Ventura County Public Health was notified on Thursday, June 22nd, of an unusually high number of Shigella cases in the county. Shigellosis is an infectious disease caused by a group of bacteria called Shigella (shih-GEHL-uh), which most often causes diarrhea and fever. It is highly contagious.

Through a series of interviews with those affected, it has been determined that a number of the cases reported to have eaten at the Souplantation in Camarillo. Of the diners interviewed, there are a total of eight individuals with laboratory evidence of Shigella infection.

Ventura County Public Health’s laboratory sent the culture confirmed samples to the State laboratory for typing.

“We’re tracking these cases closely,” said Public Health Officer Dr. Robert Levin, “and are working closely with Ventura County Environmental Health, which has completed two inspections of the restaurant in the past two days.” Dr. Levin credits Souplantation corporate office for making the decision to close the restaurant, starting Thursday through the weekend, to make certain that all steps have been taken to prevent further cases.

The Souplantation Chief Operating Officer has arrived at the Camarillo location and has been joined by a vice- president and the quality assurance manager. All employees are being put through a sanitary training refresher course, the restaurant is being thoroughly cleaned and all food on the premises is being thrown out.

“Souplantation’s actions have been exemplary. This is the kind of swift and decisive action, which leads to a collaboration with Public Health that results in a rapid resolution of the problem,” added Dr. Levin.
It is not currently clear what the source of the infection is. No one food item has been indicated. All employees are being tested and will need to be cleared before returning to work. There are approximately 40 employees at the restaurant.

Most people who are infected with Shigella develop diarrhea, fever, and stomach cramps starting a day or two after they are exposed to the bacteria. Shigellosis usually resolves in 5 to 7 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. Antibiotic treatment is known to decrease the length of illness and to end shedding of the organism within a day or two of starting therapy. People most at risk of serious illness are those with underlying immunosuppressive conditions. Those who may have been exposed who are feeling ill should consult their physician.

Florida health officials in Seminole County are warning about a shigella outbreak at a daycare. A shigella outbreak was reported to Florida Health Department officials on Tuesday at the Kids City USA daycare in Altamonte Springs. According to the Centers for Disease Control and Prevention, symptoms appear one to two day after exposure, with diarrhea, fever and abdominal pain. CDC said symptoms last five to seven days; however, people with mild cases may only need fluids and plenty of rest. In severe cases, antibiotics may be used. However, shigella is antibiotic-resistant. The bacteria is highly contagious, CDC officials said. A tiny amount of exposure to contaminated stool can cause infection. Health officials said the daycare is still open. CDC recommends that if an outbreak occurs at a daycare, to have a child who is infected with diarrhea to stay home and children who have recently recovered to be placed in one classroom to minimize the risk of exposure. Also, staff should be assigned to change diapers and prepare the food, the CDC said. Young children and travelers are among the most at-risk groups of being affected.

102557636-Shigella.1910x1000The Arkansas Department of Health (ADH) is continuing to see cases in Northeast Arkansas of Shigellosis, an infectious disease that commonly causes diarrhea, fever and stomach cramps. Shigellosis is caused by the Shigella bacteria and is very contagious. The ADH urges residents to wash their hands and take other protective measures to keep Shigella from spreading.

In Louisiana, Dr. Anatole Karpovs, pediatrician with The Children’s Clinic of Southwest Louisiana, has been treating young patients with shigellosis, caused by a group of bacteria called shigella.

“It causes specifically diarrhea and high fevers,” said Dr. Karpovs  “It sometimes causes bloody diarrhea or pus or mucus in the diarrhea.”

Dr. Karpovs says most people infected with shigella start experiencing these symptoms within a day or two of exposure to the bacteria.  It spreads easily through fecal-oral routes.

“If a child has diarrhea and that spreads or gets on a surface and somebody touches it unknowingly, then they can spread it to themselves or other people,” he said.

Anyone can be infected, but some people might not even know it.

Those most at risk are people with weakened immune systems, the elderly, and the young.

Stanislaus County has seen an increase in Shigella infections this year. According to the Stanislaus County Health Services Agency, there has been 123 confirmed cases of Shigella in the county this year, which is a significant increase from the 19 reported in 2015.

Most Shigella infections are the result of bacteria passing from improperly washed hands from one person to the mouth of another person, often through handling contaminated objects or food. Poor hand washing and hygiene, especially after changing diapers or toileting, increases the risk of infection.

“Regular and frequent hand washing with soap and running water is the single most important preventive measure to interrupt the spread of shigellosis. Everyone should thoroughly wash their hands after using the restroom or changing diapers and before eating or preparing food. People diagnosed with Shigella infection should be especially vigilant in their hand washing practices,” said Dr. John Walker, the public health officer for Stanislaus County.

Shigellosis is a highly infectious disease caused by a group of bacteria called Shigella. People infected with Shigella may have fever, stomach cramping, and mild or severe diarrhea, often with traces of blood or mucus in the stool. However, some infected people may not show any symptoms at all. Symptoms occur from one to seven days after exposure, but usually within one to three days, and last an average of four to seven days.

Approximately 500,000 cases of Shigella are reported in the United States each year, according to the Centers for Disease Control and Prevention. In 2013, the CDC declared antibiotic-resistant Shigella an urgent threat in the United States. These cases had been seen for years overseas, but more recently, the CDC has seen outbreaks of the infection that are resistant to the two main prescribed antibiotics for Shigella — ampicillin and trimethoprim-sulfamethoxazole. About 27,000 Shigella infections in the United States every year are resistant to one or both of these antibiotics. When pathogens are resistant to common antibiotic medications, patients may need to be treated with medications that may be less effective, but more toxic and expensive.

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.”

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.

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.

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.

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.

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.