Shigella found at local schools, day care centers

Twenty-one cases of Shigella had been confirmed in eastern Cuyahoga County and western Lake County as of Jan. 20, and more cases were reported this week, according to officials of the Cuyahoga County Board of Health. Some cases have occurred in the Orthodox Jewish community.

"The Academy's health professional saw a handful of cases," Rabbi Simcha Dessler, dean of Hebrew Academy of Cleveland, said Jan. 23. "As with any health-related issues, we immediately contacted the Cuyahoga County Department of Health and continued to follow their lead. A letter and fact sheet with comprehensive information and prevention strategies were sent out to the parent body."

Dessler said the school also takes care to maintain the facility's cleanliness and prevent illness.

At Mosdos Ohr Hatorah Orthodox day school in Cleveland Heights, executive director Rabbi Baruch Chaim Manies said one child in the nursery and another in elementary school had contracted the illness a couple of weeks ago. "We nipped it," he said, with precautionary measures such as frequent cleaning of water fountains, doorknobs, handrails and bathrooms. The school also sent home letters to parents about the illness.

Telshe Yeshiva in Wickliffe and Fuchs Mizrachi School in Beachwood reported no incidents of Shigella. The Cuyahoga County Board of Health confirmed Jan. 24 that no cases have been reported from mikvaot (ritual baths) or Jewish preschools.

Amy Anter, program manager in epidemiology at the Cuyahoga County Board of Health, said the board had been in touch with Mendel Singer, Ph.D., associate professor at Case Western Reserve University School of Medicine, director of Jewish Community Health Initiative, and CJN blogger, to help convey information about the illness.

In addition to cases reported in the county, Anter said, "The Lake County Health Department alerted us they had several cases."

Shigella, or Shigellosis, is an infectious bacterial disease causing diarrhea, fever and stomach cramps. Lasting four to seven days, it can usually be treated with antibiotics, according to the Ohio Department of Health.

"Shigella does pop up in the Orthodox community from time to time," Singer said. "When there are lots of kids in diapers and not fully toilet-trained, there are opportunities for the illness to spread. It's extremely contagious, and it takes very little of it to cause infection.

"Hand washing with warm water and soap is the best defense," Singer said. Within the Orthodox community, soap (that requires lathering) and pre-moistened wipes (that often require tearing) become an issue on Shabbat. He recommends liquid soap as a substitute for bar soap and advises keeping soap available where ritual hand washing is taking place. If pre-moistened wipes aren't used when diaper changing, cleaning with "Shabbat-friendly" wipes is needed, he said.

Shigella is fairly common in the United States, with approximately 14,000 laboratory-confirmed cases each year, according to the Ohio Department of Health. The actual number could be 30 times greater, Singer said.

The last major local outbreak was in 2008 and was mainly limited to the day care setting, Anter said.

What makes Shigella difficult to deal with is that the illness is asymptomatic for some people and may be mistaken for a short-lived gastrointestinal illness by others, Anter said. For older people or those whose immune systems make them more vulnerable, Shigella can last from one to one-and-a-half weeks.

shoffman@cjn.org

What is Shigella?

Shigella, or Shigellosis, is an infectious bacterial disease causing diarrhea, fever and stomach cramps. Typically, blood and mucous are present in the stool. The illness, discovered by a Japanese scientist named Shiga more than 100 years ago, generally lasts four to seven days and usually can be treated with antibiotics.

Source: Ohio Department of Health