EGMN -- As my community battles another large Shigella outbreak, I wanted to point out a few aspects of the infection that are often overlooked. An estimated 450,000 cases of shigellosis occur every year in the United States, the majority among children who are not yet toilet trained. Here in the Kansas City area, we’ve had an ongoing Shigella sonnei outbreak since November 2009, with more than 250 cases diagnosed to date. In contrast, we typically would isolate Shigella from just 5-10 children in an entire year when there is no outbreak.