On top of the lead issues in the Flint water supply, the city has now been hit with a large Shigella poisoning outbreak. There have been 177 reports of Shigella poisoning in Flint and the surrounding areas over the last 7 months. Luckily, there have not been any reports of hospitalization or death linked to this outbreak. Both Saginaw and Genesee counties have reported illnesses. The 177 cases of illness have reported start dates between March 1 and October 26, 2016. Health officials have reported that the rate of new illnesses is slowing. There were less reported Shigella poisonings in September than in previous months. October has not been completely analyzed yet, so new illnesses may be added to the total. In fact, Shigella poisoning is a very common form of foodborne illness, and it usually generates illnesses all year long. Health officials have studied the rate of infection, and declare an outbreak when the rate of infection goes up suddenly and exponentially. State and local health officials have also reported that the CDC has joined the investigation, and are hoping to find a source for the outbreak.

Flint has been in the news quite a bit recently, even making it onto the national news earlier this year. In the spring of 2016, reports of high levels of lead came out of Flint, Michigan. The Flint city government disconnected from the Detroit Water and Sewage Department in 2014, opting to use water from the Flint River. The economic issues in the city of Flint forced the switch. It was much cheaper to use the water of the Flint River than it was to use water from Detroit. Eventually, many people began to experience the symptoms of lead poisoning. Much of the lead probably came from lead piping used by the city. The city of Flint, after finding lead in the water supply, began to replace as many as 8,000 pipes. The situation continued to deteriorate. Then, more than 500 Flint residents filed a class action lawsuit was filed against the EPA. This was not the end of the story for Flint, Michigan though. It later became clear that there was an outbreak of Legionnaires disease also impacting the city. This outbreak began to affect Flint in June 2014, around the same time the water supply was changed. There were over 90 people sickened between June 2014 and October 2015. There were twelve reports of death associated with that outbreak.

Shigellosis is a common foodborne illness caused by a family of bacteria called Shigella. There are 4 different types of Shigella bacteria: Shigella sonnei, Shigella flexneri, Shigella boydii, and Shigella dysenteriae. Shigella dysenteriae and Shigella boydii are not usually found in the United States. In the United States, where about 500,000 cases of Shigellosis occur annually, Shigella sonnei is the most commonly found bacteria of the Shigella family. A Shigella infection does not require that many of the bacteria to be present, so it is very easily spread from person to person. When someone is infected with Shigella bacteria, they will begin to see symptoms in 1 or 2 days. The symptoms usually associated with Shigellosis include diarrhea, abdominal pain, fever, and bloating. Usually, though, someone with a healthy immune system will see the illness clear up within a week. Arthritis, seizures, hemolytic uremic syndrome, and even bloodstream infections are all potential, but rare, complications that present with a Shigella infection. If a person is infected with Shigella, they can develop a resistance to that specific strain of the bacteria for a few years after the infection. Infections from other strains of the bacteria are still possible, though.

When someone is diagnosed with Shigellosis, there are several treatment options. In those with mild cases of illness, rest and liquids may be all that is required. There are also medications that can help with the symptoms of the infection, including products made with bismuth subsalicylate. In severe cases, antibiotics may be prescribed in order to shorten the life of the illness, but this can run into problems. Shigella bacteria are known to be fairly resistant to antibiotics. In fact, the CDC said in 2013 that the antibiotic resistance of Shigella bacteria is an urgent health crisis in the United States. Approximately 27,000 of the yearly cases of Shigella infection are from resistant bacteria. If antibiotics are being considered, then it may be a good idea to do further testing to make sure that the strain of bacteria causing the illness is not resistant to antibiotics.

Again, a large amount of the bacteria is not necessary for someone to become infected. Shigella bacteria remain in the stool for up to two weeks after symptoms have subsided, and a tiny amount of fecal matter, even if it is too small to see, may cause an infection. This means that Shigella is very contagious, and is more likely to affect those who do not practice proper hygiene, eat food prepared by an ill person, or swallow lake or river water. Even though only a small amount of the bacteria is required to cause an infection, it is still a relatively easy process to prevent Shigella infections.

The easiest way to prevent the spread of Shigella infections is to practice proper handwashing. This is likely why the Shigella outbreak is occurring in Flint, Michigan. After the lead and Legionnaires’ Disease issues, many residents of the city avoid tap water at all costs, even going so far as to avoid bathing and hand washing all together. In these cases, the residents have taken to using baby wipes as a way to maintain hygiene. Although they are helpful, these baby wipes do not contain chlorine or any other bacteria killer, making it almost impossible to remove any Shigella bacteria that may be on a person’s hands. The CDC stresses that only proper hand washing, using soap and hot water, is able to kill or remove the bacteria that may have contaminated a person’s hands. If you or a loved one begin to show the symptoms of Shigellosis, contact a medical professional and make sure that you and your family are practicing proper hygiene in order to prevent others from becoming sick.

Sources:

http://gchd.us/wp-content/uploads/2016/11/Update-Letter-to-the-Community-Shigella-FINAL-10.26-2.pdf

http://www.cnn.com/2016/10/03/health/flint-water-shigellosis-outbreak/

http://www.cdc.gov/shigella/general-information.html