High Prevalence of Shigella or Enteroinvasive Escherichia coli Carriage among Residents of an Internally Displaced Persons Camp in South Sudan

Jesse Bliss Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah;

Search for other papers by Jesse Bliss in
Current site
Google Scholar
PubMed
Close
,
Malika Bouhenia World Health Organization, Juba, South Sudan;

Search for other papers by Malika Bouhenia in
Current site
Google Scholar
PubMed
Close
,
Peter Hale Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah;

Search for other papers by Peter Hale in
Current site
Google Scholar
PubMed
Close
,
Brianne A. Couturier ARUP Laboratories, Salt Lake City, Utah;

Search for other papers by Brianne A. Couturier in
Current site
Google Scholar
PubMed
Close
,
Anita S. Iyer Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah;

Search for other papers by Anita S. Iyer in
Current site
Google Scholar
PubMed
Close
,
John Rumunu Republic of South Sudan Ministry of Health, Juba, South Sudan;

Search for other papers by John Rumunu in
Current site
Google Scholar
PubMed
Close
,
Stephen Martin World Health Organization, Geneva, Switzerland;

Search for other papers by Stephen Martin in
Current site
Google Scholar
PubMed
Close
,
Joseph F. Wamala World Health Organization, Juba, South Sudan;

Search for other papers by Joseph F. Wamala in
Current site
Google Scholar
PubMed
Close
,
Abdinasir Abubakar World Health Organization, Juba, South Sudan;

Search for other papers by Abdinasir Abubakar in
Current site
Google Scholar
PubMed
Close
,
David A. Sack Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;

Search for other papers by David A. Sack in
Current site
Google Scholar
PubMed
Close
,
Francisco J. Luquero Department of International Health, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;
Epicentre, Paris, France;

Search for other papers by Francisco J. Luquero in
Current site
Google Scholar
PubMed
Close
,
Marc Roger Couturier ARUP Laboratories, Salt Lake City, Utah;
Department of Pathology, University of Utah, Salt Lake City, Utah;

Search for other papers by Marc Roger Couturier in
Current site
Google Scholar
PubMed
Close
,
Andrew S. Azman Department of Epidemiology, Johns Hopkins Bloomberg School of Public Health, Baltimore, Maryland;
Médecins sans Frontières, Geneva, Switzerland

Search for other papers by Andrew S. Azman in
Current site
Google Scholar
PubMed
Close
, and
Daniel T. Leung Division of Infectious Diseases, University of Utah School of Medicine, Salt Lake City, Utah;
Department of Pathology, University of Utah, Salt Lake City, Utah;

Search for other papers by Daniel T. Leung in
Current site
Google Scholar
PubMed
Close
Restricted access

Displaced persons living in camps are at an increased risk of diarrheal diseases. Subclinical carriage of pathogens may contribute to the spread of disease, especially for microbes that require a low infectious dose. Multiplex real-time polymerase chain reaction was performed to detect a panel of 20 bacterial, viral, and protozoal targets, and we report a high prevalence of enteropathogen carriage, including Shigella spp. or enteroinvasive Escherichia coli in 14%, among a sample of 88 asymptomatic individuals in an internally displaced persons camp in South Sudan. Further studies are needed to determine the contribution of such carriage to the spread of disease.

Author Notes

Address correspondence to Daniel T. Leung, Division of Infectious Diseases, University of Utah School of Medicine, 30 North 1900 East, Room 4B319, Salt Lake City, UT 84132. E-mail: daniel.leung@utah.edu

Authors’ addresses: Jesse Bliss, Peter Hale, and Daniel T. Leung, Division of Infectious Diseases, University of Utah, Salt Lake City, UT, E-mails: jesse.bliss@utah.edu, peter.hale@hsc.utah.edu, and daniel.leung@utah.edu. Malika Bouhenia, World Health Organization, Juba, South Sudan, E-mail: malik14@yahoo.fr. Brianne A. Couturier and Marc Roger Couturier, ARUP Laboratories, Salt Lake City, UT, E-mails: brianne.a.couturier@aruplab.com and marc.couturier@aruplab.com. Anita S. Iyer, Division of Infectious Diseases, Department of Internal Medicine, University of Utah School of Medicine, Salt Lake City, UT, E-mail: anita.iyer@hsc.utah.edu. John Rumunu, Department of Preventative Health, Government of the Republic of South Sudan Ministry of Health, Juba, South Sudan, E-mail: jrumunu@yahoo.com. Stephen Martin, World Health Organization, Geneva, Switzerland, E-mail: martins@who.int. Joseph F. Wamala, World Health Organization, Emergency, Juba, South Sudan, E-mail: wamalaj@who.int. Abdinasir Abubakar, World Health Organization, Juba, South Sudan, E-mail: abubakara@who.int. David A. Sack, Department of International Health, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, E-mail: dsack1@jhu.edu. Francisco J. Luquero, Epicentre, Paris, France, E-mail: francisco.luquero@epicentre.msf.org. Andrew S. Azman, Department of Epidemiology, Johns Hopkins University Bloomberg School of Public Health, Baltimore, MD, and Medecins Sans Frontieres, Geneva, Switzerland, E-mail: azman@jhu.edu.

  • 1.

    Kyu HH et al. Global Burden of Disease Pediatrics Collaboration, 2016. Global and national burden of diseases and injuries among children and adolescents between 1990 and 2013: findings from the global burden of disease 2013 study. JAMA Pediatr 170: 267287.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 2.

    UNHCR, 2016. Global Trends Forced Displacement in 2015.Geneva, Switzerland: UNHCR Global Trends.

    • PubMed
    • Export Citation
  • 3.

    Shultz A, Omollo JO, Burke H, Qassim M, Ochieng JB, Weinberg M, Feikin DR, Breiman RF, 2009. Cholera outbreak in kenyan refugee camp: risk factors for illness and importance of sanitation. Am J Trop Med Hyg 80: 640645.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 4.

    Benny E et al. 2014. A large outbreak of shigellosis commencing in an internally displaced population, Papua New Guinea, 2013. Western Pac Surveill Response J 5: 1821.

  • 5.

    Lederer I, Taus K, Allerberger F, Fenkart S, Spina A, Springer B, Schmid D, 2015. Shigellosis in refugees, Austria, July to November 2015. Euro Surveill 20: pii30081.

  • 6.

    Taniuchi M, Sobuz SU, Begum S, Platts-Mills JA, Liu J, Yang Z, Wang XQ, Petri WA Jr, Haque R, Houpt ER, 2013. Etiology of diarrhea in Bangladeshi infants in the first year of life analyzed using molecular methods. J Infect Dis 208: 17941802.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 7.

    DuPont HL, Levine MM, Hornick RB, Formal SB, 1989. Inoculum size in Shigellosis and implications for expected mode of transmission. J Infect Dis 159: 11261128.

  • 8.

    Ryan ET, 2013. The intestinal pathobiome: its reality and consequences among infants and young children in resource-limited settings. J Infect Dis 208: 17321733.

  • 9.

    Lindsay B et al. 2013. Quantitative PCR for detection of Shigella improves ascertainment of Shigella burden in children with moderate-to-severe diarrhea in low-income countries. J Clin Microbiol 51: 17401746.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 10.

    Iyer AS et al. 2016. Immune responses to an oral cholera vaccine in internally displaced persons in South Sudan. Sci Rep 6: 35742.

  • 11.

    Liu J et al. 2016. Use of quantitative molecular diagnostic methods to identify causes of diarrhoea in children: a reanalysis of the GEMS case-control study. Lancet 388: 12911301.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 12.

    Mosley W, Adams B, Lyman E, 1962. Epidemiologic and sociologic features of a large urban outbreak of shigellosis. JAMA 182: 13071311.

  • 13.

    Arvelo W et al. 2009. Transmission risk factors and treatment of pediatric shigellosis during a large daycare center-associated outbreak of multidrug resistant Shigella sonnei: implications for the management of shigellosis outbreaks among children. Pediatr Infect Dis J 28: 976980.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 14.

    Riggs MM, Sethi AK, Zabarsky TF, Eckstein EC, Jump RLP, Donskey CJ, 2007. Asymptomatic carriers are a potential source for transmission of epidemic and nonepidemic clostridium difficile strains among long-term care facility residents. Clin Infect Dis 45: 992998.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 15.

    Ko CF, Wang LY, Lin NT, Chiou CS, Yeh HC, Renn JH, Lee YS, 2013. Transmission and strain variation of Shigella flexneri 4a after mass prophylaxis in a long-stay psychiatric centre. Epidemiol Infect 141: 242250.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
  • 16.

    Thornley CN, Hewitt J, Perumal L, Van Gessel SM, Wong J, David SA, Rapana JP, Li S, Marshall JC, Greening GE, 2013. Multiple outbreaks of a novel norovirus GII.4 linked to an infected post-symptomatic food handler. Epidemiol Infect 141: 15851597.

    • Crossref
    • PubMed
    • Search Google Scholar
    • Export Citation
Past two years Past Year Past 30 Days
Abstract Views 1514 1293 467
Full Text Views 453 10 3
PDF Downloads 148 11 2
 

 

 

 
 
Affiliate Membership Banner
 
 
Research for Health Information Banner
 
 
CLOCKSS
 
 
 
Society Publishers Coalition Banner
Save