Shigella

Testing

• Please request susceptibility testing of all isolates.
• During the shigellosis outbreak, when a patient presents with a chief complaint of diarrhea, test for common enterics (e.g., Shigella, Campylobacter, Cryptosporidium, E. coli O157, Giardia and Salmonella).

Treatment Recommendations

• All lab-confirmed shigellosis cases should continue to be treated with antibiotics to which Shigella sonnei is susceptible.
• All isolates have been susceptible to both Ceftriaxone and Ciprofloxacin.
• Do not use Ampicillin or Trimethoprim-Sulfamethoxazole to treat shigellosis during the current outbreak.
• Antibiotics recommended for treatment of shigellosis include:
• Azithromycin
• Cefdinir
• Cefixime
• Ciprofloxacin
• For each of these antibiotics, the length of therapy is 5 days.
• Anti-diarrheal medications are contraindicated.

Antibiotic Resistance

Recent susceptibility results for Shigella sonnei from Franklin County area hospitals indicate 95% resistance to Ampicillin and 50% resistance to Trimethoprim-Sulfamethoxazole.

Patient Education – Prevention Steps

• Educate all members of household regarding proper handwashing.
• Wash hands with soap and water after using the bathroom, changing diapers or helping others with toileting.
• Wash hands before preparing or serving food and drinks.
• Individuals with diarrhea should not prepare food and drinks for others.
• Teach children proper handwashing and supervise them washing.
• Clean and disinfect toys and other surfaces daily.

Patient Education Materials 

• Preventing Illnesses at Home
• How To Wash Your Hands
• When To Wash Your Hands
• Handwashing Reminder for Kids
• Teaching Handwashing to Young Children
• Resources Listing

Exclusion From Childcare, School and Work

A person with Shigellosis who attends a child care center or who works in a sensitive occupation (such as food handlers and healthcare workers) should be excluded from the child care center or from work at that sensitive occupation. They can return only if the diarrhea has ceased and after two consecutive follow-up stool specimens are negative for Shigella per OAC 3701-3-13.

For More Information

Centers for Disease Control and Prevention
Communicable Disease Reporting System (CDRS)
Ohio Department of Health