TY - JOUR AU - Lamba, Katherine AU - Nelson, Jennifer AU - Kimura, Akiko AU - Poe, Alyssa AU - Collins, Joan AU - Kao, Annie AU - Cruz, Laura AU - Inami, Gregory AU - Vaishampayan, Julie AU - Garza, Alvaro AU - Chaturvedi, Vishnu AU - Vugia, Duc T1 - Shiga Toxin 1–Producing Shigella sonnei Infections, California, United States, 2014–2015 T2 - Emerging Infectious Disease journal PY - 2016 VL - 22 IS - 4 SP - 679 SN - 1080-6059 AB - Shiga toxins (Stx) are primarily associated with Shiga toxin–producing Escherichia coli and Shigella dysenteriae serotype 1. Stx production by other shigellae is uncommon, but in 2014, Stx1-producing S. sonnei infections were detected in California. Surveillance was enhanced to test S. sonnei isolates for the presence and expression of stx genes, perform DNA subtyping, describe clinical and epidemiologic characteristics of case-patients, and investigate for sources of infection. During June 2014–April 2015, we identified 56 cases of Stx1-producing S. sonnei, in 2 clusters. All isolates encoded stx1 and produced active Stx1. Multiple pulsed-field gel electrophoresis patterns were identified. Bloody diarrhea was reported by 71% of case-patients; none had hemolytic uremic syndrome. Some initial cases were epidemiologically linked to travel to Mexico, but subsequent infections were transmitted domestically. Continued surveillance of Stx1-producing S. sonnei in California is necessary to characterize its features and plan for reduction of its spread in the United States. KW - Shigella, sonnei, dysenteriae, flexneri, Escherichia coli, Shiga toxin KW - shigellemia, STEC, Stx-1 shigellosis, bacteria, diarrhea, cytotoxins, enteric infections, gastrointestinal, travel, antimicrobial drugs, antibiotic re KW - Shigella KW - sonnei KW - dysenteriae KW - flexneri KW - Escherichia coli KW - Shiga toxin KW - shigellemia KW - STEC KW - Stx-1 shigellosis KW - bacteria KW - diarrhea KW - cytotoxins KW - enteric infections KW - gastrointestinal KW - travel KW - antimicrobial resistance KW - antibiotic resistance KW - San Joaquin County KW - County of San Diego KW - California KW - United States KW - Mexico KW - Food Safety DO - 10.3201/eid2204.151825 UR - https://wwwnc.cdc.gov/eid/article/22/4/15-1825_article ER - End of Reference