Shigella Blog - Surveillance & analysis on Shigella news & outbreaks

WDRB reports that Jefferson County Kentucky schools are currently seeing a significant increase in Shigella illnesses: 

In the last few months health officials say they've noticed the increase in Shigellosis.

A letter went out to all schools on Wednesday from the health department and will soon alert parents of the outbreak in Louisville.

On November 30th, a notice from Louisville Metro Public Health & Wellness said the health department had received reports of Shigellosis, a diarrhea illness caused by Shigella bacteria, which is highly contagious.

"Unfortunately, this is something that is transmitted fecally orally. So, since kids aren't paying as much attention to hygiene sometimes, or parents who are taking care of kids who have a diarrhea illness, that can be a challenge," says Dr. Paul Schulz, Medical Director of Infection Prevention with Norton Healthcare.

Fast-forward to this week and now a JCPS spokesperson says the health department has asked all schools to send out a notice to students about an outbreak of Shigellosis in Jefferson County.

JCPS spokesperson, Lauren Roberts, says they are sending the letters out because they've been asked to, and not as a result of any particular case in the school.

The health department has averaged 62 cases a year of the illnesses for the last five years.

However, in the last 3 months, they say they've already seen 60 cases.

"Technically we would call this an epidemic and try to do things to reduce that spread, like putting out these kinds of notices so that parents, teachers and other folks in the community are more aware," says Dr. Paul Schulz.

The symptoms include blood in stools, fever, nausea, abdominal cramping and vomiting.

One of the ways they say you can prevent the spread of the disease is to wash your hands carefully, and often. They say it's especially important to wash your hands after changing diapers, using the restroom, after helping a child use the restroom, or before preparing or eating food.

Dr. Paul Schulz, with Norton Healthcare, also recommends not going to school or work if you have the illness to avoid spreading it to other people.

Going to the doctor is at the top of the list.

"Even if you don't feel like you're that ill, getting evaluated and diagnosed and treated can be a good thing for you and the community," says Dr. Paul Schulz.

There are antibiotics that doctors can prescribe to help you treat this illness.

The Health Department wants everyone to be aware, and take precautions.

Originally reported as an outbreak only at Worth County public schools, the Southwest Health District has indicated that the Shigella outbreak has spread to 6 counties.  Shigella is a highly contagious and infectious disease. Ingestion of fewer than 100 Shigella bacteria can cause food poisoning (American Public Health Association [APHA], 2000), making Shigella one of the most communicable and severe forms of the bacterial-induced diarrheas (Gomez et al., 2002).

Most Shigella infections are passed through the fecal-oral route. This happens when basic hygiene and handwashing habits are inadequate and can happen during certain types of sexual activity.  Shigella outbreaks are particularly likely to occur among toddlers who are not fully toilet-trained. Family members and playmates of such children are at high risk of becoming infected.

Shigella is the third most common pathogen transmitted through food. In FoodNet surveillance areas in 2008, the rate of Shigella food poisoning was 6.6 per 100,000 population, exceeded only by Salmonella (15.2/100,000) and Campylobacter (12.7/100,000) (CDC, 2009c).

Shigella is also responsible for a substantial portion of foodborne outbreaks on cruise ships. In a review of cruise ship outbreaks worldwide over several years, 16% of outbreaks were attributed to Shigella, affecting over 2,000 passengers (Rooney et al., 2004). Sanitation violations related to food handling and communicable disease have decreased substantially over the past 15 years (Cramer et al., 2008).

The Dupage County Health Department confirmed that at least 140 people have been culture confirmed with Shigella sonnei infections contracted at a Chicago-area Subway restaurant in March of 2010. Ten were hospitalized. Health authorities closed the restaurant at 1009 E. Roosevelt in Lombard and launched an investigation into the source of the outbreak.

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.” A person can contract shigellosis by ingesting only a few organisms, which makes shigellosis the most communicable of the bacterial-induced diarrheas.

The Northern Kentucky Health Department had placed restrictions on toddlers who are not potty trained from using the pools June 3 after a Shigella outbreak. About 300 public pools in the region were affected.

On Thursday, the health department eased those restrictions aimed at limiting the spread of the illness.

There are still concerns that Shigella may continue to spread through child care centers, then to family members of young children.

The department says they’ve received 103 reports of Shigella in Boone, Campbell, Grant, and Kenton counties since April. There are typically only 25 or so cases in a year.

Shigella is a bacteria that infects the bowels, usually in children ages two to four. The Shigella bacteria causes an illness called Shigellosis. Symptoms include diarrhea, fever, stomach cramps, nausea or vomiting.

The health department in northern Kentucky is enacting a new rule for all public pools. Children who are not potty trained are no longer allowed in public pools, even those wearing swim diapers.

The health department says it will protect the community from the highly contagious bacteria called Shigellosis, which can easily be spread, even in highly chlorinated pools.

"Even if your child is healthy, you don't know about other children or other toddlers who are not toilet trained who've been in that water," said Dr. Lynne Saddler, NKY District Director of Health.

Shigella is very common among children, and symptoms include diarrhea, fever, cramps and vomiting.