Shigella Lawyer & Attorney : Marler Clark : Shigella Blog

Last month,  we reported on a Shigella outbreak in New York's Lower Hudson River Valley involving the Jewish Community.  It was centered on Westchester, Rockland, and Putnam counties, just outside New York City.

Now it appears that outbreak has spread to the Borough Park and Williamsburg communities in Brooklyn.  The New York City Health Department is working with Orthodox Jewish residents in those areas about an ongoing shigella outbreak.

Borough Park and Williamsburg so far this year have had more than 150 cases of shigella, and more than half the cases involve very young children. 

The Alert issued by the New York City Helath Department makes no specific connection to the outbreak in the counties across the Hudson River.  However it does say this:

Large outbreaks of shigella have occurred in recent decades in traditionally observant Jewish communities in Borough Park, Williamsburg and other parts of New York State, New Jersey, Illinois, Maryland and Canada. Some 274 cases of shigella were reported in New York City in 2006, a rate of 3.4 cases per 100,000 people.

 New York health officials have stepped up community outreach activities, working with rabbis and City Council members in the area .   The alert says:

"We encourage residents to be vigilant about hand-washing," said Dr.Sharon Balter, Medical Epidemiologist in the Health Department’s Bureau of Communicable Disease. “Visit your doctor if you are sick, and stay home until you are well. It is especially important for children to stay home from school or day care when sick so that they don’t spread the disease to other kids.”

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The great Sioux Chief, Sitting Bull, lived, died, and may be buried on the Standing Rock Indian Reservation near Mobridge, South Dakota.   The actual location of Sitting Bull's grave is the subject of historical dispute.  

There is no dispute that the 8,500 Sioux who today live on the Standing Rock are at the center of an outbreak of Shigella that now concerns the South Dakota Department of Health.  So far this year, there have been 57 confirmed cases of Shigellosis in South Dakota, and all but four in people who live in Corson and Walworth counties that are just across the Mighty Missouri River from one another in north central South Dakota.

Walworth County, with close to 6,000 people, is mostly white and has seen five Shigella cases in 2008.   Then you cross the Mighty Mo at Mobridge into Corson County, one of the counties that make up the Standing Rock  Indian Reservation that spans the South Dakota-North Dakota border.

Most people of Corson are Sioux, members of the Dakota and Lakota nations.  Fewer than 4,200 make Corson home.  There have been 48 Shigella cases so far in 2008 in Corson County.

Reservations like the Standing Rock are big open places with few people.   It makes it necessary to translate numbers.  For example, were a normal urban area of one half million people experience the same rate of Shigella now being experienced in Corson County, it would translate into 5,715 cases.

 South Dakota's press release on the outbreak can be found here.

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Shigella is a bacterium that can cause sudden and severe diarrhea (gastroenteritis) in humans. Shigellosis is the name of the disease that Shigella causes. The illness is also known as "bacillary dysentery." Shigella bacteria can infect the intestinal tract after the ingestion of relatively few organisms. This is why shigellosis is the most communicable of the bacterial-induced diarrheas.

The source of Shigella bacteria is the excrement (feces) of an infected individual that is ultimately ingested by another person. The infectious material is spread to new cases by person-to-person contact or via contaminated food or water. Approximately 20% of the nearly 450,000 cases of shigellosis that occur annually in the U.S are foodborne-related. Generally, the food preparer is the individual who contaminates the food, but food may also become contaminated during processing. Contamination of drinking water by Shigella is a problem that more often occurs in the developing world, but swimming pools and beaches in the U.S. can become contaminated by infected individuals. No group of individuals is immune to shigellosis, but certain individuals are at increased risk, particularly small children. Persons infected with HIV experience shigellosis much more commonly than other individuals.

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The Journal News, the  Gannett  newspaper the Lower Hudson Valley including  Westchester, Rockland and Putnam counties in New York, today (4/17/08) is reporting on a Shigella outbreak involving local Jewish schools and day care centers.  Here's what Jane Lemer writes: 

A total of 67 cases of shigellosis have been reported so far this year, Rockland Commissioner of Health Dr. Joan Facelle said today. No cases of the infectious disease were reported during the same period last year.

A small number of cases started in January, with the majority of the infections occuring in the past three or four weeks, she said.

"We're been out in the community, talking to the schools, to the rabbis, the families," she said. "We're using a multi-pronged approach to get the information out there."

Most of the people who have the diseases live or attend school in the Monsey area, she said.

Check out the rest of the story here.

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We've been watching the Shigella outbreak in the Indianapolis area all winter.   The pace continues with 16 new cases this week and 15 last week.   The county's health department marked the sixth month of the outbreak with a news release, which in part said:

Marion County's Shigella outbreak has entered its six-month and local health officials are concerned that the highly contagious disease will gain momentum now that school-aged children have returned from spring break.

The health department has already received 16 new cases this week after receiving 15 new cases last week. More than 325 individuals, mainly pre-school and school-aged children, have been diagnosed with Shigella since the outbreak began in October of 2007. An untold number of others likely have the disease, but have not sought treatment from their health care provider.

During the last outbreak in 2000, Marion County experienced an increase in the number of cases from 15 just before Spring break to more than 120 in the weeks immediately following spring break.

In the release, the health department outlines its strategy of focusing on day care centers, childcare providers, schools, doctors and other health care providers with information about Shigella.   The education campaign, however, does not appear to be working.  The health department says:

Still, the health department continues to see double-digit new cases being reported each week. Bringing an end to the outbreak poses many challenges.

For the complete release, go here.

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Adelaide in Southern Australia has an outbreak of Shigella, ABC News is reporting tonight (4/2/08).

Director of the infectious diseases control branch, Ann Koehler, says cases of the illness, known as shigella, have been reported across Adelaide.

Dr Koehler says it is one of the few types of gastro needing treatment with antibiotics because it can spread rapidly.

She says anyone with gastro symptoms such as vomiting, diarrhoea, fever or nausea needs to pay special attention to hygiene and should not return to work or school or prepare food for 24 hours after symptoms ease.

The ABC report with map can be found here.

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News 25, the NBC affiliate in Central Illinois, is reporting a Shigella outbreak is occurring in Tazewell County.   The number of Shigella cases so far this year stands at 18, and that compares to only one during the year 2007.

News25 reports that:

Shigella is caused by a group of bacteria that health officials say can be avoided by hand-washing, sanitary food handling and diaper changing, eliminating shared water play areas, and staying home when diagnosed. Those diagnosed with the bacteria are urged not to return to school or daycare for 24 hours after being symptom free.

The bacteria is spread through the fecal-oral route and is more typical in young children and those who live in crowded conditions.

Signs and Symptoms to look for are similar to the flu. Loose watery stools with blood or mucus, fever, headache, convulsions, and abdominal pain can be associated with the bacteria.

There is not a reliable link to the story.  News 25 can be found here.

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All those Clinton and Obama campaign workers may be getting out of Ohio just in time.  Or maybe not.

Akron health officials are reporting that Ohio is suffering from the largest number of shigella cases since the 2001-2002 school year.    They say its been ongoing for several months with youngsters battling diarrhea caused by shigellosis, a highly contagious, bacterial infection.

The Akron Beacon Journal quoted Dr. Marguerite A. Erme, an epidemiologist for the Akron Health Department, as saying that about every five years, day-care centers and schools throughout the state report a rise in children sickened with shigellosis.

Erme said, like clockwork, the bacteria is back and many parents, teachers, and day-care providers can attest to that fact.

The Akron Beacon Journal reports:

''It is characteristic of this particular germ that we do see it cyclically,'' she said. '' . . . Since the fall, we started seeing an increasing number of cases of shigella throughout the whole county.''

Signs of shigellosis include diarrhea (often bloody), fever and stomach cramps starting one or two days after exposure to the bacterium, according to the Ohio Department of Health. Symptoms typically resolve in five to seven days, though young children and the elderly sometimes require hospitalization if they experience severe diarrhea.

A stool sample is required to confirm the presence of the shigella bacteria, Erme said. Severe cases can be treated with antibiotics, though that's not always necessary for milder cases.

 

The rest of the story can be found here.

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A million children are killed annually by diarrhea disease caused by Shigella and Escherichia coli (E coli).

The Info Project at the Bloomberg School of Health at John Hopkins University just published a fact sheet on "Developing New Vaccines Against Diarrheal Disease" by PATH.   It seems that PATH, an international nonprofit organization, last year was on the receiving end of a $50 million grant from the Bill and Melinda Gates Foundation  "to protect infants and children in low-resource countries by advancing development of safe, affordable, and effective new vaccines for two of the most important bacteria that cause diarrheal disease."

PATH’s Enteric Vaccine Initiative will collaborate with private- and public-sector partners to advance the development of safe and effective vaccines against the leading bacterial causes of diarrheal disease: Shigella and enterotoxigenic Escherichia coli.

According to the fact sheet,  the PATH project is looking at several ways  to produce effective vaccines, including killing the whole cell, subunit or conjugate polysacchardie-based, live attenuated strains, and bacterial vectors.  "Preventive vaccines designed to be practical for low resource countries are a high priority," the PATH fact sheet says.

PATH says diarrhea is the second leading cause of death in children age five and younger. Each year, almost two million children throughout the world die from severe, dehydrating diarrhea, and millions more are hospitalized.   Half of those deaths are due to Shigella and common E. coli.

 The Info Project abstract on the PATH fact sheet can be found here.

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