![[ Visit Client Website ]](images/banner.jpg)
BACKGROUND: During the spring of 2014 a small outbreak of Shigellosis was identified in a Fayette County childcare center. This investigation led to the discovery of a much larger community wide outbreak of Shigellosis. The bacterial infection most often results in diarrhea, fever, and abdominal cramps and is commonly associated with childcare centers. However, this outbreak continues to adversely affect the residents of Lexington and continues to spread outside of the daycare setting.
METHODS: Each case reported to the local health department was investigated to obtain patient demographics and illness characteristics, as well as exposure histories. Laboratory surveillance provided data regarding the serotype and antibiotic resistance patterns of the isolates. A comparison of cases, to determine potential routes of exposure, was conducted throughout the investigation by local and state health departments. In addition, preventive measures were distributed community wide on multiple occasions through childcare centers, media outlets, and the local health department.
RESULTS: By the end of calendar year 2014, the outbreak consisted of greater than 150 cases of Shigellosis. When compared with 2013, this represents a 50-fold increase in incidence. Clear routes of exposure among cases were difficult to determine. The median age of cases fluctuated throughout the investigation but remained above the expected age of a child in childcare. Informational packets were mailed to all licensed childcare providers in the county and area providers were notified using an internal database and a medical society listserv. The media also extensively covered the presence of the outbreak. A total of 5 media outlets shared the local health department press release, over 19 newscasts featuring Shigellosis were conducted, and a local media outlet website story was viewed greater than 21,000 times. Lastly, two social media sites were used to spread preventive messages to the community.
CONCLUSIONS: Data from the previous Shigellosis outbreaks occurring in Fayette County indicate spread among children attending daycare. However, while this outbreak began in the childcare setting, it progressed to be much more widespread. Therefore, the approach in mitigating the outbreak required more extreme tactics and the support of multiple agencies and businesses in the community.