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Thirty percent of children under 12 years were affected compared with 4% of adolescents and adults (P &lt; 0.0001). Thirty\u2013five out of 105 stool cultures (33%) grew <jats:italic>Shigella sonnei<\/jats:italic>. Thirty\u2013four isolates had the same susceptibility pattern and were sensitive to ampicillin, while one was resistant to this antibiotic. Thirty\u2013three isolates had the same plasmid profile. Based on epidemiologic and environmental findings, it was concluded that the transmission of shigellosis was waterborne. Shigella were not isolated from water, but one of the three village springs was found to be contaminated with faecal coliforms. This spring was probably contaminated by sewage material, due to its proximity to a source of untreated sewage effluent. Implementation of environmental and control measures brought the epidemic to an end.<\/jats:p>","DOI":"10.1017\/s0950268800057642","type":"journal-article","created":{"date-parts":[[2009,5,15]],"date-time":"2009-05-15T08:48:59Z","timestamp":1242377339000},"page":"235-245","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":23,"title":["An outbreak of diarrhoeal disease attributed to <i>Shigella sonnei<\/i>"],"prefix":"10.1017","volume":"112","author":[{"given":"G.","family":"Samonis","sequence":"first","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"L.","family":"Elting","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"E.","family":"Skoulika","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"S.","family":"Maraki","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]},{"given":"Y.","family":"Tselentis","sequence":"additional","affiliation":[],"role":[{"role":"author","vocabulary":"crossref"}]}],"member":"56","published-online":{"date-parts":[[2009,5,15]]},"reference":[{"key":"S0950268800057642_ref016","first-page":"838","volume-title":"Standard methods for the examination of water and wastewater","year":"1980"},{"key":"S0950268800057642_ref022","first-page":"458","article-title":"Ampicillin and shigellosis","volume":"125","author":"Haltalin","year":"1973","journal-title":"Am J Dis Child"},{"key":"S0950268800057642_ref019","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a112328"},{"key":"S0950268800057642_ref017","doi-asserted-by":"publisher","DOI":"10.1001\/jama.1976.03260380033022"},{"key":"S0950268800057642_ref025","doi-asserted-by":"crossref","first-page":"297","DOI":"10.1001\/jama.257.3.297","article-title":"Multiply resistant shigellosis in a day\u2013care center\u2013Texas","volume":"257","author":"Crowder","year":"1987","journal-title":"JAMA"},{"key":"S0950268800057642_ref012","first-page":"360","volume-title":"Manual of clinical microbiology","author":"Farmer","year":"1991"},{"key":"S0950268800057642_ref024","doi-asserted-by":"publisher","DOI":"10.1016\/S0140-6736(88)92516-0"},{"key":"S0950268800057642_ref010","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a112100"},{"key":"S0950268800057642_ref009","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a112026"},{"key":"S0950268800057642_ref021","doi-asserted-by":"publisher","DOI":"10.1093\/clinids\/8.Supplement_2.S172"},{"key":"S0950268800057642_ref007","first-page":"47","article-title":"Epidemiology of common\u2013source outbreaks of shigellosis in the United States, 1961\u20131975","volume":"108","author":"Black","year":"1978","journal-title":"Am J Epidemiol"},{"key":"S0950268800057642_ref008","first-page":"250","article-title":"Hospital\u2013associated outbreak of Shigella dysenteriae Type 2\u2013Maryland","volume":"32","year":"1983","journal-title":"MMWR"},{"key":"S0950268800057642_ref001","doi-asserted-by":"crossref","first-page":"771","DOI":"10.1093\/infdis\/147.4.771","article-title":"Shigella infections in the United States, 1974\u20131980","volume":"147","author":"Blaser","year":"1983","journal-title":"J Infect Dis"},{"key":"S0950268800057642_ref005","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/143.1.130"},{"key":"S0950268800057642_ref002","doi-asserted-by":"publisher","DOI":"10.4269\/ajtmh.1985.34.547"},{"key":"S0950268800057642_ref006","doi-asserted-by":"publisher","DOI":"10.2105\/AJPH.77.2.166"},{"key":"S0950268800057642_ref003","first-page":"811","article-title":"A prospective epidemiologic study of shigellosis in the Israel defence forces: Implications for the use of shigella vaccines","volume":"23","author":"Green","year":"1987","journal-title":"Isr J Med Sci"},{"key":"S0950268800057642_ref011","doi-asserted-by":"publisher","DOI":"10.1093\/oxfordjournals.aje.a112081"},{"key":"S0950268800057642_ref013","first-page":"1","article-title":"Antibiotic sensitivity testing. 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