hand washing.jpg

Hand washing is the best prevention while health officials seek a link between shegellosis cases in Kalamazoo County.

(File photo)

KALAMAZOO, MI -- State health officials are helping Kalamazoo County health workers try to track the source or sources of a nasty bacterial intestinal bug that has taken a leap in numbers here since April.

While the investigation continues, the public's best protection is thorough, soapy hand washing, said Mike Phillips, disease surveillance nurse, Kalamazoo Community Health and Community Services.

Since April, Kalamazoo County has been logging more cases than usual of shigellosis, an acute bacterial disease involving the intestinal tract, with 29 cases so far this year. A more typical year sees fewer than eight cases, Phillips said in an interview Friday. The incidence of the disease in other counties--nonexistent or at those typically low numbers-- can be seen in the Michigan Department of Community Health's Weekly Surveillance Report.

Shigella is virulent bacteria, requiring less that 10 organisms to cause infection, Phillips wrote in the Summer 2014 edition of the county's Public Health Notes newsletter. Transmission can be caused by contact with a sick person, or the illness can be spread when the bacteria shed by a sick person or carrier is transmitted to food, objects, or other people. It can persist three or four days outside of the human body, scientists believe.

Onset of symptoms -- watery diarrhea, diarrhea with blood, fever,

abdominal cramping, bowel spasms, and sometimes nausea and vomiting-- typically occurs 12 hours to three days after exposure.

Outbreaks elsewhere in the country have been traced to drinking water, swimming in contaminated water, and men having sex with men, but the local source of transmission has so far eluded investigators and may never be found, Phillips said. "We're looking really hard at it, we've got a lot of hours on it," he said.

Unlike the similar viral intestinal disease, norovirus, which lasts only a few days, shigellosis symptoms can persist four to seven days, Phillips said.

The infection generally goes away with or without antibiotic treatment, he said, but convulsions can be a significant complication in young children.

The lab-confirmed cases from Kalamazoo County come from seven zip

codes in the county and include children and adults of both sexes, he said.

Ages range from 2 to 78 years old.

Although health officials have been "looking intensively" since the spike in shigellosis cases was noticed, carefully investigating where each victim lives, eats and travels, no link between them has yet been found.

Not as much is known about shigellosis as some other contagious diseases, so scientists aren't sure whether people continue to spread the bacteria after symptoms have ended, whether antibiotics will halt the spread, or how long it might persist in different conditions, he said.

In addition, the 29 cases only represent those that have been reported to the health department to date, Phillips said. The Kalamazoo County department sent a

to health care providers, daycare centers, summer camps, schools and other places that might encounter illness to let them know about the bacteria's presence here and to ask them to be on the lookout for symptoms that might be shigellosis.

Phillips said the best way to avoid getting the illness and to stop its spread is to be diligent about hand washing and to keep people who have had diarrhea out of swimming pools and lakes.

"We're still at a learning curve here, but a good 15-second scrub with running water and soap is the number one prevention," he said. "Nobody is going to get shigella if they wash their hands."

Angela Minicuci, public information officer for MDCH, said the department is working with the Kalamazoo County Health Department on the investigation and is continuing to monitor other counties as well.

"Shigella is highly contagious," she said. "We agree with the hand washing message and additionally, we would like to stress further ways to minimize risks. Food handlers should be screened clear before returning to work and residents should stay out of common water areas such as swimming pools for two weeks following the resolution of symptoms. "



For more information about the illness, click here.

Updated:June 27, 7:40 p.m. to add state health department input.