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Surveillance & Analysis on Shigella News & Outbreaks

Mariscos San Juan #3 Restaurant Shigella Outbreak Update

As of Monday, October 26, 2015, the number of outbreak-associated cases of Shigella reported to Santa Clara County Public Health Department (SCCPHD) now stands at 188; 150 of these cases are Santa Clara County residents and 38 reported cases are people who live in other counties. Of the 188 total cases, 85 are lab confirmed; 65 of which are Santa Clara County residents. There are 20 confirmed cases from other jurisdictions, including the counties of San Mateo, Alameda, Santa Cruz, Marin and Merced. Nearly all of the cases have reported that they ate at Mariscos San Juan #3 restaurant on Friday October 16th or Saturday October 17th.

More Shigella in California

Shigella, an intestinal diarrheal disease, has been confirmed in 72 of 182 ill people linked with Mariscos San Juan #3 restaurant at 205 N. Fourth St., public health officials said.

Two San Jose men and one woman who ate at the restaurant and caught shigella filed separate lawsuits last week alleging negligence against the restaurant owners. The suits were filed through Rains Lucia Stern in California and Marler Clark, a Seattle-based firm specializing in food-borne illness litigation.

The total breaks down to 144 cases in Santa Clara County and 38 across the other four counties, public health officials said.

Of the 72 people with a confirmed infection, 55 are in Santa Clara County while the remaining 17 are in Santa Cruz, Alameda, Marin and Merced counties, according to public health officials.

Eight adults and a child in Alameda County have been confirmed with the infection, Alameda County public health spokeswoman Sherri Willis said.

In Santa Cruz County, three people have been found with shigella, one being through a secondary source, and two others are suspected to have the illness.

San Mateo County Health System officials have reported three confirmed cases of shigella.

The restaurant was closed on Oct. 18 after a majority of the sick people ate there one or two days earlier. Inspectors from the Santa Clara County Department of Environmental Health continue to investigate the outbreak.

Shigella Outbreak Spreads to Multiple Counties

As of October 22, 2015 the number of outbreak-associated cases of Shigella reported to Santa Clara County Public Health Department (SCCPHD) has risen to 141; 118 of these cases are Santa Clara County residents and 23 reported cases are people who live in other counties. Of the 141 total cases, 49 are lab confirmed; 35 of which are Santa Clara County residents. There are 14 confirmed cases from other jurisdictions, including San Mateo County, Alameda County and Santa Cruz County. Almost all of the cases ate at Mariscos San Juan #3 restaurant on Friday or Saturday (October 16th or 17th). Many of the ill ate at Mariscos San Juan restaurant #3, a Mexican seafood eatery at 205 N. Fourth St. last Friday or Saturday, Santa Clara County public health officials said.

Shigella Strikes San Jose

fcbc365f919b0fafa1e1100c89bf53a7According to a Public Health Warning, on Saturday afternoon, October 17, 2015, the Santa Clara County Public Health Department was notified by a local hospital of 5 patients with fever and diarrhea who had all eaten at the same restaurant. Subsequent case finding has revealed a total of over two dozen individuals with fever and diarrhea who ate at Mariscos San Juan restaurant (205 N. 4 Street) in downtown San Jose on Friday October 16 or Saturday October 17. The restaurant was closed on Sunday morning and remains closed.

Of the ill persons, over a dozen have tested positive for Shigella by PCR, and one has a blood culture growing Shigella sonnei; almost all of the reported cases have required hospital admission, and 11 are in intensive care. There are other individuals who were seen and not admitted or who were ill but did not seek medical attention.

Shigella infection can be subclinical, but typically causes watery or bloody diarrhea with abdominal pain, fever, tenesmus, and malaise. Shigella is very infectious with just 10 -100 organisms are sufficient to cause disease. Transmission occurs via the fecal – oral route and can be spread by eating food prepared by an infected food handler or by direct person – to – person contact. Sexual transmission may also occur. Young children, the elderly, and HIV – infected individuals with CD4 count < 200 are more likely to have severe symptoms including dehydration, bacteremia, and seizures.

Shigella Outbreak in Kansas City

102557636-Shigella.1910x1000The Kansas City Health Department put out new numbers on Friday, explaining that the city normally sees 10 cases of Shigella a year. So far in 2015, there have already been 150 reported cases. From January 1 to July 1 this year, there were 16 reported cases. In the past two months, 134 additional cases. That total, 150, is 15-times the annual average.

Shigella is an infectious bacterial illness that causes high-spiking fever, upward of 104 to 105 degrees Fahrenheit. Doctors say Shigella can also cause seizures. Though adults are also susceptible, the majority of the patients are children. Many cases have been reported in daycares and elementary schools.

Doctors say symptoms include diarrhea, abdominal cramping, nausea, vomiting, and fever. They say antibiotic treatment will help, though it requires culture testing to determine which kind of medicine is needed.

Shigella Strikes Cincinnati

Shigella that causes diarrhea in children is on the rise in Cincinnati, Ohio, prompting a warning from city health officials.

Shigella is spread through contaminated food and water; people can also spread it if they don’t wash their hands after handling a diaper or using the bathroom.

There were 20 cases reported in July and August, compared to just one over the same period last year. Northern Kentucky is also seeing an uptick.

Although diarrhea is the most common symptom, Shigella can also cause vomiting, fever, nausea and bloody stool. Symptoms of Shigellosis, the infection caused by the Shigella bacteria, usually go away in five to seven days.


Shigella Spike in San Joaquin

The San Joaquin County Public Health Services has seen an increase in the number of cases of Shigella in the county this year. So far, 66 people have come down with the bacteria-caused disease. Historically, the county only sees about 10 case of the disease per year.

Shigellosis is a highly infectious disease that causes stomach cramping, mild or severe diarrhea and fever. Symptoms often occur within a week after exposure, but usually within three days and usually lasts four to seven days.

The disease is the result of a bacteria that passes from improperly washed hands of one person to the mouth of another person, often through handling contaminated objects or food. The disease is especially easily passed among childcare professionals and food preparers.

Shigella Outbreak Hits 243 in 32 States

shigella-spp-300pxShigella sonnei has spread via international travelers to 32 states and Puerto Rico, US health officials say.

Between May 2014 and February 2015, a drug-resistant strain of shigella has infected 243 people across the US, according to the US Centers for Disease Control and Prevention (CDC). The CDC’s findings were first published in the agency’s Morbidity and Mortality Weekly Report.

The CDC found that 90 percent of cases of the shigellosis infection analyzed in Massachusetts, California, and Pennsylvania were resistant to ciprofloxacin (Cipro), the top shigellosis antibiotic in the US.

The agency found that the potent, Cipro-resistant strain was “repeatedly introduced as ill travelers returned and was then infecting other people in a series of outbreaks around the country.” Many shigella strains in the US were already considered too advanced for other drugs, including ampicillin and trimethoprim/sulfamethoxazole.

The CDC added that shigellosis spreads quickly among nursing homes, “childcare facilities, homeless people and gay and bisexual men, as occurred in these outbreaks.”

“These outbreaks show a troubling trend in Shigella infections in the United States,” said CDC Director Tom Frieden in a public statement.

The CDC was first alerted to the new breed of shigella – which causes diarrhea in those infected – in December. Further investigation found that the strain was resistant to Cipro. The agency found that international travelers were largely responsible for the strain’s introduction, while other cases, including around 100 infections among the homeless population in San Francisco, were contracted by other means.

Indiana Sees More Than 1,000 Shigella Cases in 2014

In 2013, the state of Indiana reported approximately 100 cases of the gastrointestinal bacterial infection, shigellosis. This year, state health officials say that number is more than 1,000.

Every year, about 14,000 cases of shigellosis are reported in the United States, according to the Centers for Disease Control and Prevention (CDC).

“Shigellosis has a cyclical trend, so we would expect to see an overall increase in cases some years,” said State Health Commissioner Jerome Adams, M.D., M.P.H. “This year, we have seen a strong association with younger children, which has helped drive the outbreak and significantly increased the number of cases.”

According to the Indiana State Department of Health, shigellosis is spread from person-to-person through the fecal-oral route. The bacteria can be transferred easily among children because of their poor hand washing habits and tendency to put things in their mouths. People can also become infected by consuming food or drinks prepared by an infected person or handling or cleaning up feces.

Symptoms usually begin 24 to 72 hours after exposure and last about four to seven days without treatment; however, severe infections may require antibiotics.

Salsarita Shigella Outbreak Lawsuit – Arkansas (2014)

Salsarita’s Restaurant in the Walmart Home Office Café in Bentonville has reopened following a Shigella outbreak that made 275 sick in nine states according to the Benton County Health Department.  According to the Arkansas State Health Department dozens of employees were also ill with Shigellosis.

The Benton County Health Department conducted an inspection on June 18, shorty after people started getting sick.  Inspectors found nine violations on that inspection.  Of those nine violations, five were marked priority, meaning they were concerns that needed to be fixed fast.  Some violations included, employees not washing their hands or touching cooked food without wearing gloves.  The report said raw chicken had been dripping on bottled drinks.

On a follow-up inspection on June 23, inspectors found seven violations, some of them the same as the previous inspection.

After the outbreak, Eurest, the third-party company in charge of managing the kitchen, hired a quality assurance manager and will retrain staff on the company’s safety protocols.

Shigella:  Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Shigella outbreaks. The Shigella lawyers of Marler Clark have represented thousands of victims of Shigella and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Shigella lawyers have litigated Shigella cases stemming from outbreaks traced to a variety of sources, such as tomatoes, airplane and restaurant food.

If you or a family member became ill with a Shigella infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Shigella attorneys for a free case evaluation.