Shigellosis in Central America

Abstract

Shigella infections are very common in Central America, except in Costa Rica and Panama where prevalence rates are low. Shigellosis is the most serious among all the specific diarrhoeas, due to its invasive character, systemic manifestations, severe nutritional impact, and tendency to become recurrent over prolonged periods. All species of shigella are found in Central America; village studies reveal the occurrence for several serotypes in any single day. The commonest species are S.fiesneri and S.alionnei. The Shiga bacillus is rare at the moment;but an extensive epidemic covered the whole Isthmus in 1969-71. The epidemic Shiga bacillus bear the multiple-drug resistance plasmid; more recently, some strains have been isolated containing the ampicillin plasmid as well. The differences in mortality due to diarrhoea among the Central American nations, attest to the importance of environmental factors in determining shigella infections. The reductions or increases in diarrhoea mortality recorded in the last 15 years appear to reflect changes in the socioeconomic situation in those nations