Diarrhea outbreak sickens hundreds of island tourists in 5-star hotels

These crazy looking hot dogs are an illustration of the Shigella bacteria.

These crazy looking hot dogs are an illustration of the Shigella bacteria.
Drawing: Stephanie Rossow/CDC

A trip to the picturesque island country of Cape Verde off the coast of Africa has turned into a nightmare for hundreds of tourists returning home. A multi-country epidemic of shigella The bacteria, a common but sometimes serious stomach bug, has been traced to travel from the island since last fall. More than 200 cases have been documented, including those returning to the United States, and some cases are believed to have multiple resistance to the antibiotics used to treat the infection.

Health officials at the European Center for Disease Prevention and Control (ECDC) reported on the outbreak earlier this month. The epidemic appears to have started in September 2022, but it “evolved rapidly” from November to December.“Most of the cases stayed in five-star all-inclusive hotels in the Santa Maria area of ​​Sal Island,” the ECDC said in its report.

There have been 221 confirmed cases and 37 other probable cases, affecting people from a dozen countries, including the US, UK and parts of Europe. No deaths have been reported, but at least one person (in Portugal) has been hospitalized as a result.

shigella is the primary cause of bacterial diarrhea worldwide, according to the World Health Organization. Most infections are self-limiting if deeply unpleasant, causing about a week of diarrhea (sometimes bloody diarrhea, also known as dysentery), cramps, and fever. More rarely, it can cause severe dehydration or other life-threatening complications, with serious illness more likely in very young children or those with weakened immune systems.

The main culprit in this current outbreak is a strain of Shigella sonei, one of the four groups of bacteria that cause disease. Officials still haven’t figured out how the outbreak spread, though they say the most likely route is through food or water, including through infected food handlers. But more than one method of transmission, including person-to-person contact, may be to blame (sometimes the infection can even be spread sexually). The last cases were reported in Sweden in mid-January, suggesting there is still a moderate risk of further infections from Cape Verde, ECDC officials said.

While most shigella infections go away on their own, severe cases require urgent treatment, including antibiotics. Unfortunately, like many bacterial infections, shigella regularly learns how to overcome these drugs. The epidemic strain showed clear signs of resistance to two antibiotics which were phased out as first-line treatments as planned, but some cases showed evidence of resistance to an even wider variety of drugs.

Despite the relative mildness of shigella, it still kills about 200,000 people a year, according to the WHO. And given the current and growing threat of the bacteria, many researchers are working hard to try to develop an effective vaccine against it. Clinical trials of these vaccines are underway around the world, with at least one in progress study in the United States is currently looking for people brave enough to swallow a drink containing the bacteria.

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