ROANOKE TIMES Copyright (c) 1997, Roanoke Times DATE: Friday, February 28, 1997 TAG: 9702280061 SECTION: VIRGINIA PAGE: C-3 EDITION: METRO SOURCE: SANDRA BROWN KELLY STAFF WRITER
Eight youngsters and possibly one grandmother in the Bedford County and Vinton areas have fallen victim in recent weeks to a highly infectious and debilitating intestinal illness, shigellosis.
In the most recent case, 7-year-old Brittany Smith was treated Sunday night at a Roanoke hospital emergency room.
Smith's grandmother, Alice Dent of Goodview, said the child's temperature was 104 degrees, and she was severely dehydrated when she got to the hospital.
Dent has not been diagnosed with the illness, but Thursday she said she was experiencing some of the symptoms and was taking an antibiotic as a precaution.
The highly infectious dysentery caused by the Shigella bacterium can result in diarrhea, high fever, nausea and often severe stomach cramps. The bacterium is found in fecal matter and is transmitted by hand-mouth contact.
It spreads easiest where there are crowds and questionable hygiene, such as schools and day care centers, where children often don't do a thorough job of washing their hands.
Worldwide, the illness kills about 600,000 people annually, most of them children under 10. The local victims are recovering, however.
Their cases appear to be related to an outbreak that began in January when a 2-year-old who attends Great Beginnings day care center in Vinton became ill.
It's not uncommon to see single cases of the illness, but the mini-outbreak that has been centered at the Vinton center and Stewartsville Elementary School is rare, health department workers say.
Health departments in Bedford and Roanoke County learned of the cases in early February. Doctors who identify shigellosis cases are required to report them to a health department, but some "do it sooner than others," said Dr. Joanna Harris of Lynchburg, director of the Central Virginia Health Department, which serves Bedford County.
Glenna Dunn, owner of Great Beginnings, said that once the first case of shigellosis was diagnosed at her center, she put up signs alerting parents to the illness. Still, her staff had a hard time convincing some parents to have their children treated quickly, she said.
The illness can be similar to the common stomach flu, and many parents thought the children could get over it quickly, she said.
Also, some children don't have as much reaction to the bacterium and can have the disease without symptoms, which makes controlling its spread even more difficult.
"Parents just didn't understand the seriousness of it," Dunn said. "It's highly, highly contagious."
To prevent its spread, the Great Beginnings staff washed toilets with bleach after every use by the children.
"And we had the little ones scrubbing their hands for a full minute," she said.
Dunn said health department workers told her the bacterium could be traced to well water or contaminated food. She said it didn't come from food prepared in her center's kitchen. The kitchen serves all four of her Roanoke Valley day-care centers and no children became ill at the other sites, she said.
The illness was confined to children from the Stewartsville school area, she said.
Six youngsters who attend the center became ill. Some of those children also attend Stewartsville Elementary and were among the six cases reported there, said health department workers.
Parents of Stewartsville students were put on alert about the problem this week when the school sent home a letter and literature about shigellosis.
Principal John Hicks said he's having school bathrooms scrubbed several times a day, and teachers are supervising students' handwashing after bathroom use and before meals.
Even the crayons students usually share have been sprayed with an antiseptic and are now assigned to children, not shared, he said.
Poor handwashing is probably the main culprit in the spread of the disease, said Anna Kennedy, public health nurse supervisor with Roanoke County.
Putting a dab of soap on your hands and rinsing them off, a practice of many students, isn't enough, she said. It doesn't matter if it's antibacterial soap, either.
"Antibacterial soap is nice, but it's not a requirement. Scrubbing works," Kennedy said.
Shigellosis has an incubation period of three days, but Kennedy said she won't believe the danger has passed until the area has gone two weeks without a new case.
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