Tag Archives: Shigella

46 sick with Shigella from imported fresh basil in Norway

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Eurosurveillance reports today an outbreak of Shigella in Norway that sickened at least 46 people.

Two municipalities were involved. A large cluster (42 cases) was concentrated in north Norway, while a small cluster (4 cases) occurred in the south-east region. Epidemiological evidence and traceback investigations have linked the outbreak to the consumption of imported fresh basil. The product has been withdrawn from the market. No further cases have been reported since 25 October.

On 9 October 2011, the Department of Infectious Disease Epidemiology at the Norwegian Institute of Public Health was informed by the Municipal Medical Officer and the Local Food Safety Authority in Tromsø (northern Norway) about an unusually high number of cases of gastrointestinal disease caused by Shigella sonnei.

A delicatessen and catering company located in the centre of Tromsø received several complaints from customers who had fallen ill with gastrointestinal symptoms after having eaten food items from there.

On 14 October, a small cluster of cases who had not been to Tromsø were reported and the outbreak was classified as national.

An outbreak case was defined as a person with gastrointestinal symptoms with laboratory confirmed infection with S. sonnei with indistinguishable multiple-locus variable number of tandem repeats analysis (MLVA) profiles in Norway after 1 October 2011.

Traceback investigations of ingredients in the pesto served in Tromsø are still ongoing. The same distributer that provided the fresh basil to the catering company in Tromsø also delivered fresh basil to the restaurant implicated in the second cluster in south-east Norway. The distributor imported this herb from a country outside the European Union and has voluntarily withdrawn it from the market. The National Veterinary Institute analysed samples of pesto and other ingredients from the catering company in Tromsø. Samples available for analysis have been negative. An epidemic intelligence information system (EPIS) enquiry has been posted to determine whether other European countries have observed a similar increase in cases infected with S. sonnei. So far, no other countries have reported any recent increase in cases that can be linked to this outbreak.

Kids can go back to the pool in Kentucky as shigella wanes

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As the temperature climbed to 105F today in Manhattan (Kansas) I was once again thankful for City Park, down the street, with it’s groovy new splash and water park.

Two-and-a-half-year-old Sorenne hasn’t had an accident – yet – but who knows if she will.

It’s a tough balancing act for city types – public health versus cool relief.

WLWT repots that children who are not toilet trained can again swim in public pools in Northern Kentucky, under revised guidelines issued by the Northern Kentucky Health Department on Thursday.

The restriction, in place since June 3, has been part of an effort to stop the spread of shigella. More than 100 cases of shigella have been reported in Boone, Campbell, Grant and Kenton Counties since April. Typically, about 25 cases are reported for the entire year.

"When faced with a shigella outbreak, a big concern is that the bacteria, and other similar illnesses, could infect a larger population through local swimming pools," said Dr. Lynne M. Saddler, District Director of Health, in a news release.

"The restriction on diapers in pools was an effective strategy. In past shigella outbreaks, when restrictions were not in place, we saw a significant increase of shigella cases and other recreational water illnesses in June. This June, with restrictions in place, we have not seen as many cases of shigella, or other illnesses, including cryptosporidium."

Other efforts to contain the Shigella outbreak will continue, focusing on child care centers and swimming pool facilities, officials said.

And keep those chlorine levels up.
 

Shigella outbreak in Kentucky causes pool scare

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A widening outbreak of shigella in northern Kentucky has residents keeping out of public swimming pools.

Eagle Country reports the Northern Kentucky Health Department says they’ve counted 74 cases, six of those in Boone County, as of June 7. The number of cases in an average year is 25.

The health department asks those who have been ill to stay out of the water for two weeks. Pools should also not allow non-potty trained children to be in them until further notice.

Some public pools, such as the Florence Aquatic Center, have closed while they undergo super chlorination.
 

A lovely cruise? Not for these passengers; know how ice is made

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Jimmy Buffett’s been singing Lovely Cruise since 1977, but it didn’t work out so well for half of the passengers on a Lake Michigan dinner cruise as reported in Epidemiology and Infection.

Of 72 cruise participants, 41 (57%) reported gastroenteritis. Stool specimens were positive for Shigella sonnei (n=3), Giardia (n=3), and Cryptosporidium (n=2). Ice consumption was associated with illness (risk ratio 2·2, P=0·011). S. sonnei was isolated from a swab obtained from the one of the boat’s ice bins. Environmental inspection revealed conditions and equipment that could have contributed to lake water contaminating the hose used to load potable water onto the boat. Knowledge of water holding and distribution systems on boats, and of potential risks associated with flooding and the release of diluted sewage into large bodies of water, is crucial for public health guidance regarding recreational cruises.

This took place on the same day as heavy rainfall, which resulted in 42·4 billion liters of rainwater and storm runoff containing highly diluted sewage being released into the lake.
 

Epidémie à shigella en belgique liée à un membre du personnel d’une cafétéria

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Qu’est-ce que Shigella ?

• Shigella est une bactérie qui va d’une personne à l’autre via une contamination transmise par la voie fécale-orale (ce qui signifie la présence de selles dans les aliments, sur les mains ou sur les surfaces).
• Les symptômes habituels peuvent comprendre du sang et du mucus dans des selles fréquentes (diarrhée), souvent appelée dysenterie.
• Si une personne est malade, elle peut transmettre Shigella aux autres personnes longtemps après que les symptômes ne soient plus présents.
• Shigella peut être transmis même si la personne ne montre pas de symptômes.

Les manipulateurs d’aliments peuvent transmettre Shigella dans leurs selles sans même montrer de symptômes

52 cas de shigellose liés à un manipulateur d’aliments sur une période de 2 mois

Que pouvez-vous faire ?
• Si vous êtes malade avec des vomissements, de la nausée ou une diarrhée, ne manipulez pas d’aliments ;
• Les manipulateurs d’aliments doivent se laver les mains avant de préparer les aliments et après passage aux toilettes.
• Les étapes du lavage des mains comprennent :
mouiller les mains, appliquer du savon, frotter les mains, les rincer et se sécher les mains avec un essuie-mains à usage unique.

Une récente étude parue dans Epidemiology and Infection a rapporté une épidémie de shigellose liée à la consommation dans une cafétéria belge. Les enquêteurs ont examiné les situations possibles conduisant à la maladie, analysé les aliments et réalisé des prélèvements de selles du personnel. Après analyse des prélèvements et après enquête auprès du personnel de maladie et de voyage récent, un membre du personnel a été identifié comme la source de l’épidémie.

Les enquêteurs ont découvert que le manipulateur d’aliments impliqué s’était rendu au Maroc peu de temps avant que des cas de maladies aient commencé à apparaître chez les clients. Ce membre du personnel est revenu travailler après le voyage et ne présentait pas de symptômes de la maladie. Seuls 13 des 52 cas signalés ont été confirmés par coproculture. Sept de ces cas ont été découverts avec la même souche de la maladie comme cela a été vu au Maroc au même moment.

Pour plus d’information contactez Ben Chapman, benjamin_chapman@ncsu.edu ou Doug Powell, dpowell@ksu.edu
 

Brote de Shigella 
en una cafetería en Bélgica causado por un empleado

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Traducido por Gonzalo Erdozain
Resumen del folleto informativo mas reciente:
– 52 casos de shigelosis conectados a un trabajador en un periodo de 2 meses.
– Preparadores de alimentos pueden transmitir Shigella 
sin tener síntomas de enfermedad.
– Si esta enfermo, y sus síntomas incluyen nausea, vomito o diarrea, no prepare alimentos.
– Preparadores de alimentos deben lavarse las manos antes de preparar/cocinar alimentos, y luego de ir al baño.
Los folletos informativos son creados semanalmente y puestos en restaurantes, tiendas y granjas, y son usados para entrenar y educar a través del mundo. Si usted quiere proponer un tema o mandar fotos para los folletos, contacte a Ben Chapman a benjamin_chapman@ncsu.edu.
Puede seguir las historias de los folletos informativos y barfblog en twitter
@benjaminchapman y @barfblog.
 

Food worker delivers Morocco strain of shigella; sickens 52 in a Belgian cafeteria

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On Nov. 13, 2009, a Belgian physician notified authorities about an apparent cluster of Shigella sonnei; ultimately, 52 cases were identified over two months, and most were linked to a canteen in a public institution building. Best guess is that a food handler who travelled to Morocco shortly before detection of the first laboratory-confirmed case, picked up shigella, and then transmitted it through food.

The details can be found in the current issue of Epidemiology and Infection, where researchers report on a matched case-control study to test an association between shigellosis and canteen-food consumption.

The three food handlers working permanently in the canteen responded to the questionnaire. Food handler A travelled to Turkey from 23 September to
4 October 2009. She started working on 7 October. She prepared sandwiches, washed dishes and served food. She fell ill on 20 October, and had been exposed to canteen food during the 4 days prior to disease onset. Food handler B travelled to Morocco from 23 September to 1 October. This person started working on 4 October and was involved in vegetable washing, preparation of hot meals, sandwiches, cold dishes involving vegetables and cleaning the canteen. He did not declare having fallen sick. Food handler C was also involved in all activities except in hot meal preparation. He had not travelled, been absent or fallen sick.

Of the 52 shigella cases found in 708 employees of a public institution in Flemish Brabant province, Belgium, between September and November 2009, seven cases were confirmed as S. sonnei. There was a common PFGE profile which resembled those from archived specimens from Morocco. Cases of
shigellosis were associated with canteen-food consumption.

Investigators worked with three hypotheses: (i) waterborne transmission through a contaminated water dispenser, (ii) person-to-person transmission or via surfaces (toilets), or (iii) foodborne transmission (through previously contaminated food or during the preparation process by a contaminated food handler).

Foodborne transmission through canteen food is supported by the results of the employee survey and by the matched case-control study. This led us to think that a food handler might have been the source of the outbreak. Food handler B returned from Morocco shortly before the appearance of the first confirmed cases. He did not report any symptoms and worked continuously since his return.

Foodborne transmission might have happened had he been an asymptomatic case. Healthy carriers can shed 102 Shigella c.f.u./g of feces during 1 month.
Thus, food handler B could have unintentionally acted as an intermittent source of food contamination during the period of faecal shedding. Conversely, food handler A, who had travelled to Turkey, could not be the source of the outbreak, since her onset of disease happened after the onset of symptoms of some confirmed cases.

The researchers recommend:
• washing hands with soap and water before eating and after defecation for employees and food handlers;
• preventing sick food handlers from working until full recovery or until negative fecal culture in the case of laboratory confirmation;
• maintaining surveillance of further possible cases of shigellosis through the institution’s prevention service; and,
• collecting information on the workplace when interviewing notifiable cases in order to detect infectious disease clusters early.

Shigellosis outbreak linked to canteen-food consumption in a public institution: a matched case-control study
01.feb.11
Epidemiology and Infection
I. Gutiérrez Garitano, M. Naranjo, A. Forier, R. Hendriks, K. De Schrijver, S. Bertrand, K. Dierick, E. Robesyn, and S. Quoilin
http://journals.cambridge.org/action/displayAbstract?fromPage=online&aid=8024291
Abstract
On 13 November 2009, the authorities of Flemish Brabant, Belgium, received an alert concerning a potential outbreak of Shigella sonnei at a public institution. A study was conducted to assess the extent, discover the source and to implement further measures. We performed a matched case-control study to test an association between shigellosis and canteen-food consumption. Water samples and food handlers’ faecal samples were tested. The reference laboratory characterized the retrospectively collected Shigella specimens. We found 52 cases distributed over space (25/35 departments) and time (2 months). We found a matched odds ratio of 3·84 (95% confidence interval 1·02–14·44) for canteen-food consumption. A food handler had travelled to Morocco shortly before detection of the first laboratory-confirmed case. Water samples and food handlers’ faecal samples tested negative for Shigella. Confirmed cases presented PFGE profiles, highly similar to archived isolates from Morocco. Foodborne transmission associated with the canteen was strongly suspected.
 

30 sick with Shigella in Daviess Co., Kentucky

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News25 reports the Green River District Health Department is confirming 30 cases of the bacteria illness called Shigella in Daviess County. Now, the Kentucky Department of Public Health is getting involved.

"We haven’t seen anything like this in a while," said GRDHD Regional Epidemiologist Janie Cambron.

NEWS 25 was the first to report health officials were investigating cases of Shigella in Daviess County. Since last Thursday, the number of confirmed cases jumped from 15 to 30. Health officials say none however stem from this past weekend’s Bar-B-Q fest where extra hand sanitizer were distributed.

Two other counties in the state are also reporting high numbers of Shigella. Prompting the state to become part of the investigation.

Of the 30 confirmed cases in Daviess County, 27 are with kids ages 13 and younger. Cambron says she’s talked with many concerned parents asking if their kids should stay home. If they attend a childcare center, they must be symptom free for 24 hours before returning.

Wash hands.

There’s a lot of poop moving around Kansas City transferring Shigella with it

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The Kansas City Missouri Health Department reports the metro area has seen some 300 cases of Shigellosis this year – when there usually are a dozen.

Jeff Hershberger said 75 per cent of the nearly 300 cases in the KC area have involved children 10-years-old and younger, and that the bacterium targets daycare centers, adding,

"People are usually good at washing their own hands after changing a diaper. But, they don’t remember to wash the child’s hands."

And those same children can then possibly spread those germs to you at your local supermarket. They can spread those germs by touching produce.

Illinois Subway still closed after illness outbreak

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Wash your damn hands so you don’t serve poop. That’s usually the key message when a shigella outbreak happens, although it could also be fresh produce grown in human poop.

Public health officials said Wednesday the number of people with confirmed cases of shigella associated with a franchised Subway restaurant in Lombard, Ill., has climbed to 78, with 11 of those individuals requiring hospitalization.

Dave Hass, public information officer for the DuPage County Health Department, said the Lombard Subway remains closed after two weeks, as his agency and the Illinois Department of Public Health continue to investigate the cluster of shigella illnesses. Ten of the 11 people hospitalized as a result of their illness have been discharged, he said.

Les Winograd, a spokesman for Doctor’s Associates Inc. of Milford, Conn., franchisor of the 32,502-unit Subway chain, said the franchisee at the Lombard store voluntary closed the restaurant after learning of the outbreak of illnesses.

Public health officials said shigella is spread through fecal contamination and that most people who are infected with the toxin develop gastrointestinal illness, such as diarrhea, vomiting, fever and stomach cramps, one to two days after being exposed.