Shigella surfaces in Georgia

WSAV reported on a Shigella outbreak in Effingham, Georgia, on Friday:

A number of Effingham County students are suffering from a bacterial infection in their digestive systems.

Health officials in the Coastal District say it is common to find shigellosis infections this time of year, but they are seeing a larger number of cases in the last couple of weeks.

Health officials are encouraging people to use proper handwashing techniques to prevent the spread of illness.  Shigellosis, the illness caused by ingestion of the Shigella bacterium, causes nausea, abdominal cramping, and diarrhea.

Preventing Shigella Infection

How can a Shigella infection be prevented?

The spread of Shigella from an infected person can be stopped by frequent and careful hand washing with soap and water.[11] The ill individual should practice this, as well as any contacts. Supervised hand washing of all children should be followed in day care centers and as soon as children return home.[12] Young children with a Shigella infection, or with diarrhea of any cause, should not be in contact with uninfected children.

If a child in diapers has shigellosis, everyone who changes the child's diapers should be sure the diapers are disposed of properly in a closed-lid garbage can, and should wash his or her 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 or bactericidal wipes.

At swimming pools, maintaining a chlorine level of at least 0.5-PPM will kill Shigella. At swimming beaches, 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.

Basic food safety precautions will also help to prevent shigellosis. 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 bacterium.

Drink water only if it has been chlorinated (most tap water) or treated with ozone (most bottled water) and then you know it will not contain pathogenic bacteria. Consume only pasteurized dairy products.

In the developing world, shigellosis is far more common and is present in most communities most of the time. Simple precautions taken while traveling to the developing world can also prevent getting shigellosis.[13] Drink beverages only if they are imported (e.g. Evian), carbonated (e.g. cola - without ice), boiled (e.g. coffee) or have been in contact with alcohol for a prolonged period (e.g. wine or beer, not mixed drinks). Eat a cooked diet with the exception of fruits you peel yourself.

11. Doyle MP, Ruoff KL, Weinberg WG. Reducing transmission of infectious agents in the home. Dairy, Food and Environmental Sanitation, 2000; 20:330-337.

12. Krilov LR; Barone SR; Mandel FS, et al. Impact of an infection control program in a specialized preschool. Am J Infect Control, 1996; 24:167-73.

13. Weinberg WG. No Germs Allowed! How to avoid infectious diseases at home and on the road. Rutgers University Press, New Brunswick, NJ, 1996.

Drug resistance linked to Shigella outbreaks

According to the Lexington Herald-Leader, many of the shigellosis cases during Lexington's 2005 day-care outbreak were resistant to multiple first-line antibiotics.

Yesterday's MMWR, a publication from the Centers for Disease Control, included a report on antibiotic-resistant  Shigella outbreaks in Kentucky, Kansas, and Missouri.  The outbreaks were all caused by multi-drug-resistant strans of the Shigella bacterium, meaning individuals ill with Shigellosis, the illness caused by Shigella,  had to be treated with several different antibiotics before doctors were able to treat patients with a prescription drug that could kill the bacterium.

The Herald-Leader article reports that:

The CDC published the report to alert doctors that although the antibiotics ampicillin and trimethoprim-sulfamethoxazole had been the drugs of choice for treating shigellosis, the bacteria is now often resistant to them. Ciprofloxacin is effective in knocking out the bacteria, but it's not approved for use in children.

From May 1 to Aug. 31, 2005, 148 cases of shigellosis were confirmed in Fayette County -- a 42-fold increase above the previous five-year averages. Ninety-three percent of the cases happened to children or staffers at 16 day-care centers in the county, or family members of the children.

Food Illnesses decline, CDC reports

AP Medical Writer Marilynn Marchione, wrote about the recent decline in foodborne illnesses, as reported by the CDC.  She spoke with several scientists and regulators from the food industry about the reported declines.

"The meat and poultry industry has made great strides. The produce industry has a long way to go to catch up," said Michael Doyle, a microbiologist who heads the University of Georgia's Center for Food Safety.

Ms. Marchione wrote in the context of the recent E. coli outbreak traced to spinach from the Salinas Valley:

The spinach sickened 187 people in 26 states, hospitalized 97 of them and killed one. Outbreaks typically are far larger than the number of lab-confirmed cases reported to federal officials, Tauxe noted.

Germs in food make 76 million Americans sick, send 323,000 to hospitals and kill 5,000 each year, the CDC estimates.

But the situation greatly improved over the last decade, according to illness statistics the agency reported Friday at a conference of the American Society for Microbiology.

In 2005, compared with the 1996-98 period when the CDC's FoodNet tracking system began, illnesses were down for virtually every major germ.

CDC estimates the declines as follows: yersinia, 49 percent; shigella, 43 percent; listeria, 32 percent; campylobacter, 30 percent; the dangerous O157 strain of E. coli, 29 percent; and salmonella, 9 percent.

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Parents alerted about disease found at Chiefland Elementary

The Chiefland Citizen reported on September 27, 2006 that:

A Sept. 14 letter distributed to parents of Chiefland Elementary School children warns of a disease known as Shigella, which can go undetected for seven days and the carriers of the disease may not show symptoms.

Those symptoms are: watery, bloody or loose stool, fever, and headache or cramps.

Shigella is spread from person-to-person, or by eating or drinking contaminated food or beverage, or by touching a contaminated object, according to the letter by Elizabeth Powers, R.N., with the Levy County Health Department.

Levy County Health Department Administrator of Health Barbara Locke, R.N., M.P.H., said Shigella is a fecal-oral bacterial infection of the intestines.

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