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Shigellosis update: advancing antibiotic resistance, investment empowered vaccine development, and green bananas

Kosek, Margareta; Yori, Pablo Peñataroa; Olortegui, Maribel Paredesb

Current Opinion in Infectious Diseases: October 2010 - Volume 23 - Issue 5 - p 475–480
doi: 10.1097/QCO.0b013e32833da204
Gastrointestinal infections: Edited by Nicholas J. Beeching and A. Clinton White

Purpose of review Shigella is the principal cause of clinical dysentery and an important cause of morbidity and mortality among children in impoverished regions. The purpose of this review is to present key findings in the areas of epidemiology, disease control, and treatment of shigellosis.

Recent findings Recent research activity has advanced the understanding of the epidemiology and host–pathogen interactions. Increased investment and activity in the area of vaccine development have lead to a diversification of candidates and ongoing technical advances yet continue to yield disappointing results in clinical trials in endemic populations and among the most relevant age groups (children under 2 years of age). The description of the rapid spread of quinolone resistance requires monitoring to ensure appropriate case management, particularly in south-east Asia. The evaluation of adjunctive nutritional therapy in endemic areas has supported the use of green bananas in shortening the duration of Shigella dysentery and persistent diarrhea due to Shigella, as well as improving weight gain in early convalescence.

Summary Despite a great level of activity in basic sciences, there continues to be a large gap in the ability to translate these findings into disease control measures or therapeutic options for individuals living in areas in which shigellosis is endemic.

aDepartment of International Health, Johns Hopkins School of Public Health, Baltimore, Maryland, USA

bAsociación Benéfica PRISMA, Lima, Peru

Correspondence to Margaret Kosek, MD, Department of International Health, Johns Hopkins School of Public Health, 615 North Wolfe Street w5515, Baltimore, MD 21205, USA Tel: +1 410 614 3959; e-mail:

© 2010 Lippincott Williams & Wilkins, Inc.