Shigella outbreak reaches Grant County

At least two Grant County residents are included in an outbreak of Shigella in Northern Kentucky.
Shigella is a bacteria that infects the bowels and causes the illness Shigellosis, which most often occurs in young children.
Eighty-seven cases of Shigellosis have been confirmed in Northern Kentucky as of June 17, according to the Northern Kentucky Health Department.
In Northern Kentucky, an average of 25 cases of Shigellosis are reported in a typical year.
Nationally, about 18,000 cases of Shigellosis are reported, but because many milder cases are not diagnosed or reported, health officials believe the actual number of infections may be 20 times greater.
There were 327 cases during a 2007 outbreak of the illness in Northern Kentucky.
“Shigella spreads very easily,” said Emily Gresham Wherle, public information administrator for the Northern Kentucky Health Department. “You only have to be exposed to a little bit of the bacteria to become infected. So, if the illness pops up in a community, it can really take root and lead to an outbreak.”
Symptoms include diarrhea, fever, stomach cramps, nausea or vomiting.
Some people may have mild or no symptoms, but still pass the bacteria on to others.
In some cases, severe diarrhea may require hospitalization to avoid dehydration.
In children less than 2-years-old, Shigellosis has been found to cause a high fever and seizures.
Children, especially toddlers aged 2 to 4, are the most likely to get shigellosis.
In the current outbreak, more than half of the cases are in children between the ages of 1 and 5.
In Northern Kentucky, many cases are related to the spread of the illness in child-care settings, and many more are the result of the spread of the illness in families with small children.
Shigellosis is spread through contact with the stool of an infected person, and then placing your hands, food or another object contaminated with the bacteria in your mouth.
Another way that Shigella can be spread, particularly during the summer months, is by exposure through swimming pools and spas.
If someone infected with Shigella has an accident in the pool, the bacteria can infect others if exposure occurs before the bacteria are killed by the chemicals in the pool.
Because of the ongoing outbreak, the health department is asking swimming facilities to exclude children who are not potty-trained from being in pools, spas or other water features until further notice.
Eight pools in Grant County, including any hotels or condos/apartment complexes with pools, are impacted.
“The restrictions on diapers in pools will limit exposure, meaning people won’t have the opportunity to get Shigella,” Wherle said. “How many people may have gotten sick without those restrictions would be hard to determine. We can compare this year’s outbreak to 2007—when pool restrictions were not implemented—to begin to access effectiveness.”
Wherle said a number of factors come into play when deciding whether to lift the restrictions on diapers in pools, including the rate of continued cases in a community, the age of those being infected, date of illness onset and related criteria.
“From what we’ve heard, most pools are enforcing the restrictions,” she said. “We will respond to complaints about kids in diapers swimming, and health inspectors will look for this issue on regular inspections. Should it be necessary, the health department could take action if the pool operators refused to comply with the request. The action would involve closure of the pool, most likely.”
Besides the restrictions in swimming pools, several other efforts are underway to prevent the spread of Shigella.
Child care centers are being monitored for cases while it is being recommended that water tables not be used.
Physicians offices are also being asked to report illnesses, update cases and provide information on diagnoses and treatment.
A person with Shigellosis is considered contagious until two negative stool cultures have been obtained 24 hours apart and 48 hours after the person has finished taking a round of antibiotics.
If a person thinks they have Shigella, Wherle said they should contact a health care provider.

Tips to avoid Shigellosis
• Wash your hands thoroughly with soap and running water after using the restroom, after changing diapers, and before preparing or eating food. This is the best way to prevent the spread of infectious diseases found in the intestinal tract, such as Shigellosis.
• Do not use wading pools for groups of children, because Shigellosis is transferred easily in standing water.
• Dispose of soiled diapers properly
• If you have diarrhea, stay home from work, school or day care until you are better. Also, do not prepare food for others while you have diarrhea. Do not go swimming in a public pool for at least two weeks. You may also want to contact your doctor for testing.