Outbreak of Central American born Shigella sonnei in two youth camps in Belgium in the summer of 2019

An Van Den Bossche,Pieter-Jan Ceyssens,Maaike Van Den Beld,Naïma Hammami,Timothy J Dallman,Sarah Denayer,Wesley Mattheus

doi:10.1007/s10096-021-04164-y

Abstract

In 2019, an outbreak of Shigella sonnei occurred during two youth camps in Belgium. The clustering of isolates from both camps was confirmed by next-generation sequencing, as well as a secondary infection of a technician. The outbreak strain clustered with internationally isolated strains from patients with recent travel history to Central America. This report exemplifies enhanced surveillance and international collaboration between public health institutes by enabling to link local outbreaks to region-specific sublineages circulating abroad.

Highlights

Onset and epidemiology of the outbreakIn Belgium, around 400 human Shigellosis cases are confirmed by the National Reference Centre (NRC) for Salmonella and Shigella each year
Each isolate is represented by the year of isolation, the country of isolation and the known recent travel history. This local outbreak of S. sonnei highlights the power of NGS for outbreak investigations
Genome analyses enabled internal investigation of the outbreak and were able to cluster the strains of the first camp and link them to the strain isolated in the second camp and to a secondary infection

Summary

Introduction

In Belgium, around 400 human Shigellosis cases are confirmed by the National Reference Centre (NRC) for Salmonella and Shigella each year. Since members of camp 1 visited camp 2 and no Shigella could be isolated from food or water samples, it is likely that the infection was transmitted between camp participants by human-to-human contacts Both camps were completely self-sustainable tent camps, including self-build toilets and showers. No SNP differences were detected (maximum likelihood substitution model, JukesCantor 2.0) between all 7 isolates of cases of camp 1, the single isolate of camp 2 or the isolate from the laboratory technician This close clustering confirmed the presence of a single outbreak in camp 1, that camp 2 was infected with the same outbreak strain and indicates that the laboratory technician was infected during manipulation of the outbreak samples. 2017 ENGLAND Mexico 2009 ENGLAND 2012 ENGLAND Mexico 2012 ENGLAND 2011 ENGLAND Mexico 2013 ENGLAND Mexico 2015 ENGLAND Mexico 2015 ENGLAND Mexico 2016 ENGLAND 2015 ENGLAND Mexico 2015 ENGLAND Mexico 2016 ENGLAND Mexico 2016 NETHERLANDS Mexico 2016 ENGLAND 2016 ENGLAND Mexico 2016 ENGLAND 2015 ENGLAND Mexico 2017 ENGLAND Mexico 2015 ENGLAND Brazil 2015 ENGLAND 2015 ENGLAND 2017 ENGLAND Mexico 2016 NETHERLANDS Mexico 2016 ENGLAND 2016 ENGLAND Mexico 2018 ENGLAND 2019 ENGLAND 2019 ENGLAND 2018 ENGLAND Colombia 2018 ENGLAND 2018 ENGLAND 2015 ENGLAND 2018 ENGLAND 2015 ENGLAND Mexico 2017 ENGLAND 2016 ENGLAND United states 2016 ENGLAND 2015 ENGLAND Mexico 2016 ENGLAND 2015 ENGLAND 2015 ENGLAND Mexico 2016 ENGLAND Mexico 2016 NETHERLANDS Mexico 2017 ENGLAND 2016 ENGLAND Mexico 2016 ENGLAND Mexico 2019 ENGLAND 2016 ENGLAND 2018 ENGLAND Mexico 2018 ENGLAND 2018 ENGLAND European continent 2018 ENGLAND Mexico 2015 ENGLAND Mexico 2017 NETHERLANDS 2017 NETHERLANDS Curacao 2018 ENGLAND 2018 ENGLAND 2017 ENGLAND 2016 ENGLAND 2016 ENGLAND 2016 ENGLAND 2015 ENGLAND Mexico 2019 ENGLAND Mexico 2017 ENGLAND Mexico 2018 ENGLAND 2017 ENGLAND Costa rica 2019 ENGLAND 2019 ENGLAND 2019 ENGLAND Mexico 2020 ENGLAND Mexico 2019 ENGLAND Mexico 2019 ENGLAND 2017 ENGLAND Mexico 2017 ENGLAND 2017 ENGLAND 2017 ENGLAND 2017 ENGLAND 2017 ENGLAND 2017 ENGLAND 2017 NETHERLANDS Mexico 2017 ENGLAND 2019 ENGLAND 2019 BELGIUM (Youth Camp) 2019 BELGIUM (Youth Camp) 2019 BELGIUM (Youth Camp) 2019 BELGIUM (Youth Camp) 2019 BELGIUM (Youth Camp) 2019 BELGIUM (Youth Camp) 2019 BELGIUM (Youth Camp) 2019 BELGIUM (Youth Camp) 2019 BELGIUM (Youth Camp)

Conclusions

Findings

Compliance with ethical standards