In countries where Shigella infection is endemic, only improvement in standards of hygiene and provision of clean water supplies will alleviate the problem. It is possible that climate change leading to reduction in water supplies will exacerbate problems and that areas of endemic infection will increase. This is likely to be a general pattern involving other enteric pathogens, such as Vibrio spp., as well as Shigella. There are implications for areas outside those that may be directly affected by climate change. These include a higher incidence of imported shigellosis amongst returning travellers and contacts. There may also be a general food-associated increase, if hygiene standards fall in countries supplying salad crops and fruit.
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