An outbreak of Shigella sonnei infection due to contamination of a municipal water supply in northern Israel.

An epidemic of more than 8000 cases of Shigella sonnei infection took place in four adjacent urban communities which share the same water supply. The epidemic was caused by massive faecal contamination of the drinking water due to a leak from a broken main sewage pipe into an adjacent drilled well. The infecting organism in most cases was S. sonnei colicine type 6, biotype A, which showed a high rate of multiple resistance to commonly used antibacterial drugs. Most of those affected were children less than 15 years of age. Among adults the attack rates were higher in women. Most cases were mild, only 91 patients being admitted to hospital. One 5-year-old child died.

Single low-dose ofloxacin for the treatment of uncomplicated urinary tract infection in young women.

Fifty premenopausal women with uncomplicated urinary tract infection (UTI) were treated with a single dose of 100 mg of ofloxacin. Duration of symptoms before the treatment, number of episodes of UTI during the last year, association with sexual activity, and the use of contraceptives were evaluated in relation to the clinical and microbiological response. Forty-seven women (94%) were cured clinically and microbiologically three days after treatment. Follow up at 28 days disclosed that 43 (86%) were free of symptoms and in 40 (80%) the urinary cultures were negative. Significantly higher rates of microbiological failure or reinfection were found among women with three or more episodes of UTI during the last year. This study shows that a single dose of ofloxacin is effective for therapy of uncomplicated UTI in young women.

A new provisional serovar of Shigella dysenteriae.

Bacterial isolates obtained in Israel from stool cultures of 17 sporadic cases of acute diarrhea during the years 1972 to 1980 and from 14 patients involved in an institutional outbreak in 1984 are described. These cultures gave the biochemical reactions and pathogenicity tests characteristics of the genus Shigella but failed to agglutinate, living or boiled, in any of the recognized or provisional Shigella antisera. All 31 cultures were biochemically and serologically identical, and owing to their inability to ferment mannitol, it is proposed that they be regarded as belonging to a new provisional serovar of Shigella dysenteriae. The strain I9809-73 is designated as the test strain for this new serovar.

Campylobacter jejuni infections in Haifa subdistrict, Israel, summer 1981.

A study investigating the clinical and epidemiological characteristics of Campylobacter jejuni infections in an urban community in Israel is presented. Most of the information was obtained by interviewing 76 patients who constituted a systematic sample out of a total of 215 patients suffering from acute Campylobacter jejuni diarrhoea during the summer of 1981. The crude annual incidence rate was 17 per 10 000. Age-specific incidence rate in infants up to one year of age was eight times higher than that in children 1-14 years of age. The median duration of infection until a negative culture was obtained in convalescent patients, was 10 days. No evidence of resistance to erythromycin was found. No statistically significant difference in keeping animals at home was found between the patients and a neighbourhood control group. The frequencies of the various complaints and clinical findings are described.

Edwardsiella tarda isolated in Israel between 1961 and 1980.

Edwardsiella tarda was isolated from patients, water tortoises (Clemmys caspica), and samples of water from Lake Kinnereth, the river Jordan, well water, and sewage water. Of the 53 isolates, 35 belonged to completely identified serotypes, among them 7 new ones. Fourteen cultures had O antigens, and one had an H antigen, different from those previously described. Three serotypes isolated from patients were also found in other sources: water tortoises, lake water, or both.

Campylobacter jejuni as an etiological agent of diarrheal diseases in Israel.

During a 2-yr period starting on 22 July 1979, Campylobacter jejuni was isolated in 3,008 stool cultures from 2,450 persons--2,430 (43.%) out of 56,439 patients with acute gastroenteritis and 20 out of 200 asymptomatic household contacts. No isolates of C. jejuni were obtained from any of a control group of 222 subjects. In 176 patients with C. jejuni, Salmonella and/or Shigella were isolated concomitantly. All illnesses were mild to severe and all patients, including 61 requiring hospitalization, recovered uneventfully. Patients' ages ranged from 2 wk to 88 yr, with infants and children comprising 84% of the total. Ninety-one institutional and 36 family outbreaks accounted for 606 patients. Except in two cases related to C. jejuni-infected dogs, no source or route of transmission was established. Sixty-two percent of the patients came from 18 urban localities and 38% from 125 rural settlements widely dispersed throughout northern Israel.

Isolates of Yersinia enterocolitica from clinical cases in Northern Israel.

Bacteriologic data and some clinical and epidemiologic aspects concerning 53 clinical cases associated with Yersinia enterocolitica are described. This is the first published report of human cases of Y. enterocolitica infection in Israel. Seventy-eight isolates of Y. enterocolitica were obtained from stool cultures of these cases, with 94% on SS agar plates. The isolation of the organism, including its differentiation from related bacteria, is discussed. In 88% of 50 cases, the organisms were of serotype 0:3, biotype 4, phage type VIII and in 12%, serotype 0:1, 2a, 3, biotype 3, phage type XI. Sensitivity in vitro to antibacterial drugs and evaluation of the serologic diagnosis are also considered. With two exceptions, all 53 patients had acute enteritis, clinically similar to shigellosis. The cases came from towns and villages throughout northern Israel and were detected from July 1976 to November 1977. Children under five years of age were 76% of the cases. Five cases appeared in two small institutional outbreaks. It is suggested that infection probably occurs in other parts of the country as well, and that difficulty in laboratory diagnosis is the reason for the lack of reported cases.