Originally reported as an outbreak only at Worth County public schools, the Southwest Health District has indicated that the Shigella outbreak has spread to 6 counties. Shigella is a highly contagious and infectious disease. Ingestion of fewer than 100 Shigella bacteria can cause food poisoning (American Public Health Association [APHA], 2000), making Shigella one of the most communicable and severe forms of the bacterial-induced diarrheas (Gomez et al., 2002).
Most Shigella infections are passed through the fecal-oral route. This happens when basic hygiene and handwashing habits are inadequate and can happen during certain types of sexual activity. Shigella outbreaks are particularly likely to occur among toddlers who are not fully toilet-trained. Family members and playmates of such children are at high risk of becoming infected.
Shigella is the third most common pathogen transmitted through food. In FoodNet surveillance areas in 2008, the rate of Shigella food poisoning was 6.6 per 100,000 population, exceeded only by Salmonella (15.2/100,000) and Campylobacter (12.7/100,000) (CDC, 2009c).
Shigella is also responsible for a substantial portion of foodborne outbreaks on cruise ships. In a review of cruise ship outbreaks worldwide over several years, 16% of outbreaks were attributed to Shigella, affecting over 2,000 passengers (Rooney et al., 2004). Sanitation violations related to food handling and communicable disease have decreased substantially over the past 15 years (Cramer et al., 2008).