History

Medical writers have described dysentery or "the flux" since ancient times, but the bacterial form of the disease was not clearly distinguished until late in the nineteenth century. Dysentery ravaged Persian armies invading Greece in 480 B.C., and the disease has always been a companion of armies, often proving much more destructive than enemy action. This disease was, and remains, common among both rural and urban poor people around the world. An epidemic of what must have been shigellosis swept France in 1779, causing especially severe damage in some rural areas of the western part of the country. Troop movements for a planned invasion of England helped spread the disease. At least 175,000 people died, with some 45,000 deaths in Brittany alone. Children constituted the majority of the fatalities. During the U.S. Civil War, Union soldiers had annual morbidity rates of 876 per 1,000 from dysentery, and annual mortality rates of 10 per 1,000. Dysentery outbreaks were problems for all belligerents in World War I, especially in the Gallipoli and Mesopotamian campaigns.

Bacterial dysenteries took a heavy toll among infants and young children in Western countries until very recent times. During the late nineteenth and early twentieth centuries, the decline in breast feeding and the growing use of cows' milk in European and American cities exposed infants and toddlers to a variety of bacterial and other agents of dysentery and diarrhea. As milk is an excellent growth medium for Shigella and many other pathogens, contaminated milk and lack of refrigeration led to especially high death rates in hot weather. Milk-borne shigellosis was a significant contributor to the "summer complaint," which took thousands of young lives annually in cities like Paris and New York. Infant health movements, public health education, and pas teurization of milk largely eliminated the problem in western Europe and North America by about 1920. Shigellosis, however, still contributes to the "weanling diarrhea," which afflicts tens of millions of Third World children every year.

The Japanese bacteriologist Kiyoshi Shiga isolated S. dysenteriae in 1898, and confirmed its role as a pathogen by showing that the organism reacted with sera of convalescing patients. The other species were discovered early in the twentieth century, and much research has been directed to immunologic studies of various strains. The role of Campylobacter species as common human pathogens has been recognized only since the 1970s.

K. David Patterson

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