Shigella Food Poisoning

There’s been much in the news recently about the shigella food poisoning which was most likely transmitted by an infected employee at a Mexican restaurant in San Jose. As of this writing, there are over 180 reported cases in six surrounding counties, including three cases here in Santa Cruz.
Shigella is one of a number of microbes (germs) that can cause gastroenteritis, a severe stomach flu-like illness. Shigella is not commonly found in our community, that’s why most people have probably never heard of it. But it can strike quickly and with a vengeance, such as the San Jose incident. A number of victims actually ended up hospitalized; some even in intensive care.
Most of us have used restrooms in stores and restaurants and seen the warning sign above the sink that employees must wash hands with soap and water after using the facilities. This is precisely for preventing food-borne illnesses from happening such as the shigella outbreak. It is likely, but not yet proven, that a food handler at the restaurant did not follow the hand-washing rule after having a bowel movement and thus passed on germs that he/she was carrying in their intestinal tract. It’s somewhat of a disgusting thought, but it does happen, that’s why they have the signs.
It’s hard to know what type of food preparation goes on in a restaurant but it is best when you can actually see your food being prepared, such as a sandwich or salad, and the preparer is using gloves.
Other food borne illnesses caused by germs include:
–         Campylobacter – spreads through undercooked poultry and its juices as well as some dairy products,
–         E. coli – found in some undercooked meats, unpasteurized dairy products and fruit juice, and can be passed like, shigella, through fecal contamination,
–         Salmonella – found in some undercooked meat, eggs, poultry, seafood, and their juices.
Food poisoning can show up within hours or a few days depending on which germ is the cause. Some lucky folks may not show symptoms, but the majority will at least have nausea, vomiting, stomach cramps, fever and diarrhea. Most people can “weather the storm” by resting and taking in plenty of liquids from a variety of sources such as water, sports drinks, or fruit juices. If these are kept down after a number of hours, one may start a bland diet progressing to a normal diet, as tolerated.
More serious signs to look out for and for which to seek medical attention include persistent vomiting which will cause dehydration as manifested by lack of urine output, excessive thirst, weakness, and light-headedness. Also serious are bloody vomit or stools and a fever above 101.5 F.
Medical care is supportive in treating the signs and symptoms of the illness, either as an outpatient or in the hospital. Occasionally, but not often, an antibiotic may be prescribed, especially when a specific germ has been identified through laboratory testing.
If in doubt about your possible symptoms of food poisoning, see your medical provider for examination and possible treatment/advice.
Terry Hollenbeck, M.D., is an urgent-care physician at Palo Alto Medical Foundation Santa Cruz in Scotts Valley. Readers can view his previous columns on his website, valleydoctor.wordpress.com, or e-mail him at va**********@sb*******.net. Information