Published: 09.02.05 Updated: 09.02.2005 18:12:10
Shigellosis is a notifiable disease in the entire region. Estonia, Denmark, Finland, Norway, Iceland and Sweden report only laboratory confirmed cases. Northwest Russia and Lithuania report both laboratory confirmed cases and cases with typical clinical picture without laboratory confirmation. In Northwest Russia, cases epidemiologically linked to a laboratory confirmed case are also reported.
Figure 20. Number of cases of shigellosis notified in 2003 per 100 000 population (1).
The Nordic countries have for many years had low and stable incidence rates of shigellosis with very few domestically acquired cases. In Northwest Russia, and to some degree in the Baltic countries, shigellosis is endemic and has long been a major public health problem. This is partly caused by unsatisfactory hygienic and sanitary conditions. Nosocomial trans-mission and outbreaks may occur. Outbreaks in childcare centres still occur in Northwest Russia and in the Baltic countries.
Incidence rates in the eastern part of the region may fluctuate depending on local outbreaks, but in general, incidence rates have for the past few years decreased in the eastern part of the region (figure 21).
Figure 21. Number of cases of shigellosis notified per 100 000 population 1999- 2003 by groups of countries or regions (1). Komi, Pskov, Novgorod and Vologda regions not included.
Shigellosis is mainly prevented by improving drinking water and sanitation services. In the eastern part of the region these preventive measures are important to prevent spread of the disease. Likewise, increased awareness of nosocomial infection control is an essential part of the preventive measures, and such projects are ongoing in the eastern part of the region. In the western part of the region, the main prevention strategy is to educate travellers to countries with higher incidence of shigellosis on how to reduce the risk of acquiring the disease. Food handlers in the entire region are educated in food hygiene.