~~-----====--==--=--======~====-===========-===========~~ 2011 Georgia Data Summary SHIGELLOSIS rtment of Public Health Shigella Quick Fact: Shigella can spread easily In household or childcare settings. OVERVIEW Shigellosis is a bacterial infection affecting the intestinal tract. Most cases occur as single cases or in association with outbreaks. Shigella case numbers can vary from year to year, in a cyclical pattern over 56 years. Common symptoms include fever and bloody diarrhea. Figure 2. Rate per 100,000 of Shigellosis, Georgia, 2011 SURVEILLANCE All Georgia physicians, laboratories and other health care providers are required by law to report both labconfirmed and clinical diagnoses of cases of Shigellosis. Cultures may be sent to the Georgia Public Health Laboratory for case confirmation Outbreaks are investigated to determine the possible source of infection and prevent additional illness . Active Surveillance for Shigellosis is conducted through FoodNet. For more information , please visit: ~ http://dph.georgia.gov/eip/ ~ http://www.cdc .gov/foodneU INCIDENCE In 2011 , 670 cases of Shigellosis were reported , for a rate of 6.8 per 100,000 persons (Figure 1). Rates vary from county to county with higher rates often due to spread within schools and childcare facilities (Figure 2). Figure 1. Shigella 2001-2011 woo 1800 1600 20 1400 1100 ~ 1000 I \ a soo \ v 1\ I 1\ -~ :; 15 ~ g g 10 - ~ l600 400 I- iii 0: 200 1;!001 2002 2003 2004 2005 2006 2007 1008 2009 2010 2011 Legend Rate r=J oOOOOOQ-3071347 ~ 3071348.11286045 ,, 186046 . 26 099508 - 26 099509. 48 602673 - 4860267<~-79283114 Cru11d MayU ,2012 Clauoto::nonNn"'-'Bruh Sourtt Gtorf'0"'"$10no(f'\lbbc'Hu!th ~~~~laton GtO'JIIplucCocrltwulle Sym OHIP_Lamtlu DEMOGRAPHICS In 2011 , 41% of reported cases were White and 43% of cases were Black (Figure 3) . Shigella infections are more commonly reported among children younger than age 10, as compared to other age groups (Figure 4) . Figure 3. Shigella Cases by Race, 2011 ASIAN 1% 8% 6% 1% Georg ia Department of Public Health - 2 Peachtree Street. NW- Atlanta, GA 30303 - (404) 657-2588- http://dph.qeorgia.gov Figure 4. All Reported Cases of Shigellosis with Known Gender/Age Group 2011 120 100 - - 80 - "'3: 60 .1--- - u"' 40 ~ - 20 t o t.._ - - =-~ ~ L. . <1 1-4 5-9 10-19 20-29 30-39 40-49 50-59 60+ Age Group Female IMPACT OF SHIGELLA Hospitalizations Of the total 670 cases of Shigella in 2011 , 139 (21% ) individuals were hospitalized ; while an additional 125 (20%) were seen in the emergency room . PREVENTION AND SPECIAL PROJECTS Prevention Carefully and frequently wash hands with soap and water; Keep young children with shigellosis who are still in diapers away from uninfected children ; Do not prepare food or pour water for others if you are carrying the Shigella bacterium ; Observe basic food safety precautions ; Avoid consuming inadequately treated water, particularly from lakes, streams, rivers , and ponds . In developing countries , drink only treated or boiled water and eat only cooked hot foods or fruits you peel yourself. Special Projects Monitoring trends in Shigella epidemiology over time . Persons at Risk Anyone can get shigellosis. Those at increased risk include young children in day care centers , persons in custodial institutions, the elderly, the immunocompromised , travelers to developing countries , and men who have sex with men (MSM) . Routes of Transmission The bacteria are spread by direct contact with an infected person or by consuming contaminated food or water. The spread of Shigella often occurs: Through contact with toddlers who are not toilet trained ; Through the consumption of contaminated foods handled by persons neglecting to wash their hands with soap and water after using the toilet; Through the ingestion of water after it has been contaminated with sewage or if someone with shigellosis has swam in it. Exclusion Criteria Most infected people may return to work or school when their stools become formed provided that they carefully wash their hands after toilet visits . However, food workers , healthcare workers , and children under the age of 5 in school or child care centers must obtain approval of the state or local health department before returning to work/school. Approval typically involves lab testing of additional stools to ensure the infection has cleared. Date updated: October 2013 Visit http://dph.georgia.gov/epidemiology for more information about Shigella Infections in Georgia. Georgia Department of Public Health - 2 Peachtree Street, NW - Atlanta, GA 30303- (404) 657-2588- http://dph.georqia.qov