EPIDEMIC SHIGELLA GASTROENTERITIS (BACILLARY DYSENTERY) IN AN ENDEMIC AREA

[摘要] The clinical aspects of acute bacillary dysentery as observed in an outbreak among a general population group in a highly endemic area are presented; age-specific clinical variations are noted.The onset was abrupt in all cases and all age-groups. The height of the illness in 84% of 106 cases was reached in 24 hours, more rapidly than in the "classical" form (3 to 5 days).The presence of blood in the stools was noted in about 25% of all cases; in about 25% of the 0 through 5 year age-group, 50% of the 6 through 10 year group, 37½% of the 11 through 15 year age-group, and 9 to 10% in the groups 16 years of age and over.The median number of stools was 9 to 10 daily, with no significant difference among the various age-groups.Fever was present in 65% of the children 10 years of age and under (55 cases), and in 35% of the older age-groups (40 cases).Vomiting is more frequent among the younger age-groups; weakness becomes a more frequent complaint with advancing age.The median duration of illness was 5.5 days in 100 cases. There was no correlation observed between age and duration.Recurrences are more frequently observed in the youngest age-groups—36% of all cases (14) under one year of age, 28% of 39 cases between 1-2 years of age. About 9% of the 26 and over age-group (34 cases) recurred, and practically none in the intervening groups.No relationship was observed between the tendency towards recurrences in households with multiple cases as compared with single cases.All the fatalities were under one year of age. Two deaths occurred in the cases studied, yielding an age-specific death rate of 14.3% for this group. Five other deaths in cases not included in this report are noted, all under one year of age; 2 caused by "infant diarrhea" and 3 by bronchopneumonia with "chronic diarrhea" as a contributing cause.The role of acquired immunity in the modification of bacillary dysentery can be evaluated from studies of attack rates and the clinical course of the disease, through age-specific groupings. Investigators should clearly define such basic terms as duration, recurrences, etc., when reporting so that necessary comparisons and/or data summation can be made.

[学科分类] 儿科学