Number of Shigella Disease Cases Rising in Kansas City, Missouri

Shigella disease cases on the rise in Kansas City, Missouri
Health officials urge residents to take precautions to prevent infection

The Kansas City, Missouri, Health Department is seeing a significant increase in the number of reported Shigella cases. Shigella is an infectious diarrheal disease caused by bacteria. Normally, there are only 10 cases of shigella per year in Kansas City. Since January 1, 2015, the department has investigated more than 143 cases with the majority of cases in children in daycare and elementary schools.

Shigellosis is transmitted by direct or indirect fecal-oral contact with a person having symptoms. Symptoms include: abdominal pain or cramps, fever, watery diarrhea, stool with blood or mucous, tenesmus (the urge to continue to go to the bathroom when your bowels are empty), vomiting and fever. A notable complication among young children may be convulsions.

A person infected with Shigella is infectious from the time they begin having symptoms until there is no presence of Shigella in the stool. If left untreated, organisms can remain in the stool for 4 weeks or more. Patients treated with appropriate antimicrobials may have stool carriage of Shigella reduced to a few days.

“What is also concerning is that that we are seeing three different strains that are resistant to certain antibiotics,” said Tiffany Wilkinson, Acting Communicable Disease Prevention Division Manager. “It only takes a few bacteria, sometimes as little as 10 organisms, to infect someone.”

To prevent Shigella or any other foodborne illness:

• Wash your hands frequently, thoroughly and correctly with soap and warm water and use paper towels for drying. Educate smaller children regarding proper hand washing techniques and supervise hand washing.
• Those infected should not prepare food or drinks for others until they have been shown to no longer be carrying the Shigella bacterium.
• Dispose of diapers from infected children correctly. The diapers should be put in a closed-lid garbage can and then your hands should be immediately washed carefully with soap and water, as well as the child’s after changing or disposing of the diapers. Diaper changing areas should be disinfected with household bleach, Lysol or bactericidal wipes, according to directions.
• Keep children and adults with diarrhea out of swimming pools, spas, and all shared water (including bath tubs) for 2 weeks following the end of diarrhea.

Certain groups of people with Shigella require 1 or 2 successive negative stool cultures before returning to work or daycare. They include:

• Children who attend daycare – require 1 negative stool
• Persons who provide daycare or work in daycare – require 1 negative stool
• Persons who work as food handlers — require 2 negative stools
• Persons who provide health care — require 2 negative stools

The specimens for these tests must be collected no sooner than 48 hours after finishing any antibiotic, if prescribed, and 24 hours after the last bout of diarrhea. If two negatives are required, they must be collected at least 24 hours apart.

Media inquiries on this topic should be directed to the media phone at 816-719-3610.