Shigellosis in South East Metropolitan Melbourne, 1 January 2022 – 31 March 2023
DOI:
https://doi.org/10.33321/cdi.2025.49.034Keywords:
Shigella, shigellosis, antimicrobial resistance, incidence, VictoriaAbstract
Introduction
Shigella is a notifiable condition in Victoria under the Public Health and Wellbeing Act. Since 24 October 2022, the South East Public Health Unit (SEPHU) has been managing these notifications for the south east region of Melbourne.
Aim
This study aimed to determine the demographics and risk factors for acquisition of shigellosis cases in the SEPHU catchment.
Methods
A review was performed of all shigellosis notifications within the SEPHU catchment during the period 1 January 1 2022 – 31 March 2023. De-identified information was collated from the Public Health Event Surveillance System (PHESS) for analysis of demographics, risk factors and antimicrobial resistance.
Results
A total of 127 cases were notified: 51 were confirmed with culture, with the remaining 76 identified as probable cases through polymerase chain reaction testing. The greatest numbers of cases were within the 0–4 and 5–9 years of age categories (each 19/127; 15%), followed by the 30–34 years age group (18/127; 14%). The highest case numbers were recorded in the local government area (LGA) of Casey (30/127; 24%) while the highest rate across the 15-month study period, of 20.2 per 100,000, was from the Stonnington LGA. The most prominent primary risk factor was travel overseas (62/127, 49%) followed by contact between men who have sex with men (MSM) (16/127, 13%). Of confirmed cases, 61% (31/51) met the criteria for classification as critical antibiotic resistance (CAR) shigellosis.
Conclusion
This review found that the LGAs with high number and rates of cases are Casey, Greater Dandenong and Stonnington. However, the risk factors for acquisition differs in these areas, indicating a need for LGA-specific education in the diverse SEPHU catchment.
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References
Baker S, The HC. Recent insights into Shigella. Curr Opin Infect Dis. 2018;31(5):449–54. doi: https://doi.org/10.1097/QCO.0000000000000475.
Mattock E, Blocker AJ. How do the virulence factors of Shigella work together to cause disease? Front Cell Infect Microbiol. 2017;7:64. doi: https://doi.org/10.3389/fcimb.2017.00064.
Ibrahim AF, Glass K, Williamson DA, Polkinghorne BG, Ingle DJ, Wright R et al. The changing epidemiology of shigellosis in Australia, 2001-2019. PLoS Negl Trop Dis. 2023;17(3):e0010450. doi: https://doi.org/10.1371/journal.pntd.0010450.
Boveé L, Whelan J, Sonder GJ, van Dam AP, van den Hoek A. Risk factors for secondary transmission of Shigella infection within households: implications for current prevention policy. BMC Infect Dis. 2012;12:347. doi: https://doi.org/10.1186/1471-2334-12-347.
Victorian State Government Department of Health. Shigellosis. [Internet.] Melbourne: Victorian State Government Department of Health; 29 November 2022. [Accessed on 26 April 2023.] Available from: https://www.health.vic.gov.au/infectious-diseases/shigellosis.
Wise J. Sixty seconds on... Shigella. BMJ. 2022;376:o253. doi: https://doi.org/10.1136/bmj.o253.
Cheftel E, Spiegel A, Bornert G, Morell E, Michel A, Buisson Y. [Toxic food infection caused by Shigella flexneri in a military unit]. Sante. 1997;7(5):295–9.
Kotloff KL, Riddle MS, Platts-Mills JA, Pavlinac P, Zaidi AKM. Shigellosis. Lancet. 2018;391(10122):801–12. doi: https://doi.org/10.1016/S0140-6736(17)33296-8.
Genobile D, Gaston J, Tallis GF, Gregory JE, Griffith JM, Valcanis M et al. An outbreak of shigellosis in a child care centre. Commun Dis Intell Q Rep. 2004;28(2):225–9.
Ingle DJ, Easton M, Valcanis M, Seemann T, Kwong JC, Stephens N et al. Co-circulation of multidrug-resistant Shigella among men who have sex with men in Australia. Clin Infect Dis. 2019;69(9):1535–44. doi: https://doi.org/10.1093/cid/ciz005.
Lane CR, Sutton B, Valcanis M, Kirk M, Walker C, Lalor K, et al. Travel destinations and sexual behavior as indicators of antibiotic resistant Shigella strains–Victoria, Australia. Clin Infect Dis. 2016;62(6):722–9. doi: https://doi.org/10.1093/cid/civ1018.
Australian Bureau of Statistics (ABS). Overseas Arrivals and Departures, Australia. [Internet.] Canberra: ABS; 2023. [Accessed on 15 May 2023.] Available from: https://www.abs.gov.au/statistics/industry/tourism-and-transport/overseas-arrivals-and-departures-australia/latest-release.
Martín-Sánchez M, Case R, Fairley C, Hocking JS, Bradshaw C, Ong J et al. Trends and differences in sexual practices and sexually transmitted infections in men who have sex with men only (MSMO) and men who have sex with men and women (MSMW): a repeated cross-sectional study in Melbourne, Australia. BMJ Open. 2020;10(11):e037608. doi: https://doi.org/10.1136/bmjopen-2020-037608.
Lolekha S, Vibulbandhitkit S, Poonyarit P. Response to antimicrobial therapy for shigellosis in Thailand. Rev Infect Dis. 1991;13(Suppl 4):S342–6. doi: https://doi.org/10.1093/clinids/13.supplement_4.s342.
Williams PCM, Berkley JA. Guidelines for the treatment of dysentery (shigellosis): a systematic review of the evidence. Paediatr Int Child Health. 2018;38(sup1):S50–65. doi: https://doi.org/10.1080/20469047.2017.1409454.
Ingle DJ, Andersson P, Valcanis M, Barnden J, da Silva AG, Horan KA et al. Prolonged outbreak of multidrug-resistant Shigella sonnei harboring blaCTX-M-27 in Victoria, Australia. Antimicrob Agents Chemother. 2020;64(12). doi: https://doi.org/10.1128/AAC.01518-20.
World Health Organization (WHO). Global priority list of antibiotic-resistant bacteria to guide research, discovery and development of new antibiotics. Geneva: WHO; 27 February 2017. [Accessed on 19 April 2023.] Available from: http://www.who.int/medicines/publications/global-priority-list-antibiotic-resistant-bacteria/en/.
Chen T, Leung RK, Zhou Z, Liu R, Zhang X, Zhang L. Investigation of key interventions for shigellosis outbreak control in China. PLoS One. 2014;9(4):e95006. doi: https://doi.org/10.1371/journal.pone.0095006.
Ranjbar R, Farahani A. Shigella: antibiotic-resistance mechanisms and new horizons for treatment. Infect Drug Resist. 2019;12:3137–67. doi: https://doi.org/10.2147/IDR.S219755.
Australian Government Department of Health and Aged Care, Communicable Diseases Network Australia (CDNA). Shigellosis: Australian national notifiable diseases case definition. Canberra: Australian Government Department of Health and Aged Care; 1 July 2018. Available from: https://www.health.gov.au/sites/default/files/documents/2022/06/shigellosis-surveillance-case-definition.pdf.
Australian Commission on Quality and Safety of Healthcare (ACSQHC). National Alert System for Critical Antimicrobial Resistances (CARAlert). [Internet.] Sydney: ACSQHC; 2023. [Accessed on May 1 2023.] Available from: https://www.safetyandquality.gov.au/our-work/antimicrobial-resistance/antimicrobial-use-and-resistance-australia-surveillance-system/national-alert-system-critical-antimicrobial-resistances-caralert.
ABS. Stonnington: 2021 Census All persons QuickStats. [Webpage.] Canberra: ABS; 2021. [Accessed on 15 May 2023.] Available from: https://abs.gov.au/census/find-census-data/quickstats/2021/LGA26350.
ABS. Casey: 2021 Census Aboriginal and/or Torres Strait Islander people QuickStats. [Webpage.] Canberra: ABS; 2021. [Accessed on 15 May 2023.] Available from: https://abs.gov.au/census/find-census-data/quickstats/2021/IQSLGA21610.
Public Health England (PHE). Shigellosis: public health management and questionnaire. [Webpage.] London: Government of the United Kingdom, PHE; 30 November 2017. Available from: https://www.gov.uk/government/publications/shigellosis-public-health-management-and-questionnaire.
PHE. Shigella data 2006 to 2015: November 2016. London: Government of the United Kingdom, PHE; 30 November 2017. Available from: https://assets.publishing.service.gov.uk/media/5a816f53ed915d74e33fe317/Shigella_2016_Data.pdf.
Jenkins C, Griffith P, Hoban A, Brown C, Garner J, Bardsley M et al. Foodborne outbreak of extended spectrum beta-lactamase producing Shigella sonnei associated with contaminated spring onions in the United Kingdom. J Food Prot. 2023;86(6):100074. doi: https://doi.org/10.1016/j.jfp.2023.100074.
Charles H, Prochazka M, Thorley K, Crewdson A, Greig DR, Jenkins C et al. Outbreak of sexually transmitted, extensively drug-resistant Shigella sonnei in the UK, 2021–22: a descriptive epidemiological study. Lancet Infect Dis. 2022;22(10):1503–10. doi: https://doi.org/0.1016/S1473-3099(22)00370-X.
Turabelidze G, Bowen A, Lin M, Tucker A, Butler C, Fick F. Convalescent cultures for control of shigellosis outbreaks. Pediatr Infect Dis J. 2010;29(8):728–30. doi: https://doi.org/10.1097/INF.0b013e3181e4ee6e.
New South Wales Government Department of Health (NSW Health). Shigellosis: NSW Control Guideline for Public Health Units. Sydney: NSW Health; July 2018. Available from: https://www.health.nsw.gov.au/Infectious/controlguideline/Documents/shigellosis.pdf.
Devanga Ragupathi NK, Muthuirulandi Sethuvel DP, Inbanathan FY, Veeraraghavan B. Accurate differentiation of Escherichia coli and Shigella serogroups: challenges and strategies. New Microbes New Infect. 2018;21:58–62. doi: https://doi.org/10.1016/j.nmni.2017.09.003.
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