© 2005 by BMJ Publishing Group Ltd & European League Against Rheumatism
LEADER
Reactive arthritis
Shigella induced reactive arthritis
Correspondence to:
Correspondence to:
J S H Gaston
University of Cambridge, Box 157, Level 5, Addenbrooke’s Hospital, Cambridge CB2 2QQ; jshg2@medschl.cam.ac.uk
A long-haul travel syndrome?
Keywords: pathogenesis; reactive arthritis; Shigella; travel
| The first 150 words of the full text of this article appear below. |
Shigella infection is the least common of the gastroenteritis-inducing organisms which are associated with reactive arthritis (ReA) in developed countries, reflecting the scarcity of the organism in these environments. A recent thorough survey of Shigella infected subjects in Finland1 describes an annual incidence of Shigella induced ReA of only 1.3 per million. This compares with the incidence figures of 46 per million for ReA due to Chlamydia infection, and 50 per million for other enteric pathogens, noted in a survey of the Oslo population.2 However, the relevant denominator for Shigella induced ReA is not the population of Finland, but the population visiting distant travel destinations—for example Egypt, India, Thailand, Congo, and Turkey—all countries where the infection was acquired by the Finnish patients. Although these countries, particularly, Turkey, are increasingly common holiday destinations for sun-starved Northern Europeans, well under 5% of the population visit such countries in any 1
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