Small Outbreak of Shigella Infection in Dane County Reported

November 1, 2012

Useful Information on the Disease and its Prevention

Public Health - Madison and Dane County (PHMDC) reports that there have been 17 cases of shigella infection occurring between September 20th and October 30th. In comparison, nineteen cases of shigella infection were reported in Dane County in all of 2011.

Shigellosis is an infectious disease caused by a group of bacteria called shigella. Shigella symptoms include diarrhea, fever, and stomach cramps starting a day or two after exposure to the bacteria. The diarrhea is often bloody. Laboratory analysis of the bacteria suggests that 12 of these cases were caused by bacteria that were genetically similar, which suggests that the cases are related in some way. All but three of the cases live in Madison (the North-East side, the South side). The others are in Belleville, Monona and Stoughton. It is likely that there are more unreported cases in the area.

Shigella infections are the result of the bacteria passing from improperly washed hands of one person to the mouth of another person, often through handling contaminated objects or food. Poor hand washing and hygiene (especially after changing diapers or toileting), as well as some sex practices, can increase the risk of infection. Infected toddlers who are not fully toilet-trained can also promote the spread of the infection. Family members and playmates of such children are at high risk of becoming infected.

People with shigellosis rarely require hospitalization. However, a severe infection with high fever may be associated with seizures in children less than 2 years old. Some people who are infected may have no symptoms at all, but may still be able to pass the shigella bacteria to others.

Those with mild infections usually recover quickly without antibiotic treatment. However, appropriate antibiotic treatment kills shigella bacteria, and may shorten the infectiousness by a few days. Popular anti-diarrheal medications such as loperamide (Imodium®) or diphenoxylate with atropine (Lomotil®) can make this illness worse and should be avoided.

People diagnosed with shigella should NOT be working in food and health care settings until they have had two negative lab tests (stool cultures) 24 hours apart, with the first sample collected at least 48 hours after the last dose of antibiotics. People who attend or work in a day care setting are also required to have a test proving that they are cured before they may return to the site. PHMDC will work with affected individuals to ensure tests of cure are complete.

PHMDC has alerted health care providers and other organizations (schools, daycares etc) of this outbreak asking them to make sure people are properly tested.

The CDC has six simple steps to help prevent and avoid this uncomfortable, inconvenient and occasionally serious illness.

• Wash hands with soap carefully and frequently, especially after going to the bathroom, after changing diapers, and before preparing foods or beverages.
• 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 toddlers and small children after they use the toilet.
• Do not prepare food for others while ill with diarrhea

For more detailed information about shigella, see
http://www.cdc.gov/nczved/divisions/dfbmd/diseases/shigellosis/#tips
and
http://www.dhs.wisconsin.gov/communicable/diseasepages/Shigellosis.htm

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NEWS RELEASE
Public Health - Madison & Dane County

Contact:
  • Jeff Golden, (608) 243-0302