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Suspected Shigellosis in Toktowom under Chhuka Dzongkhag

Report on Investigation of Suspected Shigellosis in Toktowom, Chhuka

Background: Shigellosis remains one of the major bacterial infections affecting the health of people of Bhutan. Many cases of Shigellosis were reported every year but true cases are not known as there is no lab data available at healthcare centres in Bhutan. Shigellosis is one of the disease under surveillance and recent increased cases reported to Chukha BHU from one of the village (Toktowom) has prompted Public Health Laboratory Service (PHLS) to investigate and confirm the disease.

Methodology:Detailed clinical and environmental assessments were done to determine the causes of shigella infection amongst the population of the village. Fecal samples and blood samples were collected for microbiological investigation. Microscopic examination was done on the spot to determine whether the patient is suffering from parasitic bacterial infection and to treat them appropriately.

Result:All suspected patients had abdominal cramp and tenesmus. Some patients reported with fever and headache. Three patients were still ill at the time of investigation. 14.7% (4/27) samples were positive for Shigella flexneri 1a and all isolates were sensitive to nalidixic acid, co-trimoxazole, ampicillin, ciprofloxacin and azithromycin. Ascariasis was positive in 10 patients and tape worm in 2 samples. Poor sanitation and personal hygiene was found very poor in the village.

Conclusion: Laboratory confirmation substantiated the shigellosis cases reported by the BHU. Poor sanitation and personal hygiene were cause of spread of the infection amongst the population in the village.