Shigellosis Disease on the Increase

The Chattanooga-Hamilton County Health Department is seeing an increase in cases of Shigella infection. Shigellosis is the disease that results from Shigella infection.

Since January 2008, the Health Department has received 139 reports of Shigella infection, as compared to 3 total cases in 2007 and 8 total cases in 2006. To date, the majority of cases have occurred in children 10 years and younger. Cases of Shigella infection have markedly increased in the past year, and spiked in October.

Shigella spreads easily among children in daycare and school environments. It is then common for illness to spread to family members. Cases continue to occur in Hamilton County, and the Health Department is asking the community to do their part in helping stop the spread of this illness.

Shigella is a bacterium that causes symptoms ranging from mild diarrhea to diarrhea with blood and mucous. In severe cases, it can cause dehydration, fever, severe abdominal cramps, vomiting, headache and even convulsions (in young children). The illness can last from 4 to 7 days and typically starts 1 to 3 days after exposure to the bacteria.

Because Shigella is present in the stool of infected people, without appropriate control measures the germ can be spread to the mouth of other people either by direct contact with an infected person's stool or by eating or drinking contaminated food or water. Without treatment by a doctor, the bacteria can continue to be found in the feces and potentially continue the spread to others.

"The Health Department has been working with local physicians, school administrators, parents, and daycares to provide education regarding effective ways to control the spread of the illness," said Sarah Stuart Chewning, Epidemiologist at the Health Department. "However, cases of Shigella continue. It is our responsibility as a community to work to stop the spread of this disease, which a simple action like handwashing can prevent."

The most effective way to prevent the spread of Shigella, like many other diseases, is frequent and careful handwashing with soap and water. Wash hands after going to the bathroom or changing diapers, before preparing or handling foods, before and after meals, after touching raw meat or poultry, after blowing your nose, coughing or sneezing on your hands, after touching a cut or sore, after handling pets, and whenever they are visibly dirty.

Frequent and careful handwashing is effective at preventing the spread of illness for all age groups. It is very important to supervise and help young children wash their hands to ensure proper technique. Proper handwashing technique includes always using soap and running water, rubbing hands together vigorously until soap lathers and continuing for 15 to 20 seconds, washing all hand surfaces thoroughly, including between the fingers and under the nails, rinsing hands with warm running water, and then drying hands with a clean, disposable towel.

In addition to handwashing, other effective measures for controlling the spread of Shigella include:

• · Keeping children and staff with diarrhea out of child care and school settings
• · Not preparing food for others while ill with a diarrheal illness
• · Properly disposing of soiled diapers
• · Properly sanitizing restrooms, water fountains and other areas where fecal contamination can occur
• · Avoiding swallowing water from ponds, lakes, rivers or untreated pools

Anyone who develops severe diarrhea should contact their healthcare provider. Shigella is reportable to the Chattanooga-Hamilton County Health Department; the number of cases is tracked and investigated in order to take steps to control the spread of the illness.

If you have any questions, please call the Hamilton County Health Department, Epidemiology Department at (423) 209-8190 from 8:00 a.m. to 4:00 p.m. Monday through Friday. For additional information about Shigella, you can visit the Centers for Disease Control and Prevention website at www.cdc.gov/nczved/dfbmd/disease_listing/Shigellosis_gi.html.