Iowa Reports Ongoing Shigella Outbreak – 167 Cases Confirmed

The Dubuque County Health Department, the Dubuque County Board of Health, and the Iowa Department of Public Health (IDPH) are investigating an outbreak of Shigellosis cases in Dubuque County, Iowa.

Officials apparently have been keeping an investigation of a Shigella outbreak under wraps — since it started back in October of 2015.

On April 11th, health officials announced the outbreak via press release. There have apparently been 167 confirmed cases of the disease, which causes diarrhea, fever and abdominal pain, in Dubuque County alone since October 1, 2015.

Nearby Linn County also experienced an outbreak of Shigella in 2015: more than 200 people in the county reported having the disease, which constituted more than half of the cases reported across the state that year.

Although the county press release states that Shigella is spread person-to-person, the CDC states that the pathogen may also be spread in other ways, including the following:

  • Foodborne transmission. Eating food contaminated with the bacteria may cause an individual to become ill. Food may become contaminated in a variety of ways, but primarily when food handlers themselves have the disease. Additionally, fields that grow produce occasionally have trace amounts – and sometime more – of human sewage. Finally, flies that have touched a contaminated surface may then land on food, contaminating it with Shigella.
  • Waterborne transmission. Recreational water (such as water in a swimming pool or lake) may have been contaminated by Shigella bacteria. Swallowing even a little of that water may make a person ill.
  • Person-to-Person transmission. Contaminated hands that touch food or your mouth easily transmit the disease. Hands can become contaminated through touching surfaces with minimal amounts of bacteria on them – such as toys – that have become contaminated. Children and their caretakers are particularly likely to develop the disease, as it is hard to eliminate all traces of fecal matter after changing diapers and associated activities.

Shigella spreads easily principally due to two factors: the fact that the bacteria are present in the stools of an infected person up to two weeks after symptoms have disappeared, and the fact that, according to the CDC, Shigella “is very contagious; exposure to even a tiny amount of contaminated fecal matter—too small to see– can cause infection.”

Dubuque County Recommendations

The Iowa county warns that “infected people should stay away from school, child care, food preparation or work while they have diarrhea.” (Recall, however, that the bacteria may be spread for up to two weeks after a person becomes asymptomatic, so just because you stop experiencing diarrhea does not mean that you can no longer spread the disease.)

The county press release indicates that the following groups of people should have twwo consecutive negative stool cultures prior to returning to work or child care:

  • Food handlers,
  • Health care workers, and
  • Those working in child care.

“Children who have had shigellosis,” the release continues, “and are returning to child care should have one negative stool culture.”

The release asks that you contact the Dubuque County Infection Control Specialists at the VNA (563-556-6200) or IDPH 515-242- 5935) for questions about clearing persons for work or child care.

If you or a family member have experienced food poisoning, please fill out the online evaluation form or call us toll-free at 1-888-335-4901.  There is no cost to you.