The Kansas Department of Health and Environment (KDHE) and The Shawnee County Health Department (SCHD) are currently investigating cases of Shigellosis in 2 adults and several children at a local preschool. They did not specify the name of the school though. Topeka Unified School District 501 has confirmed cases of Shigellosis at a particular center called Sheldon Child Development Center.

The Shawnee County Health Department has sent a letter to inform the parents of the steps they need to take if their child shows symptoms of Shigellosis, such as: diarrhea, abdominal cramps, etc.

Shigella infections are responsible for 300,000 illnesses and 600 deaths per year in the United States. The hospitalization rate associated with Shigella is also very high with an estimated 62,000 hospitalizations per year. Globally the burden of Shigellosis is 165 million cases per year out of which 163 million are in developing countries. The fatality rate associated with Shigella is around 10-15%, the rate is even higher in developing countries.

Shigellosis and children?

Shigella’s main victims are children, HIV patients, and those with weakened immune system. Most of the Shigella outbreaks are also associated with places that have more children like day care centers, nursing homes, etc. Some other most common settings for Shigellosis outbreaks are institutional settings (like prison) or cruise ships. In fact, Shigella is responsible for 16% of all the cruise ship outbreaks. Shigella spreads when you come in contact with the contaminated feces. Of these, 80% of all cases of Shigella are as a result of person to person infection.

Small children are not able to maintain proper hygiene. This is the main reason why Shigella is so common among children.

Another major reason why Shigella is so common among children is because they are not yet immune to S.Sonnei. Shigella bacteria is divided into 4 major subgroups A, B, C and D. S. Sonnei is Group D Shigella, which is responsible for two-thirds of Shigella. Group B is responsible for all the rest.

Complications that can arise in children due to Shigella:

Children less than 2 years old who have suffered from an infection do have chances of developing a severe infection accompanied by a fever that might turn into a seizure.

Hemolytic Uremic Syndrome (HUS): This complication predominantly affects children even though adults can also be its victims. This syndrome is associated with hemolytic anemia (destruction of RBC’s), a low platelet count and acute kidney failure. HUS is a severe condition and those affected need to get medical care immediately.

Reactive Arthritis: Reactive arthritis is a long term effect of Shigella that can lead to swollen joints and swelling due to an infection in some other part of the body.

Wrongful Death: Shigella is associated with a high fatality rate especially in the developing countries. With the complications that can arise with Shigella, there is a high chance of death associated with the infection.

Is Shigella communicable?

Shigella is one of the most communicable type of bacterial diarrhea that exists. No person is immune to Shigellosis. Considering the nastiness of the virus, there is an ongoing research for development of Shigella vaccine. Since children are a major victim of this virus, most of the cases of Shigella will automatically go down once the vaccine is injected.

Shigella can spread by a relatively tiny dose of infection (less than 100 bacteria are required to catch the disease). That is a very tiny amount of bacteria, which is why it is so easy for Shigella to transfer from person to person.

Another reason why Shigella is so dangerous because the bacteria thrives easily in the intestine of humans, which makes it so easy to transfer both from person to person and contamination of food, water, etc.

Here are some of the ways Shigella can spread:

  • Eating food or drinking water that has been contaminated with the germs. Eating food that has been prepared by someone who has Shigella. 20% of all Shigellosis infections are caused by food. In fact, in a research done by FoodNet, Shigella was in the top 3 pathogens that were responsible for foodborne illnesses along with Salmonella and Campylobacter.
  • Getting Shigella germs on your hands by the contaminated feces and then getting those hands near your mouth and using them for eating or cooking can also risk infection.
    • People working at daycare have higher chances of getting the germs through this kind of transmission because they have to change the diapers of the babies and kids.
    • Small children and babies can also get germs on hands through their own poop sometimes. Children take their hands in their mouth a lot. They also touch a lot of toys and infect it. Other children can get hold of germs by touching or taking in mouth the infected toy. Since a very small amount of dose is required for transmission, a small amount of feces and a touch is enough for contamination.
  • Swallowing or coming in contact with recreational water, like pools that have been contaminated with infected stools.

The treatment of Shigella can depend on how strongly the symptoms have developed. If the symptoms are mild, then the doctor generally do not prescribe any medicines and let immunity do its work. The patient is advised to rest and take plenty of fluids. In other cases antibiotics such as cefixime, ampicillin or trimethoprim are prescribed. Due to growing antibiotic resistance, the choices of treatment are limiting over time. It is best that we take good care of our hygiene and wish for Shigella vaccine to develop in order to avert the antibiotic resistance crisis.

Sources: