Increase in Shigella Cases in Hillsborough County- Important Information

Hillsborough County is experiencing increased transmission and we ask your help to identify cases which is critical to our efforts in preventing Shigella infections. There have been over 40 confirmed cases since the beginning of October 2010, a notable increase in Shigella cases county-wide.  The current level has not been seen since 2005 and similar increases in Shigella have historically resulted in even higher levels.

Approximately 75% of the confirmed cases reported since October have been in persons ages 0-18. 
Symptoms of Shigellosis include:

• Watery (occasionally bloody) diarrhea
• Abdominal cramps/pain
• Fever
• Duration of illness: 3-7 days

Shigella is generally transmitted person to person and is highly contagious.  We recommend the following measures to reduce transmission:

• Children with suspected infectious gastrointestinal illness should be advised to stay home from schools or daycares until 24 hours after symptoms have resolved
• Reinforce good hand washing and hygiene measures
• Ill persons should refrain from preparing or handling food
• Confirmed cases of Shigella are required to have 2 negative stool specimens prior to returning to sensitive situations (daycare attendees or workers, food handlers, and health care workers)

When indicated, please test for enteric pathogens including Shigella.  Any of the following symptoms (especially in a patient who attends childcare or school) may indicate an increased likelihood of Shigella infection: diarrhea lasting 3 days or longer, bloody stool, or high fever.

Numerous other infections cause similar symptoms and require similar exclusion and infection control measures as mentioned above. At this time each year, we see a significant rise of norovirus in our community. Norovirus has very similar symptoms to shigellosis, but typically has a shorter duration of illness (usually 24-48 hours).  If you collect stool samples for a Shigella test, you may also consider ordering a test for Norovirus through a commercial laboratory.