Office of Workforce and Career Development, Epidemic Intelligence Service, Atlanta, Georgia, USA.
Foodborne Pathog Dis. 2010 Jul;7(7):741-7. doi: 10.1089/fpd.2009.0448.
An estimated 450,000 cases of shigellosis occur annually in the United States. Outbreaks have been associated with food, water, child daycare centers, and men who have sex with men. However, for sporadic infections, which account for the majority of cases, risk exposures are poorly characterized.
Foodborne Diseases Active Surveillance Network (FoodNet) conducts active, laboratory-based shigellosis surveillance in 10 US sites. We interviewed cases with illness onset during 2005 about exposures during the week before symptom onset using a standardized questionnaire. The proportion of patients who denied nonfood risks was used to estimate the burden attributable to foodborne transmission.
Overall, 1494 cases were identified. The approximate incidence was 3.9/100,000, with the highest rates among children aged 1-4 years (16.4) and Hispanics (8.4). Of the 929 cases interviewed, 223 (24%) reported international travel in the week before symptom onset. Of the 626 nontraveling cases with complete risk factor information, 298 (48%) reported exposure to daycare or a household member with diarrhea; 99 (16%) reported drinking untreated water or recreational exposure to water; and 16 (3%) reported sexual contact with a person with diarrhea. Two hundred and fifty-nine (41%) denied all nonfood exposures examined.
Sporadic shigellosis is most common among young children and Hispanics. Common exposures include international travel and contact with ill persons or daycare. However, more than one-third of US shigellosis cases annually might be due to food consumed in the United States.
据估计，每年在美国有 45 万例志贺氏菌病发生。暴发与食物、水、儿童日托中心和男男性接触者有关。然而，对于占大多数病例的散发性感染，风险暴露情况描述较差。
食源性疾病主动监测网络（FoodNet）在美国 10 个地点开展基于实验室的志贺氏菌病主动监测。我们使用标准化问卷对 2005 年发病期间的病例进行了访谈，了解症状出现前一周的暴露情况。使用患者否认非食物风险的比例来估计食源性传播的负担。
共确定了 1494 例病例。估计发病率为 3.9/100000，发病率最高的是 1-4 岁儿童（16.4）和西班牙裔（8.4）。在接受访谈的 929 例病例中，223 例（24%）报告在症状出现前一周有国际旅行。在 626 例无旅行且完整风险因素信息的非旅行病例中，298 例（48%）报告在日托机构或有腹泻的家庭成员中接触；99 例（16%）报告饮用未经处理的水或在水中娱乐时接触；16 例（3%）报告与有腹泻的人发生性接触。259 例（41%）否认所有检查的非食物暴露。
散发性志贺氏菌病最常见于幼儿和西班牙裔。常见的暴露包括国际旅行以及与患病者或日托机构的接触。然而，每年美国有超过三分之一的志贺氏菌病病例可能是由于食用了美国国内的食物。
