Re: South Carolina - Shigella outbreak at Honea Path school sickens dozens; 3 children hospitalized
This is an official
DHEC Health Advisory
Distributed via Health Alert Network
October 14, 2011, 12:00 PM
10245-DHA-10-13-11-R1Shig
Shigella Outbreak in Anderson County
Summary
This Health Advisory is to provide information about an outbreak of shigellosis among students, faculty and family members of students attending Honea Path Elementary School in Anderson County. You are receiving this advisory as a healthcare practitioner who may see students with acute GI illness that could be related to this outbreak. Information shared in this advisory is preliminary and may be subject to change as additional cases are reported. In the past 4 weeks, 3 confirmed cases of Shigella Sonnei have been identified among students attending Honea Path Elementary School. 26 additional persons are reported to have had acute onset of gastrointestinal (GI) illness similar to shigellosis since September 14. Most of these cases have been among students in grades K5 through 4th. Additional probable cases among faculty and household contacts of students are under investigation. The spectrum of shigellosis manifestations ranges from loose, watery stools without systemic symptoms to more severe presentations with fever, cramps, and bloody diarrhea. Although most cases of shigellosis are self-limited (48-72 hours) and do not require antimicrobial treatment, antimicrobial treatment is recommended for severe cases and for shortening duration of diarrhea and eradication of organism in stools.
Control measures to interrupt transmission in child care and school settings include: meticulous hand hygiene implementation of enhanced environmental hygiene in the facility and in students? homes. exclusion of individuals with diarrhea until resolved.
For students with a shigellosis diagnosis, or whose symptoms suggest Shigella infection associated with this outbreak, school exclusion criteria are: Students in grades K3-K5: Exclude until diarrhea is resolved AND either a) completion of 5 full days of treatment with an antibiotic shown to be active against the organism in antibiotic resistance testing, or b), if a course of antibiotics is not given, one negative stool culture. A medical note is required to return to school. Students in Grades 1-12 who are not medically fragile: Exclude until asymptomatic. A medical note is required to return to school.
As requested or needed, SC DHEC will provide parent letters for schools or child care facilities experiencing two or more cases of Shigella in a single grade or class.
Providers may opt to give a copy of the Shigella fact sheet to their patients (page 3 of this Advisory).
Shigellosis testing, via stool culture, is available through commercial laboratories. Isolates from positive specimens are to be submitted to the SC DHEC Bureau of Laboratories for confirmatory testing or genotyping.
For additional information, please contact the Region 1 Epi Team at (864) 260-4358.
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continues at
http://www.scdhec.gov/health/disease/han/docs/HAN-20111014-01.pdf
