on Indian reservations. Sixty-nine percent of the reported isolates from residents of institutions were S. sonnei, and 30.8% were S. flexneri. Fifty-nine percent of the isolates from residents of Indian reservations were S. flexneri, and 40.9% were S. sonnei. S. sonnei accounted for 74.4% of the isolates with known residence; S. flexneri, for 22.9%; S. boydii, for 1.2%; and S. dysenteriae, for 0.5%. Reported by Statistical Svcs Activity and Enteric Diseases Br, Div of Bacterial Diseases, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: This report is based on CDC's Shigella Surveillance Activity, a passive, laboratory-based system that receives reports from the 50 states and the District of Columbia. These reports do not distinguish between clincial or sub-clinical infections or between chronic or convalescent carriers.

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