An epidemiological study of Shigella sonnei infection in case of B girls' high school in busan, June 2000

ABSTRACT

BACKGROUND: The students who had traveled in Jeju island developed symptoms of diarrhea at a girls' high school in Busan, June 2000. The goals of this study are to investigate the pattern of shigellosis and to compare drug resistance to S. sonnei with recent studies by reference reports. METHODS: Through epidemiological investigation and stool test of new patients, 993 students were registered from Jun.12 to 17, 2000 in a girls' high school, Busan. 2nd grade students(N=355) who had traveled in Jeju island described a questionnaire of the source of infection. Clinical and bacteriological studies were carried out on 6 cases of patients with S. sonnei. RESULTS: Among total 993 students, 79 patients were considered to have diarrhea. But 54 patients of 2nd grade students developed symptoms of diarrhea(14.7%) and the analysis of associative symptoms showed that it contained abdominal pain(72.2%), headache(61.6%), tenesmus(57.4%). 43 students of 2nd grade students who had traveled in Jeju ate chinese foods. Of them, 40 students showed diarrhea(93.0%) confirmed shigellosis(6 students), probable shigellosis(34 students). S. sonnei was isolated from 6 patients(14.0%). The attack rate of diarrhea was 20.7 times more in the group eating chinese foods than in the group not eating chinese foods(p<0.001). After the 2nd grade students ate chinese foods in Jeju, diarrhea attack day distribution was first day(23.2%), second day(39.7%), and third day(16.3%). The result of drug resistance test to S. sonnei(ampicillin, amoxicillin/clavulanic acid, tetracycline, sulfamethoxazole trimethoprim, and streptomycin) was 100%. CONCLUSION: The 2nd grade patients with shigellosis ate chinese foods in a restaurant, Jeju. The pattern of antibiotic resistance to S. sonnei was different from that of several previous cases of shigellosis in Busan.