Shigella is a genus of bacteria that can cause sudden and severe diarrhea (gastroenteritis) in humans. Shigella thrives in the human intestine and is commonly spread both through food and by person-to-person contact. A Japanese scientist Kiyoshi Shiga discovered these bacteria over 100 years ago. Shigellosis is the name of the disease that Shigella causes. The illness is also known as "bacillary dysentery."
Mar 27, 2005
Fifteen people in Florida who visited agricultural fairs recently have developed a life-threatening kidney disease or are infected with bacteria that can cause it, Florida health officials said yesterday.
Eleven of those affected are children, and petting zoos at the two fairs are suspected, but Florida's secretary of health said it was "too early to point to one single element, such as a petting zoo."
Epidemiologists are "trying to triangulate the 15 cases and see if they can be associated with a single point source," the secretary, Dr. John O. Agwunobi, said.
Officials at various Florida hospitals told The Associated Press that they knew of nine children with hemolytic uremic syndrome who had visited petting zoos at the Central Florida Fair in Orlando or the Florida Strawberry Festival in Plant City. One Florida television reporter described the death of a child who had visited a petting zoo, but it was unclear if there was any connection.
Mar 25, 2005
By JAN HOLLINGSWORTH
jhollingsworth@tampatrib.com
PLANT CITY - State agriculture officials have dispatched a team of veterinarians and inspectors to test farm animals that may be linked to life- threatening cases of kidney failure among children and at least one adult who attended recent fairs in Orange and Hillsborough counties.
First stop was Ag-Venture, a Plant City-based farm show that operated petting zoos this month at the Florida Strawberry Festival and the Central Florida Fair.
All the patients with the potentially deadly syndrome had contact with livestock at the fairs.
March 23, 2005
The Lubbock Health Department says 35 cases of shigellosis have popped up since January.
The shigella bacteria is spread hand to mouth after someone forgets to wash their hands after using the bathroom.
The Texas Department of Health is also warning everyone to take precautions to keep this from spreading further.
"Shigella has a short incubation period. Typically in 24 to 48 hours the person will become ill," says Dr. David Waagner, of the Texas Tech Division of Pediatric Infectious Diseases. "It starts with an upset stomach or vomiting. It rapidly sets on with a high fever to 103-105 (degrees) shakes, chills and profuse diarrhea, typically bloody."
Health officials say to wash your hands frequently, especially after changing a diaper and helping your child in the bathroom. Also, with summer just around the corner, remind your children not to drink the pool water.
Wednesday, March 23, 2005
The Texas Department of State Health Services is urging residents of the Texas Panhandle and South Plains to take precautions to control the spread of shigellosis, an infectious bacterial disease cousing diarrhea, fever and stomach cramps. A total of 33 cases of shigellosis have been reported since mid January.
" Most shigella infections are the result of the bacterium passing from stolls or soiled fingers from one person to the mouth of another person," said Connie Lindley, regional epidemoliogist in Canyon. To help prevent to spread of shigellosis:
Wash hands carefully and frequently with soap
Dispose of soiled diapers properly
Disinfect diaper changing areas after using them
Keep children with diarrhea out of child-care settings
Supervise hand washing of small children after they use the toliet
Do not prepare food for others if you have a diarrheal illness
Avoid drinking pool water.
By Judith Blake
Seattle Times staff reporter
March 23, 2005
The calls run the food-safety gamut:
ï A Seattle-area woman said she'd found walnuts in a packaged, pre-cut salad mix, though nuts were not listed in the ingredients. Her young son, who was severely allergic to walnuts, did not eat any of the nuts, but the woman worried that someone else might have an allergic reaction to the mislabeled product.
ï A man discovered mold on the meat-filled breakfast burrito he'd purchased at a convenience store.
ï A woman was dismayed to find larvae in an energy snack bar.
These are among the calls consumers have made to the new toll-free Food Safety Consumer Complaint Hotline (1-800-843-7890) launched in January by the Washington State Department of Agriculture.
Goal: to reduce the risk of food-borne illness by making it easier for consumers to lodge complaints and for officials to address them.
Tuesday, March 22, 2005
By Bradley Flory
Staff Writer
An outbreak of shigellosis in Jackson County may have peaked and subsided.
Twenty-nine cases of the communicable disease were confirmed between late January and mid-March, but no new cases have been confirmed in more than 10 days, said Mary Ricciardello, clinical services manger at the Jackson County Health Department.
"We're hoping this is the end, but you never know," Ricciardello said. "There are probably always cases of shigellosis out there that go undiagnosed."
The disease, caused by bacteria called shigella, usually makes people ill for five to seven days.
By Alex Cukan
UPI Science Writer
RECREATIONAL SWIMMING HEALTH THREAT
There is a growing U.S. public health threat from recreational water illnesses caused by germs such as cryptosporidium, shigella, and E. coli O157:H7. "People need to keep in mind they share the water with everyone else in the pool who may spread illness, including kids in diapers," says Dr. Michael Beach, a Centers for Disease Control and Prevention in Atlanta. CDC asks swimmers to forego swimming when they have diarrhea. It also recommends swimmers refrain from getting pool water in their mouths and practice good hygiene by showering before swimming and washing their hands after visiting the restroom or changing diapers.
Washington: Royal Fork Shigella Litigation
Marler Clark sued a Mount Vernon restaurant over a food-borne intestinal infection outbreak that sickened at least nine people in January. The civil suit against the Royal Fork was filed last week in Skagit County Superior Court on behalf of Sandra and Lester Hemmingson of Mount Vernon. Sandra Hemmingson was hospitalized for three days and has still not recovered fully from the Shigella outbreak.
Shigellosis is caused by the Shigella bacteria, and is more commonly known as dysentery. Typical symptoms include abdominal pain, stomach cramps, fever, vomiting, bloody diarrhea and rectal spasms. The outbreak was traced back to a female food service worker at the restaurant, who failed to properly wash her hands after using the bathroom.
Multistate Outbreak: Viva Mexico Shigella Litigation
Marler Clark filed suit on behalf of Suzie and Hector Lapuyade in San Mateo County Superior Court against Viva Mexico. Lab tests confirmed that Suzie Lapuyade, 40, and her 9-year-old son, Maurice, contracted shigellosis, a gastrointestinal disease that spreads through bacteria-tainted food. County health officials closed Viva Mexico as more than 250 diners became sick during the last 10 days of October. Lab tests confirm at least 45 cases of shigellosis, but the Lapuyades are the first to file suit.
Multistate Outbreak: Senor Felix Shigella Litigation
An outbreak of shigellosis in Washington and six other Western states stemming from a contaminated Mexican-style dip has developed into a major epidemic of food-borne illness. More than 335 people in Washington, California, Oregon, Idaho, New Mexico, Arizona and Alaska have had confirmed or suspected cases of the bacterial illness, characterized by severe diarrhea, nausea, fever and stomach cramps.
The outbreak is linked to several products of Senor Felix Gourmet Mexican Foods of Baldwin Park, Calif. A class-action lawsuit was filed by Marler Clark alleging negligence by the dip company.
A rise in the number of Escherichia coli cases requires diligent detection efforts.
By Debby Giusti, MT(ASCP)
Page 1
Ten-year-old Brianne Kiner spent 40 days in a coma in 1993, while teams of medical personnel worked round-the-clock to keep her alive. Brianne has little memory of the 118 days she was on kidney dialysis or the 80 units of blood she received, nor does she recall the numerous times the doctors told her mother that Brianne wouldnít live through the night. What Brianne does remember is that her hospital ordeal left her with the dubious recognition of being the sickest child in the United States to survive Escherichia coli 0157:H7.1
Over a 3-month period, more than 700 children and adults in four states in the northwest became ill after eating at various Jack in the Box restaurants. They suffered severe stomach cramps and diarrhea, often bloody, and close to 200 of the ill had to be hospitalized. Fifty-five cases progressed into hemolytic uremic syndrome (HUS), a condition that can lead to kidney failure and even death. Children and the elderly are most at risk for HUS, and in the 1993 outbreak, four children died.2
Epidemiologists quickly recognized that those infected had eaten undercooked hamburgers served at more than 90 Jack in the Box restaurants in the four state area.2 The beef shipped to the restaurants was found to be contaminated with E. coli 0157, and to date, the outbreak remains the largest in U.S. history caused by the organism.
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, but this may largely be due to an increased risk among men having sex with men.
Symptoms of Shigella infection
Most people who are infected with Shigella develop diarrhea, fever, and abdominal cramps. Severity of the disease ranges from mild to very severe diarrhea. Diarrhea is bloody 25-50% of the time and most often contains mucus. Rectal spasms are common. The illness starts 12 hours to 6 days, usually 1 to 2 days, after exposure to the bacteria. Dehydration is also a common symptom.
Detection and treatment of Shigella infection
A culture of an infected personís stool sample can identify the Shigella bacteria. The laboratory can also do special tests to tell which species of Shigella the person has and which antibiotics would be best to treat it.
Although shigellosis is usually a self-limited illness, antibiotics can shorten the course, and in the most serious cases, might be life-saving. When therapy is indicated, a fluoroquinolone antibiotic is the recommended first-line treatment for non-pregnant adults, such as ciprofloxacin 500 mg twice daily for three days. Alternative antimicrobial agents include trimethoprim-sulfamethoxazole, azithromycin, and ceftriaxone. Antidiarrheal agents such as loperamide (Imodium) or diphenoxylate with atropine (Lomotil) are likely to make the illness worse and should be avoided.
While shigellosis usually resolves in 5 to 7 days, it may be several months before an affected personís bowel habits are entirely normal. In some persons, especially young children, the elderly, and immune compromised persons, the diarrhea can be so severe that the affected person needs to be hospitalized. It is estimated that over 6,000 hospitalizations for shigellosis occur each year in the U.S. Complications of shigellosis include severe dehydration, seizures in small children, rectal bleeding, and invasion of the blood stream by the bacteria. In the U.S., it is estimated that about 70 persons die yearly from shigellosis, with small children and the elderly at greatest risk of dying.
Up to 3% of persons infected with Shigella may later develop a syndrome that includes joint pain and swelling, irritation of the eyes, and sometimes painful urination. This is a reaction to the previous gastroenteritis and is called ìreactive arthritisî or Reiter's Syndrome. Basically, the immune system, intending to fight Shigella, attacks the bodyís cells. Reiterís Syndrome is most common in persons with the human leukocyte antigen (HLA) B27 genetic makeup. Reiterís Syndrome can last for months or years, can lead to chronic arthritis, and may be difficult to treat. See the Marler Clark sponsored site on Reiterís Syndrome for more information.
How can a Shigella infection be prevented?
Frequent and careful hand washing with soap and water should be done by both the ill individual and anyone who is in contact with that person. Supervised hand washing of all children should be followed in day care centers and as soon as children return home. Young children with a Shigella infection, or with diarrhea of any cause, should not be in contact with uninfected children.
Everyone who changes an infected child's diapers should be sure the diapers are disposed of properly in a closed-lid garbage can and should wash their hands carefully with soap and warm water immediately after changing the diapers. After use, the diaper changing area should be wiped down with disinfectant, such as household bleach.
Shigella organisms are killed by heat used in cooking. People who have shigellosis or any diarrhea should not prepare food for others until they have been shown to no longer be carrying the bacteria.
At swimming pools, maintaining a chlorine level of at least 0.5-PPM will kill Shigella. Children not yet toilet trained should be excluded from public swimming areas; stay clear if this rule is broken. Children with diarrhea should never be taken to public swimming areas.
Drink water only if it has been chlorinated (most tap water) or treated with ozone (most bottled water). Avoid drinking pool or beach water. Consume only pasteurized dairy products.
Simple precautions taken while traveling to the developing world can also prevent getting shigellosis: "boil it, cook it, peel it, or forget it". Drink beverages only if they are canned/bottled in a sanitary environment, boiled (like coffee), or have been in contact with alcohol for a prolonged period (wine or beer, not mixed drinks). Do not use ice in beverages.
3/10/2005
By: Reed Upton
A highly contagious bacterial disease has been confirmed at an Albuquerque daycare center and the New Mexico Department of Health will be monitoring the center through March.
The case of Shigella was identified at La Petite Academy. The disease, which is spread through fecal matter, induces symptoms of fever, diarrhea, cramps, nausea and vomiting.
Parents of La Petite Academy students received a written notice of the presence of the disease on Wednesday. It cautioned that kids should be thorough with hand washing after using the toilet and before preparing or eating food.
Parents are being urged to monitor their children for symptoms of the disease and, if they are spotted, to notify the Department of Health and schedule an immediate doctorís appointment.
Mar 10, 2005, 8:03 AM
WKYT 27 News
Schools and daycares in Woodford County are dealing with a serious illness. It's called Shigellosis.
Health officials have confirmed nine cases so far. It's a highly contagious bacterial infection that attacks the gastro-intestinal system.
Shigellosis is marked by intense and prolonged diarrhea, often bloody. That is sometimes accompanied by a fever.
Most of the cases center around a daycare. There is one confirmed case at Simmons Elementary.
REUTERS
February 24, 2005
WASHINGTON ñ Bacteria that cause a range of diseases from dysentery to plague use a needle-like "sword" to attack cells, and some have evolved a shield to protect it from the immune system, several teams of researchers reported Thursday.
Their findings could eventually lead to new treatments, although in the case of dysentery this could be especially difficult, the researchers report in Friday's issue of the journal Science.
"This is the first description of bacteria able to use this 'sword and shield' approach, showing how dysentery is able to infect the body so effectively," said Dr. Christoph Tang of Imperial College London, who led the study on dysentery.
Rachel Oesch
News 12
Feb 17, 2005
Doctors and health officials are seeing cases of infectious disease they once knew of only in history books.
Dr. Mark Anderson: "TB was something we thought we had cornered in the 1970's but sort of to our surprise it started going back up."
Doctor Mark Anderson specializes in infectious diseases. He knows what is spreading through the area and why.
Feb 16, 2005
The number of confirmed cases of Shigella now stands at 15 in Jackson County, a nd while the number of cases hasn't spiked, health officials say there is new reason for concern. Jackson County health officials sent out dozens of lettersupdating the outbreak.
Officials tell us they were faxed to all Jackson County fast-food restaurants and schools, t hat's because of the 15 infected, 2 are food workers and 3 are area students. When officials at the Jackson County Health Department learned a few of the infected where food service workers, they took action.
Mary Ricciardello, Clinical Services Manager: "T he food service workers are a concern of course, because it is transmitted through contact."
Feb 15, 2005
Jackson County health officials are now reporting 15 confirmed cases of Shigella in the county. The highly-contagious intestinal disease 1st appeared in the county about 2 weeks ago. Health department officials tell 6 News of the confirmed cases, 2 are food service workers and 3 are students in the county.
To help prevent the spread of the disease, health officials recently sent letters to all the fast food restaurants and schools in the county. Officials are still preaching the importance message of good hygiene and frequent hand washing to prevent Shigella from spreading.
Secure Web-system will help direct state response to biological attacks, reports of emerging infectious diseases
February 9, 2005 -- SPRINGFIELD, Ill. ñ Gov. Rod Blagojevich today announced that hospitals, doctors and other health care providers now can electronically report infectious diseases to the state and local health departments as part of a continuing effort to improve the stateís ability to respond to public health emergencies.
ìWe are committed to strengthening the capacity of our public health system to meet health threats,î the Governor said. ìThe roll out of this electronic disease reporting system to private health care providers enhances the stateís ability to quickly identify health problems and direct the appropriate response.î
Tuesday, February 8, 2005
By JEAN ENERSEN / KING 5 News
Ever wonder how risky it is to be munching on grapes in the produce aisle? And what about everything else you touch, including the handles on those grocery carts? Here's a closer look at some dirty shopping secrets.
Ten times out of 10, there are germs on a shopping cart. It may look clean, but there really is no telling how many children have been in it or how many birds have claimed it.
And what about all that produce, which may be every bit as dirty?
One news crew went into several grocery stores to pick up a few things that are out in the open, like fruits and vegetables. Next they swabbed a number of carts, inside and out, where you put your hands, where your kids sit and touch.
2/8/05
Good hygiene can help keep students and staff healthy.
By: Tiffany Bommarito, KY3 News
SPRINGFIELD ñ Three confirmed cases of shigellosis have surfaced in students at Campbell Elementary School. Thatís a type of dysentery caused by a bacteria called shigella. People can battle or prevent the illness by keeping their hands washed well and out of their mouths.
Springfield-Greene County Health Department officials say the staff at Campbell did everything correctly after the intestinal-borne sickness appeared. They called the health department to find the place of origin, which was determined to not be at the school. They also talked again to every child about proper hand washing at school and at home and bought extra anti-bacterial sanitizers for the students and staff.
Symptoms of shigella include diarrhea, abdominal cramping, fever, nausea and vomiting. Good hand washing can also prevent other types of illnesses, including influenza and colds.
2/5/05- There are now 8 confirmed cases of Shigella in Jackson County. Shigella is a highly-contagious intestinal illness. Jackson County health officials say since they announced the outbreak Thursday, their phones have been ringing off the hook.
They say some people are reporting Shigella-like symptoms, but many just want more information. Officials say they're glad people are taking notice, because they want to stop the disease from spreading.
Mary Ricciardello, Jackson Co. Health Department: "I t's just a highly contagious illness that secondary infections occur approximately 40-60% of the time within a home."
And while the disease is easily spread, if caught early, it's also easily treated. If you have any questions, you're urged to call your doctor or local health department. You can also contact the Jackson County Health Department at (517) 788-4619.
By Natalie Johnson
Jackson County is experiencing a Shigellosis Outbreak. So far there are seven confirmed cases, but more are predicted to surface. The Jackson County Health Department does not know where or who the outbreak stems from, as the cases are not in one isolated area.
Shigellosis is most commonly contracted through children because they have less hygienic tendencies, but the disease can spread to people of any age. Shigella is a bacteria spread by oral-fecal contact and symptoms include: bloody diarrhea, nausea, vomiting, fever and stomach cramps. The best prevention method is to wash hands with soap and warm water.
2/4/05- The Jackson County Health Department is investigating an outbreak of Shigella. More than half a dozen people in Jackson County have the highly contagious intestinal illness,prompting health officials to issue an alert.
The Jackson County Health Department announced there are 7 confirmed cases and other suspected cases of the intestinal illness in the county. As most may remember, Shigella recently made headlines in Ingham County after dozens of students there became ill. Jackson County Health Department officials tell us they've received some sporadic reports of intestinal illness over the past month, b ut noticed it was reaching outbreak proportions.
Staff to disinfect Lansing school after outbreak
By Susan Vela
Lansing State Journal
February 3, 2005
Resurrection School children were vomiting in the school's hallways, gymnasium and offices Wednesday, causing Principal Diana Repichowski to cancel classes for the rest of the week.
About 60 of the school's 151 kindergartners through eighth-graders were absent Wednesday morning. By noon, an additional 15 had been sent home.
"I don't know if I'm well or sick after cleaning up after so many kids," Repichowski said.
"The children were just violently ill. I've never seen this in my life."
1/31/2005
Don Finley
Express-News Medical Editor
At the child care center at San Antonio College, tiny hands are trained to rub and scrub with lots of lather at kid-sized sinks several times a day for the length of time it takes to sing the "Happy Birthday" song a couple of times ó about 15 seconds.
When they're finished, the children dry their hands with a paper towel, then use that towel to shut off the water. After all, there are plenty of germs on the sink handles, too.
"It's like all the routines that children learn in the first few years of life. They learn it through modeling and through the teachers helping them do it," said Earlene Gonzales, lab center director at SAC's Child Development Center. "It's kind of a fun game at first when they're learning it."
By Judith R. Tackett, jtackett@nashvillecitypaper.com
January 13, 2005
Nashville City Paper
The Metro Public Health Department has issued a Communicable Disease Alert to physicians in Davidson County after observing an unusual increase in reported cases of Shigella.
Shigella is a bacterial infection that can cause vomiting, diarrhea, fever and stomach cramps. Symptoms, which last about a week, usually develop one or two days after exposure.
Usually one or two cases of Shigella are reported each month in Nashville, health officials said. However, nine cases were reported in October, 11 additional cases were reported in November, and 21 in December.
The Banner
Dec 16, 2004
Jackson County-According to a press release from Jackson County Health Department, officials have alerted area residents about an outbreak of gastrointestinal ailment due to an organism identified as shigellosis.
The release said the department has received seven positive identifications of the shigella organism in persons who were associated with an unnamed Seymour day care center.
"There has been a significant number of confirmed cases of the infection and a larger number of suspected, but unconfirmed cases reported to the health department," the release said.
12/14/2004
Associated Press
An outbreak of a gastrointestinal illness has sickened at least seven children at a southern Indiana day care center, Jackson County health officials said Tuesday.
County health officer Dr. Kenneth Bobb said the confirmed cases of shigellosis were in children age 3 to 8, but other confirmed and suspected cases were being investigated.
None of the cases of the illness, which is spread by oral contact with an infected person's fecal material, are considered life-threatening, he said.
"The infection is easily passed from one person to another and is very serious in babies, older adults and people who are not well," Bobb said.
By ANITA MILLER, News Editor
San Marcos Daily Record
Efforts to stem an increasing number of cases of the intestinal malady shigellosis in local public schools seem to have paid off, according to a county health official.
Kristy Phillips, coordinator for tuberculosis and communicable disease for the Hays County Personal Health Department, said new cases have trickled down to one or two a day, when at the peak of the outbreak there were "anywhere from five to 10" daily.
As of Thursday, Phillips said there have been a grand total of 206 cases of shigellosis, which is caused by the shigella bacteria which is spread by hand to mouth contact with fecal material.
Dec 6, 2004
Named after the Japanese scientist Shiga who discovered it in 1897, Shigella is a type of bacteria that infects the intestinal tract. Four different groups of Shigella can affect humans, with some causing a mild illness and others a more severe one.
About 18,000 cases of Shigella infection are diagnosed each year in the United States, but many more go unreported because they involve only mild symptoms and sometimes no symptoms at all. The infection is most common during the summer months. Shigella rarely infects infants younger than 6 months old, but it is common in children 2 to 4 years old, especially those in child care.
Signs and Symptoms
Shigella can cause a spectrum of illnesses. Some people with a mild case have only loose watery stools, and a few may not have any symptoms at all. Others go on to develop a more severe disease known as dysentery, with abdominal cramps, high fever, loss of appetite, nausea, vomiting, and diarrhea, which may contain mucus and blood. Some children with severe cases of Shigella infection may need to be hospitalized.
December 3, 2004
The Surry County Health Department said Thursday that more than 40 people who ate at La Fuenta Mexican restaurant in Elkin last week became ill because the food was contaminated.
The health department said 13 people had Shigella, a bacteria that causes diarrhea.
Health officials closed the restaurant last week for testing but reopened it Thursday after all tests came back negative.
Shigellosis is an infectious disease caused by a group of bacteria called Shigella. Most who are infected with Shigella develop diarrhea, fever and stomach cramps starting a day or two after they are exposed. The diarrhea is often bloody.
Shigellosis usually resolves in five to seven days. In some people, especially young children and the elderly, diarrhea can be so severe that the patient needs to be hospitalized. A severe infection with high fever may also be associated with seizures in children less than two years old. Some persons who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others.
How can Shigella infections be treated?
Shigellosis can usually be treated with antibiotics. Unfortunately, some Shigella bacteria have become resistant to antibiotics and using antibiotics to treat shigellosis can actually make the germs more resistant in the future.
Public Health Dispatch: Outbreak of Shigella sonnei Infections Associated with Eating a Nationally Distributed Dip -- California, Oregon, and Washington, January 2000
A multistate outbreak of Shigella sonnei infections with at least 30 culture-confirmed cases in California, Oregon, and Washington has been linked to eating a nationally distributed five-layer dip. Symptom onsets occurred during January 10-23, 2000; case-finding is ongoing. The implicated product is manufactured by SeÒor Felix's Mexican Foods* (Baldwin Park, California) and distributed under the brand names SeÒor Felix's 5-Layer Party Dip (sold in 16-ounce, 20-ounce, and 41-ounce containers), Delicioso 5-Layer Party Dip (33-ounce containers), and Trader Joe's 5-Layer Party Dip (20-ounce containers). The dip consists of layers of bean, salsa, guacamole, nacho cheese, and sour cream.
During June 2001--March 2003, outbreaks of Shigella sonnei infections were reported in Delaware, Maryland, New Jersey, North Carolina, South Carolina, and Virginia (Figure). Five- to fortyfold increases in statewide shigellosis rates were observed during this period. These increases were attributed primarily to outbreaks in multiple day care settings that became prolonged and communitywide. S. sonnei isolates from these states, as well as from New York City and Philadelphia, were similar genetically by pulsed-field gel electrophoresis (PFGE). Many of these isolates lacked the capacity to ferment rhamnose, which is unusual for S. sonnei. This report summarizes these outbreaks and describes the laboratory characteristics that link them. The findings underscore the importance of rapid and coordinated public health responses to isolated outbreaks of shigellosis.
Shigellosis is a nationally reportable disease. During June 2001--March 2003, approximately 3,081 laboratory-confirmed cases of S. sonnei were reported from the six states through the Public Health Laboratory Information System (PHLIS). Each state or city health department investigated outbreaks independently and submitted case counts, including cases not reported through PHLIS; demographic information and laboratory data also were submitted. A day care--related case was defined as S. sonnei infection in a child attending day care or in a close contact of a child attending day care. The extent of laboratory testing, including PFGE, varied substantially from state to state on the basis of available resources and health department policies. Selected isolates and PFGE patterns were submitted to the National Molecular Subtyping Network for Foodborne Disease Surveillance (PulseNet) for comparison among states.
11/12/04
Health officials in Ingham County say they're making some progress in tracing the source of the Shigella outbreak. I t was declared on October 19th, when 3 cases of the contagious intestinal illness were confirmed at Lansing's Willow Elementary.
The number of cases peaked Tuesday with 61 confirmed and 35 probable cases. B oth health and school leaders met to discuss their progress. While they do not know exactly what caused the outbreak,they say the research done so far says it was not from any of the food the schools served for lunch.
Dr. Dean Sienko: "Evaluating every food item, both with the kids that were sick and the kids that were not sick, we couldn't find any association with the foods."
Taco meat, vegetables and apple sauce were among 15 district foods listed for analysis by the department. Dr. Dean Sienko says, while they cannot rule out food entirely as a cause, they have no evidence to say it was a factor.
October 22, 2004
Health official finds no evidence of intestinal illness outside schools
By Tom Lambert
Lansing State Journal
There's no evidence the intestinal illness shigella has spread to the general public, Ingham County's top medical examiner said Thursday after contacting local doctors and emergency rooms.
The Lansing School District is now possibly dealing with 32 cases of shigella - 29 at Willow Elementary and potentially three more at Sheridan Road Elementary.
Four of the Willow cases have been confirmed by laboratory tests as shigella, said Dr. Dean Sienko, Ingham County's medical director.
The outbreak has parents, Lansing school officials and outlaying school districts uneasy and looking to the county Health Department for answers.
Thomas L. Hale
Gerald T. Keusch
General Concepts
Clinical Manifestations
Symptoms of shigellosis include abdominal pain, tenesmus, watery diarrhea, and/or dysentery (multiple scanty, bloody, mucoid stools). Other signs may include abdominal tenderness, fever, vomiting, dehydration, and convulsions.
Structure, Classification, and Antigenic Types
Shigellae are Gram-negative, nonmotile, facultatively anaerobic, non-spore-forming rods. Shigella are differentiated from the closely related Escherichia coli on the basis of pathogenicity, physiology (failure to ferment lactose or decarboxylate lysine) and serology. The genus is divided into four serogroups with multiple serotypes: A (S dysenteriae, 12 serotypes); B (S flexneri, 6 serotypes); C (S boydii, 18 serotypes); and D (S sonnei, 1 serotype).
Pathogenesis
Infection is initiated by ingestion of shigellae (usually via fecal-oral contamination). An early symptom, diarrhea (possibly elicited by enterotoxins and/or cytotoxin), may occur as the organisms pass through the small intestine. The hallmarks of shigellosis are bacterial invasion of the colonic epithelium and inflammatory colitis. These are interdependent processes amplified by local release of cytokines and by the infiltration of inflammatory elements. Colitis in the rectosigmoid mucosa, with concomitant malabsorption, results in the characteristic sign of bacillary dysentery: scanty,. unformed stools tinged with blood and mucus.
School Asks Parents To Keep Sick Children Home
October 12, 2004
CLOVERDALE, Ind. -- Health officials this week declared a shigellosis outbreak in southern Putnam and northern Owen counties after six cases were confirmed and 24 other people showed signs of having the disease.
The first case, noticed last week, involved a Cloverdale kindergartner. Symptoms of the contagious disease are diarrhea, vomiting, fever and stomach cramps.
In some shigellosis patients, especially children and senior citizens, diarrhea can lead to hospitalization, according to the Web site of the Centers for Disease Control and Prevention. Symptoms usually conclude within a week.
October 23, 2004
By Kevin Grasha
Lansing State Journal
Ingham County health officials are focusing on the period between Oct. 12 and Oct. 15 in trying to determine what caused a shige-llosis outbreak in at least one Lansing elementary school.
Dr. Dean Sienko, the county's medical director, said of the 31 cases initially suspected to be shigellosis, 18 were reported Oct. 15, the most on any one day.
The disease, which is caused by the shigella germ, has an incubation period of one to three days, he said.
"That's where we're leaning in our analysis," Sienko said.
Lab tests confirmed two more cases were caused by shigella bacteria, Sienko said Friday, bringing the total to six confirmed cases.
The Shigella blog supplements Marler Clark's Web site www.about-shigella.com, a site that provides information about Shigella, the symptoms and risks of infection, testing and detection of Shigellosis, and how to prevent the spread of the Shigella bacterium.
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