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Shigella & Northwest Airlines - Arkansas DOH

September 9, 2004

The Hawaii State Department of Health is asking for assistance in identifying S. sonnei infections that may be linked to an in-flight exposure . As of Friday, 9/3/04 the HDOH has identified 17 confirmed shigella infections that may be linked to airline travel. Thus far the cases come from 3 clusters: Cluster 1 . Japan : 12 confirmed infections from 9 different prefectures; onset 1-2 days after flying from Hawaii to Japan on flights detailed below: Originating on 8/23 NW # 9 Hnl-Japan - 2 confirmed S. sonnei NW # 15 Hnl-Japan - 5 confirmed S. sonnei NW # 21 Hnl- Japan - 4 confirmed S. sonnei Originating on 8/24 NW #15 Hnl to Japan - 1 case confirmed S sonnei. No common exposure other than the Northwest flights has been identified. PFGE pending. Cluster 2. Ohio resident: 1 confirmed Shigella (sp. ?) and 2 companions with illness; flight originated on 8/22 NW # 920 Honolulu to Minneapolis , MN Cluster 3 . Minnesota : anecdotal data: 4 S. sonnei infections with indistinguishable PFGE pattern - at least one of which traveled on a NW flight from Honolulu . Given the potential exposure involved it is possible that cases could be occurring in other areas of the U.S. Please notify the AR Department of Health if any of your patients meet any of the above criteria.

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