Figure 26–3 Reported isolates of Shigella by species and year, United States, 1975–2000. Centers for Disease Control and
Prevention (2002).

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Figure 26–4 Reported cases of shigellosis per 1,000,000 population by year, United States, 1970–2000. Date from PHLIS, Centers for
Disease Control and Prevention (2002).

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Foodborne Cases
For the period 1973–1987, foodborne shigellosis accounted for 12% of reported food poisoning
cases in the United States for which an etiological agent could be found, placing it third behind staphylococcal food poisoning (14%) and salmonellosis (45%).4 Poor personal hygiene is a common factor
in foodborne shigellosis, with shellfish, fruits and vegetables, chicken, and salads being prominent
among vehicle foods. The prominence of these foods is due to the fecal–oral route of transmission. The
shigellae are not as persistent in the environment as are salmonellae and escherichiae. The recorded
species isolations of Shigella in the United States for the years 1975–2000 are noted in Figure 26–3.
It should be noted that the isolations noted were from many sources including foods. S. sonnei is
clearly the most frequent isolate followed by S. flexneri. The recorded shigellosis cases (per 100,000
population) in the United States for the years 1970–2000 can be seen from Figure 26–4, and they
include foodborne as well as non-foodborne cases.
In 2000, an outbreak of shigellosis in three western states of the United States was caused by S.
sonnei; the vehicle food was a 5-layer party dip, and there were 30 victims.12 The dip layers consisted of

bean/salsa/guacamole/nacho cheese/sour cream. An outbreak caused by S. sonnei occurred in Spain
in 1995–1996 and it was traced to fresh pasteurized milk cheese;there were >200 victims, and an
infected food handler appeared to be the source of the pathogen to susceptible individuals.
Virulence Properties
The virulence mechanisms of the shigellae are much more complex than previously thought, and
they are discussed in Chapter 22 along with salmonellae and some E. coli strains.
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