Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1

Overview

Shigellosis continues to be a major public health problem and remains endemic in many developing countries. Among Shigella species, Shigella dysenteriae type 1 (Sd1) represents a particular threat because of the severity of disease it causes and its epidemic potential. In this context, a workshop on shigellosis was jointly organized by: WHO; ICDDR, B; IVI; and USAID to prepare recommendations for controlling endemic and epidemic shigellosis.

The review of the situation with regard to shigellosis led to revision of the WHO guidelines for the control of dysentery. The main modifications brought to these guidelines concerned:

• the development of guidelines for the control of dysentery in general, rather than focused on Sd1 outbreaks only;
• the need to put more emphasis on interventions targeting hand-washing practices, among other prevention methods;
• the need to change antibiotics recommended for the treatment of cases of shigellosis. Nalidixic acid should no longer be recommended. Fluoroquinolones should be used as the first-line treatment for all patients suffering from shigellosis. Patients should also receive zinc supplementation.