Twenty-one cases of Shigella had been confirmed in eastern Cuyahoga County and western Lake County as of Jan. 20, and more cases were reported this week, according to officials of the Cuyahoga County Board of Health. Some cases have occurred in the Orthodox Jewish community.

“The Academy’s health professional saw a handful of cases,” Rabbi Simcha Dessler, dean of Hebrew Academy of Cleveland, said Jan. 23. “As with any health-related issues, we immediately contacted the Cuyahoga County Department of Health and continued to follow their lead. A letter and fact sheet with comprehensive information and prevention strategies were sent out to the parent body.”

Amy Anter, program manager in epidemiology at the Cuyahoga County Board of Health, said the board had been in touch with Mendel Singer, Ph.D., associate professor at Case Western Reserve University School of Medicine, director of Jewish Community Health Initiative, and CJN blogger, to help convey information about the illness.

“Shigella does pop up in the Orthodox community from time to time,” Singer said. “When there are lots of kids in diapers and not fully toilet-trained, there are opportunities for the illness to spread. It’s extremely contagious, and it takes very little of it to cause infection.

“Hand washing with warm water and soap is the best defense,” Singer said. Within the Orthodox community, soap (that requires lathering) and pre-moistened wipes (that often require tearing) become an issue on Shabbat. He recommends liquid soap as a substitute for bar soap and advises keeping soap available where ritual hand washing is taking place. If pre-moistened wipes aren’t used when diaper changing, cleaning with “Shabbat-friendly” wipes is needed, he said.