志贺氏杆菌在英国的发病率约为每 1000 人中 0.27 例。[4]Murphy MS. Management of bloody diarrhoea in children in primary care. BMJ. 2008;336:1010-1015.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2364807/http://www.ncbi.nlm.nih.gov/pubmed/18456632?tool=bestpractice.com抗生素耐药导致了更长期和广泛的暴发。在美国和世界各地,很难获得细菌性痢疾年发病率的准确数字。尽管志贺氏杆菌感染是腹泻性疾病的常见原因,但它并不容易被隔离,而且轻症患者往往不去就医,因而被遗漏。[1]Kotloff KL, Winickoff JP, Ivanoff B, et al. Global burden of Shigella infections: implications for vaccine development and implementation of control strategies. Bull World Health Organ. 1999;77:651-666.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2557719/pdf/10516787.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10516787?tool=bestpractice.com据一项回顾性分析估计,志贺氏杆菌感染的全球年发患者数为 16470 万,其中 150 万发生在工业化国家。[1]Kotloff KL, Winickoff JP, Ivanoff B, et al. Global burden of Shigella infections: implications for vaccine development and implementation of control strategies. Bull World Health Organ. 1999;77:651-666.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2557719/pdf/10516787.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10516787?tool=bestpractice.com其中大约 110 万病例造成死亡,且 62% 的死亡者为不足 5 岁的儿童。估计 69% 的所有报告病例是不足 5 岁的儿童。
在美国,志贺氏杆菌的监测数据由公共卫生实验室信息系统 (public health laboratory information system, PHLIS) 进行不间断地收集。[3]Centers for Disease Control and Prevention (CDC). National Shigella surveillance. http://www.cdc.gov/ (last accessed 22 April 2016).http://www.cdc.gov/nationalsurveillance/shigella-surveillance.html在过去 14 年里,估计美国志贺氏杆菌感染率已下降了 57%,为每 100,000 人 3.8 例。[5]Centers for Disease Control and Prevention (CDC). Vital signs: incidence and trends of infection with pathogens transmitted commonly through food: foodborne diseases active surveillance network, 10 U.S. sites, 1996-2010. MMWR Morb Mortal Wkly Rep. 2011;60:749-755.http://www.cdc.gov/mmwr/preview/mmwrhtml/mm6022a5.htmhttp://www.ncbi.nlm.nih.gov/pubmed/21659984?tool=bestpractice.com宋内氏志贺氏菌感染病例占 74%,其次是福氏志贺氏菌,为 13.6%,鲍氏志贺氏菌为 1.2%,志贺氏痢疾杆菌为 0.5%。报告的大多数病例为 1-9 岁的儿童。美国的整体死亡率非常低(估计为 0.4%)。[1]Kotloff KL, Winickoff JP, Ivanoff B, et al. Global burden of Shigella infections: implications for vaccine development and implementation of control strategies. Bull World Health Organ. 1999;77:651-666.http://www.ncbi.nlm.nih.gov/pmc/articles/PMC2557719/pdf/10516787.pdfhttp://www.ncbi.nlm.nih.gov/pubmed/10516787?tool=bestpractice.com