An epidemic of shigellosis is growing between Europe and the US with 258 cases (221 confirmed and 37 suspected) recorded as of February 16 in 10 European Union/European Economic Area (EU/EEA) countries, the UK and the US. The alert comes from the ECDC, the European Center for Disease Prevention and Control. But what is it? And what are the symptoms?
“Since September 2022 – informs the ECDC which conducted a rapid risk assessment, classified as moderate for now – an increase in the number of cases of shigellosis, mainly caused by Shigella sonnei, has been reported among travelers returning from Cape Verde in the EU/EEA, UK and the United States. The epidemic evolved rapidly in November-December. Possible modes of common infection or exposure have not yet been identified – explains the agency – but investigations are underway in Cape Verde. several transmission routes are plausible: the most probable is through food or through food business operators infected” with the bacterium. “However – it is specified – transmission from person to person is also possible”.
The S. sonnei strain responsible for the outbreak shows “predicted resistance to trimethoprim and streptomycin,” antibiotic drugs, “but multidrug resistance has also been detected in some cases.” Based on the data available, the ECDC reports that “many of those infected have stayed in all-inclusive hotels located in the Santa Maria region” in Cape Verde, “on the island of Sal. The most recent cases were reported in Sweden on January 19”, specifies the agency which warns of “a moderate risk of new infections among travelers heading to Cape Verde, in particular among those staying in the Santa Maria region on the island of Sal”.
Italy does not appear among the countries in which cases of shigellosis were recorded as of 16 February. Infections have so far been reported in the EU/EEA from Belgium, the Czech Republic, Denmark, Finland, France, Germany, the Netherlands, Norway, Portugal and Sweden, for a total of 159 cases (122 confirmed and 37 suspected), mainly concentrated among Netherlands, Sweden and France. The UK has reported 95 cases, all confirmed; the USA 4, confirmed.
The ECDC encourages the competent authorities of the EU/EEA countries to “raise health professionals’ awareness of the possibility of Shigella infections among people who have recently traveled to Cape Verde – reads the note – Together with the World Health Organization Europe , the agency is in regular contact with the Cape Verde authorities to support investigations into the sources of infection and raise awareness among the African country’s health professionals.
Shigellosis, what it is: symptoms
Shigellosis is a gastrointestinal infection caused by bacteria belonging to the Shigella genus, which can present with clinical pictures of variable severity. In untreated cases, lethality can reach 10-20%, according to the website of the Ministry of Health. These are germs that are very sensitive to the action of common disinfectants and detergents, but which in the external environment can present varying degrees of resistance, above all when they are contained in organic material.
Shigellosis continues to be a major public health problem and remains endemic in many developing countries. Among Shigella species, S. dysenteriae type 1 poses a particular threat, due to the severity of the disease it causes and its epidemic potential.
The disease is more severe and the risk of death greater in:
infants and adults over the age of 50
babies who are not breastfed
children hospitalized for measles
malnourished children and adults
any patient presenting with dehydration, loss of consciousness or hypo- or hyperthermia, or with a history of seizures.