Shigella Lawyer & Attorney : Marler Clark : Shigella Blog

April 27, 2006
The Brunswick News (Ga.)
Lauren McCallister

The Glynn County school system is warning parents of pre-kindergarten children at the Family and Children's Education Services center to be on the lookout for symptoms of shigellosis, an infectious disease that's treatable with antibiotics.

Students carried letters home with them Wednesday from the school advising parents that there have been reported cases of shigellosis at FACES.

Health officials said there have been at least two confirmed cases.

Shigellosis is an infectious disease caused by the bacterium Shigella. It is caused by contaminated food, water or improper hand washing.

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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: ìboil it, cook it, peel it, or forget itî. 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.

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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 Reiterís 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.

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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.

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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.

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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, but this may largely be due to an increased risk among men having sex with men.

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Apr 13, 2006 (CIDRAP News) - The incidence of most major foodborne diseases in 2005 changed little from the previous year and generally continued a slow decline from levels measured in the late 1990s, according to the Centers for Disease Control and Prevention (CDC).

As in past years, Salmonella infections were the most common foodborne illness, followed by Campylobacter cases. Shigella, Cryptosporidium, and Escherichia coli O157 infections ranked third, fourth, and fifth.

The data come from the CDC's FoodNet surveillance system, which covers all or parts of 10 states with about 15% of the US population. The agency reported the data in the Apr 14 issue of Morbidity and Mortality Weekly Report, published today.

The CDC assesses trends in foodborne illness by comparing each year's figures with data from 1996 through 1998, the first 3 years of the FoodNet active surveillance program. On that basis, the agency says the rates of Campylobacter, Salmonella, Listeria, and several other infections were lower in 2005 than in the baseline period, but most of the progress came before 2005.

The surveillance program identified a total of 16,614 laboratory-confirmed foodborne infections in 2005. Salmonella accounted for 6,471 cases, about 39% of the total. There were 5,655 Campylobacter cases, or about 34% of the total. The CDC reports 2,078 Shigella cases, 1,313 Cryptosporidium cases, and 473 cases of Shiga toxinñproducing E coli (STEC) O157. The remaining cases included Yersinia, STEC non-O157, Listeria, Vibrio, and Cyclospora.

The report shows 44 cases of hemolytic uremic syndrome, a major complication of E coli O157, among children in 2004, the latest data available. That compares with 52 cases reported in 2003.

A comparison of the 2005 data with the CDC data for 2004 shows little change in incidence for most of the pathogens. The rate of salmonellosis cases in 2005 was 14.55 per 100,000 people, compared with 14.7 in 2004. The 2005 and 2004 incidence rates for others are as follows: Campylobacter, 12.72 and 12.9; Shigella, 4.67 and 5.1; Cryptosporidium, 2.95 and 1.32 (13.2 per million); and E coli O157, 1.06 and 0.9.

The CDC said the big increase in incidence of Cryptosporidium cases in 2005 over 2004 was due to a large outbreak at a water park in New York last year.

Because the FoodNet surveillance area has increased greatly since 1996, the CDC uses a statistical model to estimate the changes in rates of foodborne infections since the baseline period. Using that method, the agency cites the following estimates of declines in foodborne infections: Yersinia, 49%; Shigella 43%; Listeria, 32%: Campylobacter, 30%; E coli O157, 29%; and Salmonella, 9%.

However, there are several caveats. One is that Vibrio cases have increased an estimated 41% since the baseline period. Further, most of the progress on the other illnesses occurred before 2005. For Campylobacter, most of the decline came before 2001, and the rate of Listeria cases in 2005 was higher than in 2002.

In addition, only one of the five most common Salmonella serotypesóTyphimuriumóhas declined significantly, the CDC said.

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Bill Marler is the managing partner in the law firm Marler Clark L.L.P., P.S. Since 1993, Bill has represented thousands of victims of E. coli, Salmonella, Hepatitis A, Listeria, Shigella, Campylobacter and Norovirus illnesses in over thirty states. As a trial lawyer, Bill has been involved in several cases of national importance. He represented Brianne Kiner in her $15.6 million E. coli settlement with Jack-in-the-Box. This settlement created a Washington State record for an individual personal injury action. Bill resolved several other Jack-in-the-Box E. coli cases for more than $2.5 million each.

In May of 1998, he settled the Odwalla Juice E. coli litigation for the families of children who were severely injured after consuming Odwalla apple juice for a reported $12 million. Bill represented several children in an E. coli outbreak stemming from E. coli-contaminated swimming pool water in Georgia in 1998. In 2001 he successfully tried to verdict an E. coli case involving a school lunch program in Washington State. The jury returned a verdict of $4.75 million. He also resolved dozens of E. coli cases in 2003 related to one of the largest meat recalls in United States. Bill recently settled an E. coli case for a young girl for $11 million. In addition, Bill has been lead counsel in:

Sheetz Salmonella Outbreak Litigation
Chi-Chi's Hepatitis A Outbreak Litigation
Pat & Osacarís E. coli Outbreak Litigation
Chili's Salmonella Outbreak Litigation
And in many more cases . . .

Bill speaks frequently on issues of safe food and has formed Outbreak, Inc., a non-profit business dedicated to training companies on how to avoid foodborne illness outbreaks.

Bill graduated from the Seattle University School of Law in 1987. In 1998 he became the Law School's "Lawyer in Residence." He received undergraduate degrees in Political Science, English and Economics from Washington State University in 1982. While attending WSU, Bill was elected to the Pullman City Council. At 19 years of age he was the youngest person, and first student ever elected. In 1997, Bill received the Distinguished Achievement Award from the WSU College of Liberal Arts. In 1998, Governor Gary Locke appointed Bill to the University Board of Regents. He recently served as President of the Board. He also served on the State Higher Education Coordinating Board.

He has an AV rating from Martindale-Hubbell, and is listed in the Bar Register of Preeminent Attorneys. He is married to Julie Marler and they have three daughters, Morgan, Olivia and Sydney. He is a past board member of the Washington State Trial Lawyers, a member of the board of directors of Bainbridge Youth Services, and a member of the Children's Hospital Circle of Care. He is involved in numerous other civic and political causes.

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Press Release
Source: Mary Ann Liebert, Inc.
Tuesday April 11, 8:01 am ET

NEW ROCHELLE, N.Y.--(BUSINESS WIRE)--April 11, 2006--The prevention and control of foodborne infections in the U.S. has improved significantly since the initiation of PulseNet, a nationwide program that enables the rapid analysis and comparison of DNA "fingerprints" of foodborne pathogens, as described in a series of reports in the Spring 2006 Special Issue (Volume 3, Number 1) of Foodborne Pathogens and Disease, a peer-reviewed journal published by Mary Ann Liebert, Inc. The issue is available free online at www.liebertpub.com/fpd.

PulseNet is a national network of public health and food regulatory agency laboratories, coordinated by the Centers for Disease Control and Prevention (CDC). The network performs standardized molecular subtyping (or DNA fingerprinting) of foodborne disease-causing bacteria using pulsed-field gel electrophoresis (PFGE). PFGE is a sensitive means of separating DNA and detecting patterns, or fingerprints that can be stored in a database and rapidly searched to distinguish between strains of disease-causing organisms, such as Escherichia coli O157:H7, Salmonella, Shigella, Listeria, and Campylobacter.

PulseNet is transforming public health and surveillance efforts to detect and investigate outbreaks of foodborne infection, identify the causative agent, and institute control and containment measures at an earlier stage. This interactive network and national database allows public health officials to track and compare outbreaks in multiple states or regions and to determine whether they represent a single large, but dispersed, outbreak and to trace the source of the pathogen.

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Ten Places You'd Better Observe a "Hands-Off" Policy
Be Vigilant to Stave Off Illness in Winter

Millions of germs writhe around and inside us at all times, and while 99 percent are harmless or beneficial to humans, pathogenic ones can in the worst case be fatal. A germ splits every 10 minutes: that makes four in 20 minutes, 64 in an hour and 16 million in four hours. Normally they coexist with people in peace, but then for one reason or another they suddenly attack. Here is a beginnerís guide for guarding against rogues.

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Swimming, one of the most popular activities in the country, is a fun, active, and healthy way to spend leisure time. Every year, millions of people visit ìrecreational waterî sites, such as swimming pools, water parks, hot tubs, lakes, rivers, or the ocean.

Over the past century, the use of modern disinfection systems in pools and environmental improvements in our lakes, rivers, and oceans has improved the quality of recreational water. Despite this, there has been an increase over the past decade in the number of outbreaks of illness associated with swimming.

Practicing "Healthy Swimming" behaviors should reduce the risk of getting ill. Click on the links below to learn more about RWIs.

What are recreational water illnesses (RWIs)?

RWIs are illnesses that are spread by swallowing, breathing, or having contact with contaminated water from swimming pools, spas, lakes, rivers, or oceans. Recreational water illnesses can cause a wide variety of symptoms, including skin, ear, respiratory, eye, and wound infections. The most commonly reported RWI is diarrhea. Diarrheal illnesses can be caused by germs such as Crypto, short for Cryptosporidium, Giardia, Shigella, and E. coli O157:H7.

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BY A STAFF REPORTER | Monday, March 27, 2006 11:3:49 IST

Do you really know whatís cooking in your kitchen?

Regular soap does not kill germs.

Common soaps only help wash the germs off your skin. Better to wash with good antibacterial soaps, which clean your hands and kill germs. Don't be concerned if you've read about building up resistance or creating 'supergerms.' You will not be attacked by mutant bacteria. A soapy hand-wash is still always healthy. Scrub your palms, between your fingers, across the top and under your fingernails for about 10 seconds-the time it takes to sing 'Happy Birthday'-then rinse and repeat for another verse.

Between 50 percent and 80 percent of all food-borne illnesses are contracted in the home.

Restaurants and supermarkets are bound to health codes by law: Food storage, food handling, utensil cleaning and cooking temperatures are all regulated. In the home, all bets are off. . There are more than 250 known food-borne diseases, including botulism, salmonella, shigella, listeria, campylobacter and hepatitis A.

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April 5, 2006
Fresh Cut: the magazine for value-added produce
Kimberly Warren

"Do I have to wash my salads?"

That's the one question consumers ask Dole more than any other when it comes to food safety. The answer, according to www.dole.com, is no.

"Dole Salads are thoroughly washed in purified water and are sold ready-to-eat,î according to the site. ìAs a result, it is not necessary for you to wash the salad prior to eating. Nevertheless, rinsing your salad again will not damage the lettuce or vegetables in any way."

This is just one way Dole reaches out to its consumers to share the company's food safety practices - and works to ensure food safety from the field to the dining room table. Openness and honesty to consumers about how the company deals with food safety is one of the most important aspects of Dole's overall quality assurance and food safety program, said Eric Schwartz, president of the fresh vegetables division of Dole. The Web site even allows people to take a virtual tour of a fresh-cut salad processing plant.

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