Shigella Cases Reported in Kerala, Outbreak Under Control: Say Health Department Officials
A fresh case of Shigella infection was reported from Chottanikkara in Ernakulam district of Kerala, leading to steps to prevent the spread of virus being beefed up in the area. An emergency meeting was held at the District Medical Office on December 29 to review the situation.
Health Department officials, experts from the medical college, food safety officials and the medical officer of the primary health centre at Chottanikkara also visited the area and collected samples from water sources for testing. As a precautionary measure, there will be awareness campaigns in the area and preventive steps will be implemented, according to an official.
What is Shigella Infection?
Shigella is one of the leading bacterial causes of diarrhoea worldwide and is an intestinal infection caused by a family of bacteria. According to World Health Organisation, Shigellosis occurs predominantly in developing countries due to overcrowding and poor sanitation. Infants, non breast-fed children, children recovering from measles, malnourished children, and adults older than 50 years have a more severe illness and are at greater risk of death. Transmission occurs via the faecal-oral route, person-to-person contact, household flies, infected water, and inanimate objects.
Shigella species can survive in gastric acid, and infection can occur following exposure to as few as 10- 100 organisms. Once infected, all Shigella species multiply and cause acute bloody diarrhoea by invading the colonic epithelium where pro-inflammatory cytokines are released, and the subsequent inflammatory reaction (recruiting a number of polymorphonuclear cells) destroys the epithelial cells lining the gut mucosa, allowing for further direct invasion by Shigella, WHO website says.
The resultant infectious diarrhoea is associated with loss of water and electrolytes and a clinical picture of abdominal cramping, fever, and bloody/mucoid stools.
On a global scale, of the estimated 165 million Shigella diarrhoeal episodes estimated to occur each year, 99% occur in developing countries, mainly in children, says WHO adding that, “In 1999, a systematic review reported Shigella to be responsible for 1.1 million deaths per year, 61% of which is in children less than 5 years of age, based on prevalence in diarrhoea cases and limited data on case-fatality rates amongst hospitalised children.”
The studies also point out that Shigellosis is one of the major causes of diarrhoea in India. Though the accurate estimates of morbidity and mortality due to shigellosis are not adequate, the endemic has been reported to have caused many outbreaks across the country.
“The prevention of shigellosis is desirable as it will substantially reduce the morbidity associated with diarrhoea in the country. Public health measures like provision of safe water and adequate sanitation are of immense importance to reduce the burden of shigellosis, however, the provision of resources to develop such an infrastructure in India is a complex issue and will take time to resolve. Thus, the scientific thrust should be focused towards development of a safe and affordable multivalent vaccine,” a study by Neelam Taneja and Abhishek Mewara, published in the India Journal of Medical Research, had stated.
Earlier on December 21, an 11-year-old boy reportedly died of Shigella, that has so far affected six people in Kozhikode, health officials said.
In Kozhikode, the infections have been mostly reported from Kottaparambu ward within the municipal corporation limits. Kozhikode District Medical Officer Dr V Jayasree told PTI that 26 diarrhoea cases had been reported, of which six were confirmed to be that caused ny Shigella. "The other people have been cured. Two children have been shifted to the medical college here since they have fever," the DMO said.
Dr Amar Fettle, state nodal officer for communicable disease, said Shigella usually spreads through food and water, which are contaminated to some extent by human excreta, adding, "The disease is treatable and is manageable by antibiotics. Proper sanitisation methods should be followed. It is not deadly but requires public awareness and one must take due precautions food and water safety along with proper waste management.”
The istrict health authorities had soon initiated mitigation steps, including super-chlorination of wells of the region, and inspections of eateries, including hotels. Awareness classes have also been held, officials said.
State health minister KK Shailaja has urged the people to maintain hygiene saying, “We have started inspection of all houses in the affected areas. Initial reports do suggest water contamination led to the infection. We have asked people to drink only boiled water and maintain strict personal hygiene.”
(With inputs From PTI)
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