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Shigella dysenteriae serotype 1 in west Africa: intervention strategy for an outbreak in Sierra Leone | Journal Article / Research | MSF Science Portal
Journal Article
|Research

Shigella dysenteriae serotype 1 in west Africa: intervention strategy for an outbreak in Sierra Leone

Guerin PJ, Brasher C, Baron E, Mic D, Grimont F, Ryan M, Aavitsland P, Legros D
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Abstract
In November 1999, a Médecins Sans Frontières team based in the southeastern part of Sierra Leone reported an increased number of cases of bloody diarrhoea. Shigella dysenteriae serotype 1 (Sd1) was isolated in the early cases. A total of 4218 cases of dysentery were reported in Kenema district from December, 1999, to March, 2000. The overall attack rate was 7.5%. The attack rate was higher among children younger than 5 years than in the rest of the population (11.2% vs 6.8%; relative risk=1.6; 95% CI 1.5-1.8). The case fatality was 3.1%, also higher for children younger than 5 years (6.1% vs 2.1%; relative risk=2.9; 95% CI 2.1-4.1]). Among 583 patients regarded at increased risk of death who were treated with ciprofloxacin in isolation centres, case fatality was 0.9%. A 5-day ciprofloxacin regimen, targeted to the most severe cases of bloody diarrhoea, was highly effective. This is the first time a large outbreak caused by Sd1 has been reported in west Africa.

Countries

Sierra Leone

Subject Area

outbreaksdisease surveillance

Languages

English
Published Date
30 Aug 2003
PubMed ID
12957094
Journal
Lancet