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When residents in Lavaca County, Texas began falling ill with Shigellosis, the illness associated with infection with Shigella bacteria, the State Health Department stepped in to begin an investigation.
State Health Department Steps In
Why the State Health Department and not the local Health Department? In areas where there is no local health authority, the Department of State Health Services becomes the governing body.
Hallettsville, with a population of 2,742 and Lavaca County, with a population of 20,544 does not have such an authority. As such, the regional State Health Department responded when people began falling sick with the same illness.
The Texas Department of State health Services Public Health Region 8 is responsible for inspecting and issuing permits for businesses, such as food establishments in that particular region.
Public Health Advisory Issued
On June 1, 2023, this agency issued a Public Health Advisory for the area called, “Shigellosis Outbreak in Lavaca County.” According to the announcement, the agency is currently working on identifying the source of the outbreak. They are interviewing those who have fallen ill and have collected food samples from a local restaurant that kept popping up in the food survey.
The advisory does not explicitly list the restaurant, as the investigation is still in the early stages, however one restaurant seems to be implicated. In an effort to cooperate, they temporarily closed their doors and issued a statement. That restaurant is Los Cabos San Lucas Mexican Grill.
Several Lawsuits Associated with Outbreak
Dozens of people have been linked to this outbreak, some of which have filed suit after becoming sick with shigellosis after eating at Los Cabos San Lucas Mexican Grill. More lawsuits are expected.
Restaurant Issues Statement
After the news broke on May 31st, the owner, Mr. Sanches voluntarily closed the restaurant and contacted health inspectors. He issued the following statement: “We would like to offer our apologies to our customers affected by last Thursday’s dinner service. We have been working closely with our food suppliers, employees, and health inspectors on fixing the problem.”
Health Inspectors Arrived the Next Day
Health inspectors arrived at 9:00am on June 1st to do a complete investigation. The entire facility was inspected, samples were obtained, and the restaurant discarded all food products.
Sanchez indicated that all new food products would be arriving the following day so that staff could prepare all food from scratch. The restaurant reopened on Friday, June 2nd for dinner service at 5:00pm.
Where Could Shigella Come From
Shigella is the bacteria that causes the illness, shigellosis. It is spread from contact with infected feces and also lives naturally in fresh water. Shigella spreads quite easily, with microscopic amounts causing illness. To make matters worse, those who are infected can continue to spread the infection long after their own symptoms end. This can end up being several weeks after they feel better.
The primary way for Shigella bacteria to spread is though inadvertently swallowing it. This can occur in several different ways. It often happens when someone touches their mouth after touching surfaces – such as bathroom fixtures, changing tables, door handles, or other high traffic contact surfaces. You can get it from swallowing water from a lade or improperly treated swimming pool. It can come from consuming contaminated drinking water or eating food prepared by someone with a Shigella infection. Any contact with poop is a high-risk activity – such as changing the diaper of a child or caring for a family member with a Shigella infection. In some cases, sexual contact with someone with a Shigella infection or recently recovered from one can spread the illness.
No Obvious Source
From the owner’s quote, “We have been working closely with our food suppliers, employees, and health inspectors on fixing the problem” it seems that he considers the ingredients to be a potential source. Of course, that is a realistic first step.
As of this week, there have been no United States Food and Drug Administration (FDA) or United States Department of Agriculture (USDA) recalls for any food products related to Shigella contamination. There have been no reported Centers for Disease Control and Prevention (CDC) outbreaks listed citing shigellosis. There have been no reports of water contamination as of the most recent reports for the City of Hallettsville Water Plant, however the latest report is about 2 months old.
So Where Does That Lead Us?
So, if it is unlikely to be an ingredient or water contamination. That only leads us to the human factor. Somewhere along the way, someone who was sick spread the illness to those who ate at the restaurant. Poor hand washing is often the cause.
Combined with the microscopic amounts necessary to spread the illness and the length of time the illness can be spread after diarrheal symptoms; this is often the source of foodborne outbreaks.
What Does an Investigation Look Like?
Samples of food in packages and those of food that has been handled could shed light on whether the contamination may have occurred prior to or after it was received by the restaurant. Unfortunately, any food prepared during the timeframe in questions has been used or discarded at this point.
Being a small town, many folks’ paths likely cross. Eating at the same places, shopping at the same stores, etc. Combing through interview data and getting as many food surveys as possible can help investigators pinpoint a likely source.
Symptoms often include diarrhea (sometimes bloody and lasting more than 3 days), fever, stomach pain, and the sensation of needing to pass stools even though the bowel is empty. These symptoms often begin around a day or two after exposure. In rare cases, some people will not experience any symptoms.
Symptoms often last around 5 to 7 days, though this can be much longer for some. It could take weeks or even months for some to resume normal bowel habits.
Some may recover without medical intervention. Some may need some help managing serious symptoms leading to dehydration. Others may experience serious, and sometimes life-threatening illness as a result of Shigella infection. Reactive arthritis, bloodstream infections, seizures, and hemolytic-uremic syndrome are serious complications.
Around 2% of those infected with certain strains of Shigella will experience reactive arthritis from infection. These can cause joint pain, eye irritation, and painful urination. It often lasts around 3 to 5 months, can go on for years in some cases, developing into chronic arthritis.
Around 0.4 to 7.3% of people infected by Shigella bacteria develop bloodstream infection. This occurs when germs inside the gut make their way into the bloodstream. For Shigella, this happens when the bacteria damages the intestinal lining. This type of complication is more common in those with a weakened immune system such as those with diabetes, HIV, cancer, or severe malnutrition. It is more commonly seen in children than adults. Shigellosis that leads to a bloodstream infection has a higher risk of fatality compared to those who do not migrate to the bloodstream.
Children are more likely to experience seizures when experiencing Shigellosis, and they often resolve without treatment. High fever, low blood sugar and abnormal blood electrolytes are commonly seen in children that experience Shigella-related seizures.
Another rare complication that more commonly infects children with Shigellosis is Hemolytic-uremic syndrome (HUS). This complication is a type of kidney failure that results when the bacterial infection destroys red blood cells, which in turn produces a toxin that blocks the kidneys’ ability to filter.
Bloody diarrhea is often common with this type of infection. HUS is more likely to present after treatment with antimicrobial resistant drugs are started after 4 days of symptoms. This scary complication is the leading cause of death in Shigella dysenteriae outbreaks.
What to Do If You Are Affected By this Outbreak
If you or a family member are affected by this outbreak, there are a few tips to help you through it.
Wash Hands Often
Proper hand washing is key to preventing the spread of Shigellosis. Use warm, soapy water for at least 20 seconds especially after using the restroom and before and after eating or drinking.
Us a Separate Bathroom
If available, use a separate bathroom from other household members. If this is not an option, be sure to clean and disinfect the bathroom after each use.
Do Not Prepare Food for Others
While you are sick and even a little while afterward, do not prepare food for others. The risk of spreading the harmful bacteria into food is too great to risk it.
Do Not Go Swimming
Swimming provides an opportunity to spread the harmful bacteria to others. It only takes microscopic amounts to become sick.
Do not go to school, daycare, or jobs in healthcare or food service. The CDC recommends a minimum of at least 24 hours after symptoms (without taking medications that mask those symptoms).
Create a Food Diary
Write down the foods you have eaten and where you got them in the days leading up to falling ill. Most people think about the last meal they consumed prior to becoming sick. Often exposure occurs days prior. The faster you put those facts down on paper, the better. Our memories may fade and information could be lost over time.
Reach Out to a Food Poisoning Lawyer
Shigella infection is very scary and incurs huge long-term risks. As an experienced food poisoning lawyer, The Lange Law Firm can help answer your questions and navigate you through the aftermath. Reach out to (833) 330-3663 or email here for a free consultation.