Since beginning in October, an outbreak of dysentery caused by the shigella bacteria has been a thorn in the side of Grayson County Public Health Emergency Preparedness Coordinator Jeff Lillis. His day-to-day work tasks still require attention — a rabid kitten in Denison was Monday’s crisis du jour — but the persistence of the shigellosis outbreak has been a constant drain on his Department’s resources. Lillis said health officials are cautiously optimistic they finally see the light at the end of the tunnel.
“Hopefully, during this two-week period of kiddos not being at school, the transmission will slow down, is what we’re hoping,” said Lillis. “Our new cases we’re seeing are within family units, from just being cooped up through the holidays, which is a different kind of spread versus the classroom.”
The Grayson County Health Department has confirmed 93 cases of the disease, which causes severe diarrhea. Small children with oft-substandard hygiene regimens are particularly susceptible to contracting and spreading the illness. But as the outbreak has matured, several adults have fallen victim as well. Of the last 15 cases confirmed, five were over the age of the 20.
“We’re seeing more distribution up in the higher ages, and that’s more likely because families being home and out of school and those parents being around the kids more,” said Lillis, who explained that cloth toys frequently are vectors for contagion. “Particularly toys that are not smooth or easily cleanable, like a stuffed animal — that absorbent-type fabric on those really holds the shigella in that type of material. More than likely, it’s the sharing of those toys and just not properly hand-washing after the use of the restroom.”
Lillis said the bacteria is potent even in small doses, making it exceptionally difficult to control.
“If somebody doesn’t take their course of antibiotics or … if somebody just tries to tough it out from their house, they can actually shed shigella cells for up to a 30-day period. So that’s why it’s so difficult to contain this. And it takes such a small amount of cells to get somebody sick. It can take as few as 10-100 cells of Shigella, versus a couple hundred thousand of salmonella or E. coli. That’s why we’re seeing the continued spread; it’s so contagious, and it takes such a little amount to make somebody sick.”
The Health Department said one of the last remaining hurdles to containment is ensuring those who are ill avoid others for 7-10 days after becoming symptomatic.
“Mainly (people need to stay) at home, particularly the health-care workers and the food-handling individuals that work in restaurants or work with any of the highly susceptible populations. They need to refrain from working until they’ve gone to the doctor after they’ve experienced symptoms and completed a course of the appropriate antibiotics.”
With the public’s cooperation, Lillis said the Department hopes to close the book on shigella in early 2014.
“We’re still seeing a few cases here and there, but like I said, the spread we’re really concerned with now is under the same roof,” said Lillis. “We’re just trying to get the education portion of it out — stressing the importance of hand washing. Hopefully we’ve got a good enough effort put forth with education and preventative measures that it will stop in the near future. I sure hope so, at least.”