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Epidemiologic Notes and Reports Shigella dysenteriae Type 1 in Tourists to Cancun, Mexico

From January 1 to August 1, 1988, 17 cases of diarrheal disease caused by Shigella dysenteriae type 1 (Shiga bacillus) were reported to CDC. Three cases were reported to CDC during the same period in 1987. Fifteen of the patients with shigellosis had visited Cancun, Mexico, andd two had visited other areas in Mexico in the weeks before or during onset of their illness. The patients had no common exposures in hotels or restaurants. Thirteen (76%) of the patients required hospitalization ; two patients developed hemolytic-uremic syndrome. Six isolates tested thus far at CDC were resistant to chloramphenicol and tetracycline; two isolates were also resistant to ampicillin and trimethoprim-sulfamethoxazole. An epidemiologic and laboratory investigation is under way in Mexico. Reported by: J Sepulveda Amor, Director General de Epidemiologia, Secretaria de Salud, Mexico. Enteric Diseases Br, Div of Bacterial Diseases, Center for Infectious Diseases, CDC.

Editorial Note

Editorial Note: The antimicrobial agents often taken prophylactically and therapeutically by travelers--trimethoprim-sulfamethoxazole and tetracycline--may be ineffective against the S. dysenteriae type 1 strains for which sensitivity data are available. Physicians should consider this diagnosis in persons with severe or bloody diarrheal illness who have recently returned from Mexico, obtain appropriate cultures, and report suspected cases of S. dysenteriae to local and state public health authorities. Laboratories are requested to send isolates of S. dysenteriae to appropriate public health laboratories for serotyping. Travelers to Cancun and other regions with recognized risk for travelers' diarrhea should follow CDC's recommendations for international travel (1).

Reference

  1. CDC. Health information for international travel, 1988. Atlanta: US Department of Health and Human Services, Public Health Service, 1988; HHS publication no. (CDC)88-8280.

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