Missouri Department of Health & Senior Services
06/27/05

FROM:
Nanci Gonder
751-6062

Infectious Disease on the Rise This Summer; Missouri Third in Shigellosis Case Rates

As parents think about summer safety for their children they also should think about protecting them from infectious diseases this time of year, an official with the Missouri Department of Health and Senior
Services said today. Some infectious diseases can even be spread through swimming pool water.

According to Harvey Marx, DHSS disease investigation chief, shigellosis is on the rise in Missouri, and Missouri ranks third in the nation in the rate of shigellosis cases. Shigellosis is a common infectious
disease caused by bacteria often found in contaminated water and food.

"When people think about summer safety they probably don't think first about contagious diseases," said Marx. "But shigellosis and other bacterial infections can be spread through summer activities like
swimming and picnics," Marx added.

Marx said people can reduce their chances of getting sick by frequent hand washing, prompt disinfection of contaminated surfaces with household chlorine bleach-based cleaners, and prompt washing of soiled
articles of clothing.

In addition, people who have diarrhea should not swim, to avoid contaminating recreational water. And people should not swim or wade if they have open cuts or abrasions that might serve as entry points for
germs.

"Summer is a wonderful time for people to get out and enjoy the outdoors and Missouri offers countless places and opportunities for people to have fun doing things like swimming and going to picnics," said Marx. "However, there are some risks involved and people should be aware of how to protect themselves and others," he said.

Marx said Missouri has had 284 shigellosis cases reported so far this year, with around two-thirds of those cases occurring in the state's northwest region. The number of shigellosis cases in Missouri in 2005 is more than double the five-year average. Neighboring states of Oklahoma and Tennessee also are seeing an increase in shigellosis cases. Missouri has the third highest case rate (number of cases per 100,000 population) in the nation, Tennessee is second and Oklahoma has the highest case rate according to the federal Centers for Disease Control and Prevention (CDC).

Most people with shigellosis develop diarrhea, fever, and stomach cramps starting a day or two after they are exposed. Shigellosis usually resolves in five to seven days. In some people, especially young children and the elderly, the diarrhea can be so severe that the patient needs to be hospitalized. A severe infection with high fever may also be associated with seizures in children less than two years old. Some persons who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others.

Shigellosis can usually be treated with antibiotics. Appropriate treatment kills the Shigella bacteria that might be present in the patient's stools, and shortens the illness. Unfortunately, some Shigella bacteria have become resistant to antibiotics and using antibiotics to treat shigellosis can actually make the germs more resistant in the future. Persons with mild infections will usually recover quickly without antibiotic treatment. Therefore, when many persons in a community are affected by shigellosis, antibiotics are sometimes used selectively to treat only the more severe cases, and those persons
employed as food handlers, childcare providers, and healthcare providers. Antidiarrheal medications, such as Imodium or Lomotil, are likely to make the illness worse and should be avoided. People who have symptoms or think they may have been exposed to shigellosis should contact their healthcare provider for consultation and treatment.

Additional information on shigellosis is available at:http://www.cdc.gov/ncidod/dbmd/diseaseinfo/shigellosis_g.htm

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