On April 1, the Pennsylvania Department of Health (DOH) issued an alert to physicians in southwestern and northwestern Pennsylvania, saying that the Allegheny County Health Department (ACHD) was investigating an outbreak of Shigellosis linked to daycare facilities in Allegheny County. The alert cited that an unusually high number of cases had been reported to the ACHD since last October. Increases in shigellosis also have been observed in surrounding counties in southwestern Pennsylvania.
An April 3 article in the Philadelphia Inquirer said there had also been six patients in Philadelphia who had been struck by a different type of Shigella, this one an antibiotic-resistant bug, during a 10-month period ending in February. Nationally, that number was at least 243.
The April 1 DOH alert said providers in the affected areas should:
- Maintain a high index of suspicion for shigellosis in patients who have symptoms clinically compatible with the Shigella infection (e.g., diarrhea, fever, nausea, vomiting, abdominal cramps), especially if they are associated with a child care facility, have recent international travel, or have other risk factors.
- Collect stool cultures for Shigella testing in these patients.
- Inquire about the food handler, child care provider, or health care worker status of the ill individual and close contacts.
The best defense against Shigellosis is handwashing, as the microbe is commonly spread when an infected person touches other people or prepares food for them.
Shigellosis is transmitted, directly or indirectly, via the fecal-oral route, and is highly contagious. DOH’s alert reminded providers that, due to this highly infectious nature of Shigellosis, infected individuals working or functioning in high-risk situations where transmission is particularly likely (child care facilities, health care facilities, and food establishments) are subject to the state’s communicable disease control regulations. DOH’s alert summarizes these regulations.
More information on Shigellosis is available on the Centers for Disease Control and Prevention’s website at www.cdc.gov/shigella.AC