{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,20]],"date-time":"2026-09-20T15:13:44Z","timestamp":1789917224313,"version":"4.0.1"},"reference-count":12,"publisher":"Cambridge University Press (CUP)","issue":"11","license":[{"start":{"date-parts":[[2016,5,16]],"date-time":"2016-05-16T00:00:00Z","timestamp":1463356800000},"content-version":"unspecified","delay-in-days":0,"URL":"https:\/\/www.cambridge.org\/core\/terms"}],"content-domain":{"domain":["journals.cambridge.org"],"crossmark-restriction":true},"short-container-title":["Epidemiol. Infect."],"published-print":{"date-parts":[[2016,8]]},"abstract":"<jats:title>SUMMARY<\/jats:title><jats:p>Shigellosis is endemic in most developing countries and thus a known risk in refugees and internally displaced persons. In 2015, a massive influx of refugees into Greece, due to the political crisis in the Middle East, led to the development of appropriate conditions for outbreaks of communicable diseases as shigellosis. We present a cluster of 16 shigellosis cases in refugees, detected by the implementation of a syndromic notification system in one transit centre in Athens, between 20 August and 7 October 2015. Both <jats:italic>Shigella flexneri<\/jats:italic> (<jats:italic>n<\/jats:italic> = 8) and <jats:italic>S. sonnei<\/jats:italic> (<jats:italic>n<\/jats:italic> = 8) were identified, distributed in various serotypes. All tested isolates (<jats:italic>n<\/jats:italic> = 13) were multidrug resistant; seven were CTX-M-type extended-spectrum <jats:italic>\u03b2<\/jats:italic>-lactamase producers. Our results indicate lack of a potential common source, although pulsed-field gel electrophoresis typing results revealed small clusters in isolates of the same serotype indicating possible limited person-to-person transmission without identifying secondary community cases related to the refugees. To prevent the spread of shigellosis, empirical antibiotic treatment as well as environmental hygiene measures were implemented. The detection of multi-drug resistance is important for determining the appropriate empirical antibiotic treatment for the more severe cases, while at the same time real-time typing is useful for epidemiological investigation and control measures.<\/jats:p>","DOI":"10.1017\/s095026881600100x","type":"journal-article","created":{"date-parts":[[2016,5,16]],"date-time":"2016-05-16T07:17:32Z","timestamp":1463383052000},"page":"2415-2419","update-policy":"https:\/\/doi.org\/10.1017\/policypage","source":"Crossref","is-referenced-by-count":16,"title":["Resistant <i>Shigella<\/i> strains in refugees, August\u2013October 2015, Greece"],"prefix":"10.1017","volume":"144","author":[{"ORCID":"https:\/\/orcid.org\/0000-0001-9559-7476","authenticated-orcid":false,"given":"T.","family":"GEORGAKOPOULOU","sequence":"first","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"G.","family":"MANDILARA","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"MELLOU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"K.","family":"TRYFINOPOULOU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"CHRISOSTOMOU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"H.","family":"LILLAKOU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"C.","family":"HADJICHRISTODOULOU","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"A.","family":"VATOPOULOS","sequence":"additional","affiliation":[],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"56","published-online":{"date-parts":[[2016,5,16]]},"reference":[{"key":"S095026881600100X_ref7","doi-asserted-by":"publisher","DOI":"10.1093\/jac\/dki412"},{"key":"S095026881600100X_ref3","doi-asserted-by":"publisher","DOI":"10.1177\/140349489001800304"},{"key":"S095026881600100X_ref6","unstructured":"WHO. Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1. Geneva: World Health Organization, 2005."},{"key":"S095026881600100X_ref5","doi-asserted-by":"publisher","DOI":"10.5365\/wpsar.2014.5.2.003"},{"key":"S095026881600100X_ref2","unstructured":"ECDC. Communicable disease risks associated with the movement of refugees in Europe during the winter season \u2013 10 November 2015. Stockholm: European Centre for Disease Prevention and Control, 2015 (http:\/\/ecdc.europa.eu\/en\/publications\/Publications\/refugee-migrant-health-in-european-winter-rapid-risk-assessment.pdf). Accessed 10 January 2015."},{"key":"S095026881600100X_ref8","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pmed.0030353"},{"key":"S095026881600100X_ref11","first-page":"645","volume-title":"Red Book 2012 Report of the Committee on Infectious Diseases","author":"Pickering","year":"2012"},{"key":"S095026881600100X_ref12","unstructured":"ECDC. Rapid risk assessment. Shigellosis among refugees in the EU: 26 November 2015. Stockholm: European Centre for Disease Prevention and Control, 2015."},{"key":"S095026881600100X_ref10","doi-asserted-by":"publisher","DOI":"10.2807\/1560-7917.ES.2015.20.48.30081"},{"key":"S095026881600100X_ref9","doi-asserted-by":"publisher","DOI":"10.1093\/infdis\/159.6.1126"},{"key":"S095026881600100X_ref4","doi-asserted-by":"publisher","DOI":"10.1371\/journal.pone.0004494"},{"key":"S095026881600100X_ref1","unstructured":"United Nations High Commissioner for Refugees (UNHCR). Refugees\/migrants emergency response \u2013 Mediterranean. Europe's refugee emergency response update no. 14, 2015 (http:\/\/data.unhcr.org\/mediterranean\/download.php?id=282) Accessed 10 January 2015."}],"container-title":["Epidemiology and Infection"],"original-title":[],"language":"en","link":[{"URL":"https:\/\/www.cambridge.org\/core\/services\/aop-cambridge-core\/content\/view\/S095026881600100X","content-type":"unspecified","content-version":"vor","intended-application":"similarity-checking"}],"deposited":{"date-parts":[[2019,4,18]],"date-time":"2019-04-18T21:38:03Z","timestamp":1555623483000},"score":1,"resource":{"primary":{"URL":"https:\/\/www.cambridge.org\/core\/product\/identifier\/S095026881600100X\/type\/journal_article"}},"subtitle":[],"short-title":[],"issued":{"date-parts":[[2016,5,16]]},"references-count":12,"journal-issue":{"issue":"11","published-print":{"date-parts":[[2016,8]]}},"alternative-id":["S095026881600100X"],"URL":"https:\/\/doi.org\/10.1017\/s095026881600100x","relation":{},"ISSN":["0950-2688","1469-4409"],"issn-type":[{"value":"0950-2688","type":"print"},{"value":"1469-4409","type":"electronic"}],"subject":[],"published":{"date-parts":[[2016,5,16]]},"assertion":[{"value":"Copyright \u00a9 Cambridge University Press 2016\u00a0","name":"license","label":"License","group":{"name":"copyright_and_licensing","label":"Copyright and Licensing"}}]}}