The changing panorama of bacterial enteric infections

Abstract

SUMMARYWe studied the age-specific population-based incidence of bacterial enteric infections caused by Shigella, Salmonella and Campylobacter, in Jerusalem. During 1990–2008, 32 408 cases were reported (incidence rate 232·1/100 000 per annum). The patterns of Shigella (47·4% of cases), Salmonella (34·4%) and Campylobacter (18·2%) infections evolved noticeably. Campylobacter rates increased from 15·0 to 110·8/100 000 per annum. Salmonella rates increased from 74·2 to 199·6/100 000 in 1995 then decreased to 39·4/100 000. Shigella showed an endemic/epidemic pattern ranging between 19·7 and 252·8/100 000. Most patients (75%) were aged <15 years; children aged <5 years comprised 56·4% of cases, despite accounting for only 12·9% of the population. Campylobacter was the predominant organism in infants aged <1 year and Shigella in the 1–4 years group. The hospitalization rates were: Shigella, 1·8%; Campylobacter, 2·3%; Salmonella, 6·9%. Infants were 2·2 times more likely to be hospitalized than children aged 1–14 years (P=0·001). Household transmission occurred in 21·2% of Shigella cases compared with 5% in the other bacteria.