Interruption of shigellosis by hand washing

High attack rates, increasing resistance to antibiotics and high mortality make shigellosis a serious problem. As Shigella is associated with poor hygiene we examined the effectiveness of a simple intervention, washing hands with soap and water, in checking the spread of the disease. The study population was comprised of confirmed cases of shigellosis. These and matched controls were followed up for 10 days. Several pieces of soap and earthenware pitchers for storing water were provided to the study families and they were advised to wash their hands with soap and water after defaecation and before meals. Compliance was monitored daily by observing the size of the soap and residual water. Rectal swabs of contacts of both the groups were obtained for culture. The secondary infection rate was 10.1% in the study group and 32.4% in the control group. The secondary case (symptomatic) rate was 2.2% in the study group and 14.2% in the control group. These results suggest that hand-washing has a positive interrupting effect, even in unsanitary environments.