Header graphic for print

Shigella Blog

Surveillance & Analysis on Shigella News & Outbreaks

Flint has Shigella Issues Too

Food Safety News reports that along with the highly publicized lead contamination of its water supply, Flint, MI, also bears the dubious distinction of having the highest number of Shigella cases in the state.

The Genesee County Health Department has reported 85 cases so far this year, with more than half of them within the Flint city limits. Twenty-seven people have been hospitalized. A higher-than-normal number of shigellosis cases is also being reported in Saginaw County, which borders Flint.

Flintwaterplant_406x250In a statement issued Wednesday, the Michigan Department of Health and Human Services noted that the 85 Genesee County cases compares with 20 shigellosis cases reported there in 2015 and four cases in 2014.

Shigellosis is a highly contagious disease caused by four different strains of Shigella bacteria. Even a microscopic amount of contaminated fecal matter in food or water can cause infection if consumed.

Most people infected with the bacteria develop diarrhea, fever and stomach cramps within a day or two after being exposed. The symptoms usually resolve within five to seven days.

Some people who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others. The spread of Shigella can be stopped by frequent and careful hand-washing with soap and by taking other hygiene measures.

Flint’s water contamination problems began in April 2014 when the city switched its source from treated Lake Huron and Detroit River water to the Flint River. Because officials did not add corrosion inhibitors to the highly corrosive river water, it caused lead from aging pipes to leach into the city’s water supply.

Between June 2014 and November 2015, there were 87 cases of infection with Legionella bacteria reported in Genesee County. Ten of those people died. However, no direct link was made between the spike in Legionnaires’ disease and the change in the water system.

Some public health officials are speculating that the current shigellosis problem stems from Flint residents being afraid to use the tainted city water to wash their hands, even though hand-washing is a recommended method for limiting foodborne and other illnesses.

According to Jim Henry, environmental health supervisor for Genesee County, “People aren’t bathing because they’re scared. Some people have mentioned that they’re not going to expose their children to the water again.”

In an interview with CNN, Henry advised county residents not to rely on baby wipes, handed out for free at bottled water distribution centers, because they aren’t chlorinated, don’t kill the bacteria, and can’t replace thorough hand-washing.

However, others find no connection between the water problems and the uptick in shigellosis cases.

“We don’t know the exact reason,” said Dr. Gary Johnson, medical director at the Genesee County Health Department, in a Facebook post. “There isn’t a particular reason why.”

New Mexico Warns of Shigella Cases

The New Mexico Department of Health is investigating an increase in cases of Shigella sonneithat has mostly been affecting Lea and Eddy counties.  Among the 36 people who have been identified, the large majority were children associated with child care centers and their family members.

Shigellosis is a bacterial disease characterized by diarrhea, fever, nausea, and sometimes vomiting, cramps, and toxemia (blood poisoning from toxins produced by the bacteria). The diarrhea will often contain blood and mucus. The time between infection and the onset of symptoms varies from 1 to 7 days, but is typically 1-3 days. Possible complications from Shigella infections include post-infectious arthritis, blood stream infections (although rare), seizures, and hemolytic-uremic syndrome or HUS.

Shigella is very contagious. An infected person can shed the bacteria in their stool when they have diarrhea and up to a month after the diarrhea has gone away. If an infected person doesn’t wash their hands thoroughly after using the restroom, they can then spread the bacteria to other surfaces they touch. For example:

Infected persons can spread Shigella by not washing their hands after going to the bathroom and then handling food that other people will eat.
Caretakers can become infected by changing the diaper of an infected child or caring for an infected person. The caretaker’s hands may get some small amount of stool and bacteria on their hands, and without proper hand hygiene, spread the bacteria to everything they touch afterwards (including their mouths).
Swallowing recreational water (for example a lake, splash pad, and/or pool) that was contaminated by infected fecal matter.
Exposure to feces through sexual contact.
“If your child is sick, please do not take him/her to daycare.  This will only spread this illness to other children and their families,” advises Secretary of Health Lynn Gallagher. “If you think that your child may have Shigella, please take your child to their healthcare provider to be tested.”

You can decrease your chance of coming into contact with Shigella by doing the following:

Washing your hands frequently, especially after using the bathroom, changing a diaper, or before preparing and/or eating food.
Promptly cleaning possible contaminated surfaces with household chlorine bleach-based cleaners.
Washing soiled clothing and linens.
Avoiding food or water from sources that may be contaminated.
Do not send children to school or daycare if they have persistent diarrhea.

Shigella Strikes Wisconsin

102557636-Shigella.1910x1000The Shawano-Menominee County Health Department said a recent outbreak of the Shigella bacteria has made schools and day care facilities take extra precautions when it comes to spreading germs. County Public Health Nurse Kris Labby said some children in Shawano have been diagnosed and the warnings have been sent out.

“This has been in connection with area day cares and Hillcrest Summer School” said Labby. “Notification has been sent to those who need to know.”

Now the public is being warned about preventing the spread. Shigella causes diarrhea, and a fever, and in some cases, dehydration is a concern.

“Shigella is very contagious from one person to another so it is important if a child has these symptoms that they stay home to prevent the spread.”

Labby said those who have been diagnosed are being treated, but parents are being reminded to have their kids and everyone in their family practice good hand washing consistently, and take the precautions needed.

Iowa Shigella Outbreak

The Dubuque County Health Department, the Dubuque County Board of Health, and the Iowa Department of Public Health (IDPH) are investigating an outbreak of Shigellosis cases. Shigellosis is a disease caused by the bacterium, Shigella, which causes watery and sometimes bloody diarrhea. Symptoms of Shigellosis usually begin one to three days after infection and include diarrhea, fever, nausea, vomiting, and abdominal cramps.Shigella is spread:

Person-to-Person. Any infected person can infect others by failing to properly wash their hands before

handling food or coming into close contact with another person. Infections in households, pre-schools, child care facilities, and elderly and developmentally disabled living facilities are commonly spread in this manner.

Shigellosis is an extremely contagious disease. Because of this, measures should be taken to prevent its spread. These measures include:

Thoroughly wash hands with soap and running warm water for no less than 15 seconds. This should be done after using the toilet, changing diapers, or before eating or preparing any food.

Infants and children should have their hands washed as above after a diaper change, after using the toilet, or before eating.

Infected people should stay away from school, child care, food preparation or work while they have diarrhea. Food handlers, health care workers, and those working in child care who have shigellosis should have two consecutive negative stool cultures before returning to work or child care. Children who have had shigellosis and are returning to child care should have one negative stool culture.

Contact the Dubuque County Infection Control Specialists at the VNA (563-556-6200) or IDPH 515-242- 5935) for questions about clearing persons for work or child care.

Shigellosis typically goes away without treatment after four to seven days; however, if the infection is severe or the infected person has a poor immune system, antibiotic treatment may be needed. In some cases, the diarrhea associated with shigellosis can be dangerously dehydrating, especially in the very young and very old. In that event, see a doctor immediately. If you have symptoms of shigellosis, or have had contact with someone diagnosed with the infection, you should contact your health care provider.

152 with Shigella in Illinois

The Winnebago County Health Department is reporting additional cases of Shigellosis in our community, bringing the new total to 152, since October 2015. The majority of these cases are isolated and have impacted in children in daycare and elementary schools.

Todd Kisner with the Department’s Center for Health Protection says the best way to prevent the disease, which can cause diarrhea and vomiting, is to enforce routine handwashing, particularly among children.

“When it comes to children, supervision of handwashing may be more appropriate now because not all kids are perfect handwashers yet,” he says.

While an increase in cases is likely over the next few weeks, Kisner says it’s due to doctors performing more routine testing. However, he addds that Kisner says with effective hygiene practices, lingering shigella bacteria won’t live long enough to spread further.

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.