{"status":"ok","message-type":"work","message-version":"1.0.0","message":{"indexed":{"date-parts":[[2026,9,3]],"date-time":"2026-09-03T11:40:06Z","timestamp":1788435606969,"version":"build-2803163510"},"reference-count":54,"publisher":"Frontiers Media SA","license":[{"start":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T00:00:00Z","timestamp":1770854400000},"content-version":"vor","delay-in-days":0,"URL":"https:\/\/creativecommons.org\/licenses\/by\/4.0\/"}],"content-domain":{"domain":["frontiersin.org"],"crossmark-restriction":true},"short-container-title":["Front. Public Health"],"abstract":"<jats:sec>\n                    <jats:title>Background<\/jats:title>\n                    <jats:p>\n                      <jats:italic>Shigella<\/jats:italic>\n                      infections remain a significant public health threat in the United States because of their diverse outbreak patterns and high disease impact, particularly among young children. This study aimed to investigate the trends in\n                      <jats:italic>Shigella<\/jats:italic>\n                      outbreak incidence and demographic patterns by age and sex from 2009 to 2022 in order to inform targeted prevention strategies.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Methods<\/jats:title>\n                    <jats:p>\n                      We performed a retrospective observational analysis of 1,208\n                      <jats:italic>Shigella<\/jats:italic>\n                      outbreak surveillance data sourced from the Centers for Disease Control and Prevention (CDC) via the National Outbreak Reporting System (NORS). The incidence rates per 1 million population\u2013years were calculated overall and by age and sex. Descriptive statistics were used to summarize the data, and joinpoint regression with 95% confidence intervals was used to identify trends.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Results<\/jats:title>\n                    <jats:p>\n                      The outbreak incidence rate was 0.27 (95% CI: 0.01\u20130.84) per 1 million population\u2013years in 2009, peaking at 0.74 (95% CI: 0.65\u20130.84) in 2016 and declining to 0.03 (95% CI: 0.01\u20130.05) by 2022. Children aged 1\u20134\u202fyears had the highest incidence, and females had a slightly higher incidence rate than males, as indicated in outbreak\u2013associated case data. Joinpoint incidence trends showed an annual percent change (APC) of 25.12% (95% CI: 11.47\u201353.76,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f=\u202f0.001) from 2009 to 2015, followed by a decline with an APC of \u221238.91% (95% CI: \u221260.07 to \u221229.57,\n                      <jats:italic>p<\/jats:italic>\n                      \u202f&amp;lt;\u202f0.001). The outbreaks were predominantly person\u2013to\u2013person transmission, with the highest frequency occurring in childcare settings.\n                    <\/jats:p>\n                  <\/jats:sec>\n                  <jats:sec>\n                    <jats:title>Conclusion<\/jats:title>\n                    <jats:p>\n                      These findings underscore the need for targeted prevention strategies, such as ongoing hygiene education and sanitation enhancements in childcare, as well as reminders about\n                      <jats:italic>Shigella<\/jats:italic>\n                      prevention in shared educational facilities before the fall semester.\n                    <\/jats:p>\n                  <\/jats:sec>","DOI":"10.3389\/fpubh.2026.1740303","type":"journal-article","created":{"date-parts":[[2026,2,12]],"date-time":"2026-02-12T06:52:21Z","timestamp":1770879141000},"update-policy":"https:\/\/doi.org\/10.3389\/crossmark-policy","source":"Crossref","is-referenced-by-count":1,"title":["Temporal trends of Shigella outbreaks in the United States, 2009\u20132022"],"prefix":"10.3389","volume":"14","author":[{"given":"Muhammad Rashid","family":"Bajwa","sequence":"first","affiliation":[{"name":"College of Veterinary Medicine, University of Illinois Urbana-Champaign","place":["Urbana, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Charles Ayooluwa","family":"Adegbole","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, University of Illinois Urbana-Champaign","place":["Urbana, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]},{"given":"Rebecca Lee","family":"Smith","sequence":"additional","affiliation":[{"name":"College of Veterinary Medicine, University of Illinois Urbana-Champaign","place":["Urbana, IL, United States"]}],"role":[{"vocabulary":"crossref","role":"author"}]}],"member":"1965","published-online":{"date-parts":[[2026,2,12]]},"reference":[{"key":"ref1","doi-asserted-by":"publisher","first-page":"611","DOI":"10.1080\/20477724.2023.2179451","article-title":"The increasing antimicrobial resistance of Shigella species among Iranian pediatrics: a systematic review and meta-analysis","volume":"117","author":"Baharvand","year":"2023","journal-title":"Pathog Glob Health"},{"key":"ref2","doi-asserted-by":"publisher","first-page":"812","DOI":"10.15585\/mmwr.mm6531a5","article-title":"Notes from the field: shigellosis outbreak among men who have sex with men and homeless persons \u2014 Oregon, 2015\u20132016","volume":"65","author":"Hines","year":"2016","journal-title":"MMWR Morb Mortal Wkly Rep"},{"key":"ref3","doi-asserted-by":"publisher","first-page":"81","DOI":"10.1007\/s40475-014-0019-6","article-title":"Shigella: a highly virulent and elusive pathogen","volume":"1","author":"Zaidi","year":"2014","journal-title":"Curr Trop Med Rep"},{"key":"ref4","volume-title":"Shigella prevention and control toolkit\u2014March 2021","year":"2020"},{"key":"ref5","doi-asserted-by":"publisher","first-page":"692","DOI":"10.1093\/infdis\/jiae235","article-title":"Extended-Spectrum \u03b2-lactamase Shigella sonnei cluster among men who have sex with men in Chicago, Illinois, July\u2013October 2022","volume":"231","author":"Faherty","year":"2025","journal-title":"J Infect Dis"},{"key":"ref6","doi-asserted-by":"publisher","first-page":"1906","DOI":"10.1093\/cid\/ciab771","article-title":"Enteric illness outbreaks reported through the National Outbreak Reporting System - 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