In Springfield MA 699 residents got Shigella 7/91-12/91; 1/92-6/99 the average number of cases/half year was <5. During the second half of 1999 the City incurred 314 cases. Both Springfield DHHS and Massachusetts DPH responded promptly and intensely when two 6/99 cases were followed by several more in late 7/99. Community control measures were information packets mailed to food establishments, health and day care providers, summer camps, youth groups, WIC programs, nursing homes and faith communities, with follow-up inspections. Ongoing media participation promoted community awareness, stressing preventive behaviors. Distinctive English and Spanish flyers promoting handwashing were distributed. Public health nurses interviewed and educated virtually every case and their family. Two negative stool specimens were required before day care clients, providers, and food handlers could resume activities. Computer mapping tracked geographic/geo-temporal spread. Entering August the epidemic was rising and the School Department's support was enlisted. An overall action plan, including a letter to all parents the first week of school, was accepted. Though presumed person-to-person transmission in several schools accounted for small clusters, and for one larger cluster of 10 there was no fulminant school-mediated outbreak. Containment and control measures for the 1991 and 1999 outbreaks were not dissimilar; in 1999 we benefited from reports and materials prepared in 1991, enabling quicker response. The question left to ponder: Why another,albeit smaller, outbreak 8 years later?
Learning Objectives: To identify containment strategies for an outbreak of a communicable disease transmitted through the fecal-oral route. To distinguish outbreak containment strategies that are best suited for various population sub-groups
Keywords: Communicable Disease, Epidemiology
Presenting author's disclosure statement:
Organization/institution whose products or services will be discussed: Springfield (MA) Department of Health and Human Services, Massachusetts Department of Public Health
I do not have any significant financial interest/arrangement or affiliation with any organization/institution whose products or services are being discussed in this session.