Publications, Data, & Statistics

CDC currently has six surveillance systems for obtaining information about Shigella. They serve different purposes and provide information on various features of the organism's epidemiology, such as number of outbreaks, antimicrobial-resistant infections, or subtypes.

• Laboratory-based Enteric Disease Surveillance (LEDS)

  The Laboratory-based Enteric Disease Surveillance (LEDS) system contributes to the understanding of enteric disease by conducting basic laboratory-based surveillance for four enteric pathogens, Salmonella, Shigella, Shiga toxin-producing Escherichia coli (STEC), and Campylobacter, using reports of confirmed human infections from state and territorial public health laboratories.

  Annual summaries of the LEDS Shigella surveillance data:

  • 2013 Annual Report [PDF - 9 pages], 2013 Appendix [PDF - 9 pages]
  • 2012 Annual Report [PDF – 9 pages], 2012 Appendix [PDF – 8 pages]
  • 2011 Annual Report [PDF – 9 pages], 2011 Appendix [PDF – 8 pages]
  • 2010 Annual Report [PDF – 10 pages], 2010 Appendix [PDF – 8 pages]
  • 2009 Annual Summary [PDF – 3 pages], 2009 Annual Summary Tables[PDF – 23 pages]
  • 2008 Annual Summary [PDF – 3 pages], 2008 Annual Summary Tables [PDF – 21 pages]
  • 2007 Annual Summary [PDF – 3 pages], 2007 Annual Summary Tables [PDF – 21 pages]

• National Electronic Telecommunications System for Surveillance (NETSS)

  NETSS is a passive, physician-based surveillance system that captures both laboratory-confirmed and clinically suspected cases of all nationally notifiable diseases, including Shigella. The number of illnesses reported through NETSS tends to be higher than the number reported through PHLIS because NETSS does not require confirmation by the state public health laboratory.

  Shigella infections and other surveillance data collected by NETSS is published weekly in the CDC Morbidity and Mortality Report (MMWR)

  The MMWR also publishes an annual summary of the NETSS Shigella surveillance data.

• FoodNet

  The Foodborne Diseases Active Surveillance Network (FoodNet) is an active surveillance system for identifying and characterizing culture-confirmed infections that may be foodborne, including Shigella. FoodNet workers regularly contact more than 300 laboratories for confirmed cases of foodborne infections in 10 states encompassing a population of more than 44 million persons. In addition to monitoring the number of Shigella infections, investigators monitor laboratory techniques for isolation of bacteria, perform studies of ill persons to determine exposures associated with illness, and administer questionnaires to people living in FoodNet sites to better understand trends in the eating habits of Americans.

  Annual FoodNet reports that include data about Shigella.

• National Molecular Subtyping Network for Foodborne Diseases Surveillance (PulseNet)

  PulseNet is a national network of public health laboratories that perform pulsed-field gel electrophoresis (PFGE), a type of DNA "fingerprinting", on certain foodborne bacteria, including Shigella. PFGE "fingerprint" patterns are submitted electronically to CDC and can be compared rapidly with others in a large database. This system can help determine if individual infections are related or if an outbreak is occurring.

• National Antimicrobial Resistance Monitoring System (NARMS)

  NARMS is a passive surveillance system that monitors antimicrobial resistance of Shigella and selected other bacteria that cause human illness. NARMS is a collaboration among CDC, all state and local health departments, the Food and Drug Administration (FDA), and the United States Agricultural Department (USDA).

  Annual NARMS reports that include data about Shigella.

• Foodborne Outbreak Response and Survellance Team

  CDC monitors outbreaks of foodborne disease, including outbreaks caused by Shigella. Each year, state and territorial epidemiologists voluntarily report the results of outbreak investigations to CDC. While outbreaks account for a small percentage of the total number of illnesses that occur each year, these investigations provide valuable information about sources of foodborne infection and often highlight important prevention opportunities.

  Latest summaries of foodborne outbreaks.

• Bowen A, Eikmeier D, Talley P, Siston A, Smith S, Hurd J, Smith K, Leano F, Bicknese A, Norton C, Campbell D. Notes from the Field: Outbreaks of Shigella sonnei infection with decreased susceptibility to azithromycin among men who have sex with men — Chicago and Metropolitan Minneapolis-St. Paul, 2014. MMWR Morb Mortal Wkly Rep. 2015;64(21):597-8.
• Bowen A, Hurd J, Hoover C, Khachadourian Y, Traphagen E, Harvey E, Libby T, Ehlers S, Ongpin M, Norton C, Bicknese A, Kimura A. Importation and Domestic Transmission of Shigella sonnei resistant to ciprofloxacin — United States, May 2014–February 2015. MMWR Morb Mortal Wkly Rep. 2015;64(12):318-20.
• Outbreak of Gastroenteritis Associated with an Interactive Water Fountain at a Beachside Park - Florida, 1999. MMWR June 30, 2000 / 49(25);565-8
• Outbreaks of multidrug-resistant Shigella sonnei gastroenteritis associated with day care centers---Kansas, Kentucky, and Missouri, 2005. MMWR 2006 / 55:1068--71
• Outbreaks of Shigella sonnei infection associated with eating fresh parsley - United States and Canada, July - August 1998. MMWR April 16, 1999 / 48(14);285-9
• Shigella flexneri Serotype 3 Infections Among Men Who Have Sex with Men --- Chicago, Illinois, 2003—2004. MMWR August 26, 2005 / 54 (33): 820 – 22

• CDC Safe Water System
• FoodNet
• Laboratory Methods for the Diagnosis of Epidemic Dysentery and Cholera
• PHLIS Data

• Gupta A, Polyak CS, Bishop RD, Sobel J, Mintz ED. Laboratory-confirmed shigellosis in the United States, 1989--2002: epidemiologic trends and patterns. Clin Infect Dis 2004;38:1372--7.
• Jain SK, Gupta A, Glanz B, Dick J, Siberry GK. Antimicrobial-resistant Shigella sonnei: limited antimicrobial treatment options for children and challenges of interpreting in vitro azithromycin susceptibility. Pediatr Infect Dis J. 2005;24:494–7.
• Shane A, Crump J, Tucker N, Painter J, Mintz E. Sharing Shigella: risk factors and costs of a multi-community outbreak of shigellosis. Archives Pediatrics and Adolescent Med 2003; 157 601-603.
• Sobel J, Cameron DN, Ismail J, et al. A prolonged outbreak of Shigella sonnei infections in traditionally observant Jewish communities in North America caused by a molecularly distinct bacterial subtype. J Infect Dis 1998; 177: 1405-1408.
• Sivapalasingam S, Nelson JM, Joyce K, Hoekstra M, Angulo FJ, Mintz ED. A high prevalence of antimicrobial resistance among Shigella isolates in the United States, 1999--2002. Antimicrob Agents Chemother 2006;50:49--54.