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Food Poison Journal

Food Poisoning Outbreaks and Litigation: Surveillance and Analysis

What Souplantation should have known about Shigella

Shigella

shigellaShigella is the bacterium that causes the disease shigellosis, also known as bacillary dysentery. Shigella is one of the most easily transmitted bacterial diarrheas, since it can occur after fewer than 100 bacteria are ingested. While reported cases of Shigellarange between 14,000 and 20,000 annually, with the majority of these cases occurring between July and October. Shigella Sonnei is the most common type of Shigella. It accounts for over two-thirds of cases of shigellosis in the United States.

Shigella bacteria are generally transmitted through a fecal-oral route.  Foods that come into contact with human or animal waste can transmit Shigella. Thus, handling toddlers’ diapers, eating vegetables from a field contaminated with sewage, or drinking pool water are all activities that can lead to shigellosis.

SYMPTOMS OF SHIGELLA FOOD POISONING

Symptoms of Shigella poisoning most commonly develop one to three days after exposure to Shigella bacteria, and usually go away within five to seven days. It is also possible to get Shigella but experience no symptoms, and still be contagious to others, a condition known as being asymptomatic.

Common Shigella Food Poisoning Symptoms

  • Diarrhea: Diarrhea ranges from mild to severe. It is bloody in 25 to 50 percent of cases and usually contains mucus
  • Fever
  • Stomach cramps
  • Rectal spasms

COMPLICATIONS FROM SHIGELLA

Complications from shigellosis can include severe dehydration, seizures in small children, rectal bleeding, and invasion of the blood stream by the bacteria. Young children and the elderly are at the highest risk of death. The following is a list of specific complications caused by Shigella.

Proctitis and Rectal Prolapse: The bacteria that causes shingellosis can also cause inflammation of the lining of the rectum or rectal prolapse.

Reactive Arthritis: Approximately 3 percent of patients with Shigella infection, most often those with Shigella flexneri, develop Reactive Arthritis. It occurs when the immune system attempts to combat Shigella but instead attacks the body. Symptoms of Reactive Arthritis include inflammation of the joints, eyes, or reproductive or urinary organs. On average, symptoms appear 18 days after infection.

Toxic Megacolon: In this rare complication, the colon is paralyzed and unable to pass bowel movements or gas. Symptoms of Toxic Megacolon include abdominal pain and swelling, fever, weakness, and disorientation. If this complication goes untreated and the colon ruptures, the patient’s condition can be life-threatening.

Hemolytic Uremic Syndrome, or HUS: Shigella rarely results in HUS, which is more commonly a complication of Shiga toxin-producing E. coli infections. HUS can lead to kidney failure.

DIAGNOSIS OF SHIGELLA

A Shigella infection is diagnosed through laboratory testing of a stool sample.

SHIGELLA FOOD POISONING TREATMENT

A Shigella infection usually goes away on its own in five to seven days, although bowel movements may continue to be abnormal for up to a month following infection. Antibiotics, however, can shorten the course of the illness. A doctor can prescribe antibiotics after testing a stool sample for the presence of Shigella bacteria.

Some strains of shigellosis are resistant to antibiotics, meaning that antibiotics might not always be an effective treatment. Antidiarrheal medication should be avoided, as it can actually make the illness worse.

PREVENTING A SHIGELLA INFECTION

Frequent hand washing is key to preventing Shigella, since individuals can carry Shigellawithout noticing symptoms, and Shigella bacteria can remain active for weeks after illness.

Steps for Preventing the Spread of Shigella Infection

  • If a child in diapers has shigellosis, wash your hands after changing their diaper and wipe down the changing area with disinfectant
  • People with Shigella should not prepare food for others for at least two days after diarrhea has stopped
  • Drink only treated or boiled water while traveling and only eat fruits you peel yourself
  • Only swim in pools maintaining a chlorine level of 0.5 parts per million and stay clear of pools where children not yet toilet trained are swimming

ADDITIONAL RESOURCES FOR SHIGELLA

About-Shigella.com is a comprehensive site with in-depth information about Shigella bacteria and Shigella infection.

Shigella Blog provides up-to-date news related to Shigella outbreaks, research, and more.

Shigella Hits Souplantation in Camarillo in California

Ventura County Public Health was notified on Thursday, June 22nd, of an unusually high number of Shigella cases in the county. Shigellosis is an infectious disease caused by a group of bacteria called Shigella (shih-GEHL-uh), which most often causes diarrhea and fever. It is highly contagious.

Through a series of interviews with those affected, it has been determined that a number of the cases reported to have eaten at the Souplantation in Camarillo. Of the diners interviewed, there are a total of eight individuals with laboratory evidence of Shigella infection.

Ventura County Public Health’s laboratory sent the culture confirmed samples to the State laboratory for typing.

“We’re tracking these cases closely,” said Public Health Officer Dr. Robert Levin, “and are working closely with Ventura County Environmental Health, which has completed two inspections of the restaurant in the past two days.” Dr. Levin credits Souplantation corporate office for making the decision to close the restaurant, starting Thursday through the weekend, to make certain that all steps have been taken to prevent further cases.

The Souplantation Chief Operating Officer has arrived at the Camarillo location and has been joined by a vice- president and the quality assurance manager. All employees are being put through a sanitary training refresher course, the restaurant is being thoroughly cleaned and all food on the premises is being thrown out.

“Souplantation’s actions have been exemplary. This is the kind of swift and decisive action, which leads to a collaboration with Public Health that results in a rapid resolution of the problem,” added Dr. Levin.
It is not currently clear what the source of the infection is. No one food item has been indicated. All employees are being tested and will need to be cleared before returning to work. There are approximately 40 employees at the restaurant.

Most people who are infected with Shigella develop diarrhea, fever, and stomach cramps starting a day or two after they are exposed to the bacteria. Shigellosis usually resolves in 5 to 7 days. Some people who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others. The spread of Shigella can be stopped by frequent and careful hand-washing. Antibiotic treatment is known to decrease the length of illness and to end shedding of the organism within a day or two of starting therapy. People most at risk of serious illness are those with underlying immunosuppressive conditions. Those who may have been exposed who are feeling ill should consult their physician.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Shigella outbreaks. The Shigella lawyers of Marler Clark have represented thousands of victims of Shigella and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Shigella lawyers have litigated Shigella cases stemming from outbreaks traced to a variety of sources, such as tomatoes, airplane and restaurant food.

If you or a family member became ill with a Shigella infection after consuming food and you’re interested in pursuing a legal claim, contact the Marler Clark Shigella attorneys for a free case evaluation.

Target Pulls Hampton Creek Products – Salmonella and Listeria Risk

UnknownBloomberg News reported today that Target began removing all of Hampton Creek Inc.’s products from its stores.

According to Bloomberg, a Target spokeswoman said the company received allegations of food safety concerns as well as accusations of manipulation and adulteration of Hampton Creek’s products. She said one concern involved reports of pathogens found in a manufacturing facility used by Hampton Creek. Target also received allegations that Hampton Creek products had tested positive for Salmonella and Listeria.

Target said other allegations involve mislabeling: that some products are incorrectly labeled as non-Genetically Modified Organism (or non-GMO) food, and that Hampton Creek’s Just Sweet Mustard salad dressing contains honey, even though it is not listed as an ingredient on the

Target carries 20 different Hampton Creek products, among them Just Cookie Dough, Just Dressings, Just Cookies and Just Mayo. Target pulled all 20 products, the spokeswoman said. The retailer has 1,800 stores nationwide.

Target made the decision to pull Hampton Creek’s products through a voluntary market withdrawal, said the company’s spokeswoman. A voluntary market withdrawal is when a retailer removes a product on its own rather than being ordered to do so by a government agency like the FDA.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Salmonella outbreaks. The Salmonella lawyers of Marler Clark have represented thousands of victims of Salmonella and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Salmonella lawyers have litigated Salmonella cases stemming from outbreaks traced to a variety of foods, such as cantaloupe, tomatoes, ground turkey, salami, sprouts, cereal, peanut butter, and food served in restaurants.  The law firm has brought Salmonella lawsuits against such companies as Cargill, ConAgra, Peanut Corporation of America, Sheetz, Taco Bell, Subway and Wal-Mart.

Marler Clark, The Food Safety Law Firm, is the nation’s leading law firm representing victims of Listeria outbreaks. The Listeria lawyers of Marler Clark have represented thousands of victims of Listeria and other foodborne illness outbreaks and have recovered over $600 million for clients.  Marler Clark is the only law firm in the nation with a practice focused exclusively on foodborne illness litigation.  Our Listeria lawyers have litigated Listeria cases stemming from outbreaks traced to a variety of foods, such as cantaloupe, cheese, celery and milk.

Clostridium perfringens tied to Rifle Rodeo

The Post Independent reports that Colorado health officials have confirmed that the 80 people who became ill after attending the Rifle Rodeo early this month were stricken with a foodborne illness.

Garfield County Public Health announced the state lab’s findings late Wednesday afternoon. Since the June 5 rodeo, the county and state health departments have had a team investigating the outbreak, using “nurses, licensed food inspectors, regional and state epidemiologists and the laboratory staff,” according to the county.

“Lab samples sent to the Colorado Department of Public Health and Environment came back positive for Clostridium perfringens – a leading cause of foodborne illness,” according to a county press release. “The illness is contracted from consuming large amounts of the bacteria, creating a toxin in the intestinal tract causing abdominal cramps and diarrhea.”

Several people posted on the Post Independent’s Facebook page or emailed to say they had eaten pulled pork sandwiches at the event.

County public health officials said last week that no food inspections, which are normally required at such public events, occurred because the department was not informed about food being served at the Rifle Rodeo, which was held at the county fairgrounds.

“The Rifle Rodeo is a privately organized event. It should be noted that this particular food vendor has a primary location that has been inspected, is licensed and is regulated. In the case of the Rifle Rodeo, temporary event and coordinator permits were not submitted, therefore Garfield County Public Health was not aware of or able to inspect food at the event prior to the June 5 outbreak,” said Yvonne Long, executive director for Garfield County Public Health.

“One thing that we want the public to know is that for public events it is the coordinator’s responsibility to find out and comply with the rules, regulations, permits, sales tax requirements and licenses required to host an event,” she said.

Clostridium perfringens are bacteria that produce toxins harmful to humans. Clostridium perfringens and its toxins are found everywhere in the environment, but human infection is most likely to come from eating food with Clostridium perfringens in it. Food poisoning from Clostridium perfringens is fairly common, but is typically not too severe, and is often mistaken for the 24-hour flu.

The majority of outbreaks are associated with undercooked meats, often in large quantities of food prepared for a large group of people and left to sit out for long periods of time. Because of this, it is sometimes referred to as the “food service germ.” Meat products such as stews, casseroles, and gravy are the most common sources of illness from C. perfringens. Most outbreaks come from food whose temperature is poorly controlled. If food is kept between 70 and 140 F, it is likely to grow Clostridium perfringens bacteria.

People generally experience symptoms of Clostridium perfringens infection 6 to 24 hours after consuming the bacteria or toxins. Clostridium perfringens toxins cause abdominal pain and stomach cramps, followed by diarrhea. Nausea is also a common symptom. Fever and vomiting are not normally symptoms of poisoning by Clostridium perfringens toxins.

Illness from Clostridium perferingens generally lasts around 24 hours, and is rarely fatal.

The Type C strain of Clostridium perfringens can cause a more serious condition called Pig-bel Syndrome. This syndrome can cause death of intestinal cells and can often be fatal.

To prevent infection by Clostridium perfringens, follow the these tips:

  • Cook foods containing meat thoroughly
  • If keeping foods out, make sure they maintain a temperature of 140 F (60 C)
  • When storing food in the refrigerator, divide it into pieces with a thickness of three inches or less so that it cools faster
  • Reheat foods to at least 165 F (74 C)

Clostridium perfringens.” Illinois Department of Public Health. Available at http://www.idph.state.il.us/Bioterrorism/factsheets/clostridium.htm.
Rohrs, Barbara. “Clostridium perfringens.” Ohio State University Extension Family and Consumer Sciences. Available at http://ohioline.osu.edu/hyg-fact/5000/5568.html.