Rhode Island: Shigella reported as cause of outbreak linked to Spring Lake Beach

In a follow-up to a story Monday about an gastrointestinal disease outbreak in Burrillville, the Rhode Island Department of Health (HEALTH) Tuesday linked the outbreak to the bacterial pathogen, Shigella sonnei.

The colonial morphology displayed by a Shigella species bacteria cultivated on a Hektoen enteric (HE) agar surface
Image/CDC

HEALTH is reporting that stool specimens from 19 of the patients who became ill with diarrheal illness after swimming at Spring Lake Beach on July 4 are positive for the bacteria.

According to health officials Tuesday, they began investigating the outbreak of gastrointestinal illness associated with the public swimming area on July 6. To date, 92 individuals have been identified as ill and 16 have been hospitalized with bloody diarrhea. All swam at Spring Lake Beach in Burrillville on July 4. HEALTH believes that Shigella came from fecal contamination of the water on that date.

Some eight out of 10 of those infected are children under 18 years of age. Hospitalized cases at Hasbro Children’s Hospital are recovering well and no severe illness has been reported in adults.

“Anyone who recently swam at Spring Lake and is experiencing diarrhea, abdominal pain, fever, or vomiting should see his or her doctor,” said Michael Fine, MD, Director of Health.

Shigellosis is an acute bacterial disease of the intestines caused by several species of the bacterium, Shigella. It is typified by loose stools, frequently containing blood and mucus (dysentery), accompanied by fever, vomiting, cramps and occasionally toxemia.

Related story: Rhode Island Family Brings Rabid Raccoon In Their Home, 18 People Affected

It can cause bacillary dysentery because of the invasive ability of the organism that may result ulcerations and abscesses of the intestines.

It rarely spreads to the bloodstream.

More severe complications may include convulsions in children, Reiter’s syndrome and hemolytic uremic syndrome depending on the species of Shigella implicated.

This diarrheal disease is found worldwide with the vast majority of cases and deaths being in children. Outbreaks usually occur where there are crowded conditions and where personal hygiene is poor: prisons, day care centers and refugee camps are three examples.

It is transmitted primarily by fecal-oral person to person means. It can also occur through contaminated food or water. Those primarily responsible for transmission are people that fail to wash their hands thoroughly after defecation.

Because Shigella is resistant to gastric acid, a person can be infected with as little as 10 organisms.

After being infected, symptoms usually appear 1-3 days later. It can be transmitted during the acute phase of infection until approximately four weeks after illness when the organism is no longer present in the feces. Asymptomatic carriers can also infect others.

Diagnosis is confirmed through bacteriological culture of feces. Treatment of shigellosis may include fluid and electrolyte replacement if there are signs of dehydration.

Antibiotics can shorten the course of infection, the severity of illness and the period of time a person may excrete the pathogen. Because of some antibiotic resistance, an antibiotic susceptibility test should be performed to determine which antibiotic would be effective.

HEALTH said it is reopening Spring Lake beach for swimming beginning Wednesday, as water test results from Sunday and Monday show no evidence of fecal coliform bacteria. In addition, Shigella does not survive outside the body for long periods and does not survive in warm temperatures. The water temperature in Spring Lake has been high over the last several days.

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