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Cited by 128Salmonella and Campylobacter epidemiologyEscherichia coli research studiesHIV/AIDS Research and Interventions

Case-control study of shigellosis in San Francisco: the role of sexual transmission and HIV infection.

Aragon, T. J., Vugia, D. J., Shallow, S., Samuel, M. C., Reingold, A., Angulo, F. J., Bradford, W. Z.·2007·Clinical Infectious Diseases
DOI 10.1086/510593
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Abstract

BACKGROUND: Shigella species infect approximately 450,000 persons annually in the United States. Person-to-person transmission of Shigella species, which have a low infectious dose, occurs frequently, particularly in areas with poor sanitation and hygiene. Sexual transmission of Shigella species among men who have sex with men (MSM) has been inferred from outbreaks of shigellosis among that population, and limited studies have suggested the importance of human immunodeficiency virus (HIV) infection as a risk factor for shigellosis. No population-based study of sporadic shigellosis has evaluated the role of sexual practices (especially among MSM) and HIV infection along with other established risk factors for shigellosis. METHODS: We conducted a population-based case-control study of shigellosis in adults in San Francisco, California, during the period 1998-1999. Cases of Shigella infection were identified through laboratory-based active surveillance conducted by the California Emerging Infections Program. Seventy-six case patients were matched by sex with 146 control subjects. Exposure data were collected on established risk factors, sexual practices, and HIV infection status. Bivariable and multivariable analyses were conducted. Population-attributable fractions were calculated. RESULTS: From the multivariable analysis, for men, shigellosis was associated with MSM (odds ratio [OR], 8.24; 95% confidence interval [CI], 2.70-25.2), HIV infection (OR, 8.17; 95% CI, 2.71-24.6), direct oral-anal contact (OR, 7.50; 95% CI, 1.74-32.3), and foreign travel (OR, 20.0; 95% CI, 5.26-76.3), with population-attributable fractions of 0.72, 0.42, 0.31, and 0.18, respectively. For women, shigellosis was associated only with foreign travel (OR, 21.0; 95% CI, 2.52-899), with a population-attributable fraction of 0.37. CONCLUSIONS: Among MSM, shigellosis is predominantly a sexually transmitted disease, with direct oral-anal contact conferring the highest risk and HIV infection likely contributing to increased host susceptibility.

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Crossref · 10.1086/510593

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  • The importance of sexual transmission of enteric pathogens among MSM has been recognized since the 1970s, after the first report of MSM-associated shigellosis was reported in San Francisco.

    “The importance of sexual transmission of enteric pathogens among MSM has been recognized since the 1970s, after the first report of MSM-associated shigellosis was reported in San Francisco (250,251).”

    From Sexually Transmitted Infections Treatment Guidelines, 2021 (2021) · cites this paper as [251]

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Authors
Aragon, T. J., Vugia, D. J., Shallow, S., Samuel, M. C., Reingold, A., Angulo, F. J., & Bradford, W. Z.
Affiliations
  • California Health and Human Services Agency (US)
  • University of California, Berkeley (US)
  • Centers for Disease Control and Prevention (US)
ORCID
Vugia, D. J.
Venue
Clinical Infectious Diseases
Publisher
Oxford University Press (OUP)
Published
2007-02-01
Volume
44
Issue
3
Pages
327-334
ISSN
  • 1058-4838 (ISSN-L)
  • 1537-6591
DOI
10.1086/510593
OpenAlex
W2152617566
Cited by
128
References
34
Citations by year
2026: 3 · 2025: 3 · 2024: 5 · 2023: 9 · 2022: 8 · 2021: 11 · 2020: 10 · 2019: 8 · 2018: 9 · 2017: 9 · 2016: 10 · 2015: 13 · 2014: 1 · 2013: 4 · 2012: 9
FWCI
7.05
Type
journal article
Language
en
Open access
closed
Locations
  • Clinical Infectious Diseases (publishedVersion)
  • PubMed (publishedVersion)
  • eScholarship (California Digital Library) (submittedVersion)
Funders
Centers for Disease Control and Prevention
Topics
  • Life Sciences › Agricultural and Biological Sciences › Food Science › Salmonella and Campylobacter epidemiology
  • Life Sciences › Biochemistry, Genetics and Molecular Biology › Endocrinology › Escherichia coli research studies
  • Health Sciences › Medicine › Infectious Diseases › HIV/AIDS Research and Interventions
Keywords
shigellosis, Shigella, sexual transmission, men who have sex with men, HIV infection, international travel, risk factors, San Francisco, population attributable fraction, sexually transmitted infections, host susceptibility, women, men, active surveillance, sanitation and hygiene, population-based case-control study
MeSH terms
Adult, Dysentery, Bacillary, Female, Humans, Male, Middle Aged, Population Surveillance, Risk Factors, San Francisco, Sexual Behavior, Sex Factors, Sexual Partners, Shigella, Travel, Sexually Transmitted Diseases, Bacterial, HIV Infections, Multivariate Analysis, Likelihood Functions, Logistic Models, Odds Ratio, Case-Control Studies, AIDS-Related Opportunistic Infections, Homosexuality, Male

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