Peltola H, Gorbach SL, 1997. Traveler’s diarrhea. DuPont H, Steffen R, eds. Textbook of Travel Medicine and Health. Hamilton, Ontario, Canada: B.C. Decker, Inc., 78–86.
Brewster SJ, Taylor DN, 2004. Epidemiology of travelers’ diarrhea. Keystone JS, Kozarsky PE, Freedman DD, Nothdurft HD, Connor BA, eds. Travel Medicine. Edinburgh, United Kingdom: Mosby, 175–184.
Gorbach S, 1987. Bacterial diarrhoea and its treatment. Lancet 12 :1378–1382.
Bourgeois AL, Gardiner CH, Thornton SA, Batchelor RA, Burr DH, Escamilla J, Echeverria P, Blacklow NR, Herrmann JE, Hyams KC, 1993. Etiology of acute diarrhea among United States military personnel deployed to South America and west Africa. Am J Trop Med Hyg 48 :243–248.
Sanchez JL, Gelnett J, Petrucelli BP, Defraites RF, Taylor DN, 1998. Diarrheal disease incidence and morbidity among United States military personnel during short-term missions overseas. Am J Trop Med Hyg 58 :299–304.
Kilpatrick M, 1993. Diarrhoeal disease: current concepts and future challenges. Diarrhoeal disease - a military perspective. Trans R Soc Trop Med Hyg 87 (Suppl 3):47–48.
Haberberger RL, Mikhail IA, Burans JP, Hyams KC, Glenn JC, Diniega BM, Sorgen S, Mansour N, Blacklow NR, Woody JN, 1991. Travelers’ diarrhea among United States military personnel during joint American-Egyptian armed forces exercises in Cairo, Egypt. Mil Med 156 :27–30.
Cohen D, Ashkenazi S, Green M, Gdalevich M, Yavzori M, Orr N, Robin G, Slepon R, Lerman Y, Block C, Ashkenazi I, Taylor D, Hale L, Sadoff J, Schneerson R, Robbins J, Wiener M, Shemer J, 1996. Clinical trials of Shigella vaccines in Israel. Cohen S, Shafferman A, eds. Novel Strategies in Design and Production of Vaccines. New York: Plenum Press, 159–167.
Cohen D, Sela T, Slepon R, Yavzori M, Ambar R, Orr N, Robin G, Shpielberg O, Eldad A, Green M, 2001. Prospective cohort studies of shigellosis during military field training. Eur J Clin Microbiol Infect Dis 20 :123–126.
Nachamkin I, 1999. Campylobacter and Arcobacter. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 716–726.
Gray LD, 1995. Escherichia, Salmonella, Shigella, and Yersinia. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 450–456.
Altwegg M, 1999. Aeromonas and Plesiomonas. Murray PR, Baron EJ, Pfaller MA, Tenover FC, Yolken RH, eds. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 507–516.
Woods GL, Washington JA, 1995. Antibacterial susceptibility tests: dilution and disk diffusion methods. Murray P, Barron D, Pfaller M, Tenover F, Yolken R, eds. Manual of Clinical Microbiology. Washington, DC: American Society for Microbiology, 1327–1341.
Stacy-Phipps S, Mecca JJ, Weiss JB, 1995. Multiplex PCR assay and simple preparation method for stool specimens detect enterotoxigenic Escherichia coli DNA during course of infection. J Clin Microbiol 33 :1054–1059.
Sethabutr O, Venkatesan M, Murphy GS, Eampokalap B, Hoge CW, Echeverria P, 1993. Detection of Shigellae and enteroinvasive Escherichia coli by amplification of the invasion plasmid antigen H DNA sequence in patients with dysentery. J Infect Dis 167 :458–461.
Oyofo BA, Lesmana M, Subekti D, Tjaniadi P, Larasati W, Putri M, Simanjuntak CH, Punjabi NH, Santoso W, Sukarma M, Soritua-Sarumpaet S, Abdi M, Tjindi R, Ma’ani H, Sumardiati AL, Handayani H, Campbell JR, Alexander WK, Beecham HJ, Corwin AL, 2002. Surveillance of bacterial pathogens of diarrhea disease in Indonesia. Diag Microbiol Infect Dis 44 :227–234.
|Past two years||Past Year||Past 30 Days|
|Full Text Views||330||105||2|
We investigated the etiology of acute diarrhea among Peruvian military recruits undergoing three months of basic combat training near the Amazonian city of Iquitos. From January through September 2002, 307 of 967 recruits were seen at the Health Post for diarrhea (attack rate [AR] = 31.8%, incidence = 1.28 95% confidence interval [CI] = 1.14–1.43] episodes/person-year). Shigella spp. were the most common bacterial pathogen recovered from recruits experiencing diarrhea episodes. These bacteria were isolated from 89 (40%) of 225 diarrheal stools examined (AR = 7.6%, incidence = 0.30 [95% CI = 0.24–0.38] episodes/person-year). Most (83 of 90; 92%) of the Shigella isolates were S. flexneri, of which 57 (69%) were serotype 2a. Seventy-six percent of Shigella isolates were resistant to sulfamethoxazole/trimethoprim and all were sensitive to ciprofloxacin. Peruvian soldiers may be an excellent population in which to test the efficacy of S. flexneri vaccines in advanced development.