Lillian B. Brown, MPH¹, Barbara Adam², Jeffrey W. Todd, MS, CAE³, Pamela Kirkpatrick, RN³, and Mark S. Dworkin, MD, MPH&TM². (1) Illinois Department of Public Health, 100 W. Randolph, Suite 6-600, Chicago, IL 60601, 312/814-4730, lbrown1@idph.state.il.us, (2) Division of Infectious Diseases, Communicable Disease Section, Illinois Department of Public Health, 4302 N Main, Suite 6-600, Rockford, IL 61105, (3) Stephenson County Health Department, 10 W. Linden Ave, Freeport, IL 61032

Background: In the United States, Shigella infects an estimated 450,000 persons annually resulting in >5000 hospitalizations. Stephenson County, Illinois first recognized a community-wide outbreak of shigellosis in November, 2002 which was initially controlled using routine measures (e.g. education about handwashing). Although a marked reduction in cases followed, a resurgence occurred in April 2003. Methods: A community task force comprised of the state and local health department, health care providers, school nurses and principals, the superintendent of the school district, community leaders, and the local media was created and first convened in early May. The task force augmented the local health department’s surveillance and control efforts in the community through an aggressive educational campaign targeting health care providers, schools, and day cares and emphasizing diagnosis and reporting of diarrheal illness in addition to hand hygiene. Results: Among 305 cases of shigellosis reported between November 2002 through July 2003, 251 were laboratory-confirmed and 54 were probable cases, including 149 cases reported in May, 48 in June, and 9 in July 2003. Of confirmed and probable cases, 27% were day care center attendees and 18% were their household contacts, 30% were reported in kindergarten students of one school and their household contacts, and 25% of cases had no epidemiological links to day care or kindergarten students. Conclusion: Community-wide outbreaks of shigellosis can be difficult to control because of high secondary attack rates, poor hand hygiene, and multiple points of exposure. Community task forces can address lack of education and apathy regarding hand hygiene, and improve surveillance. This outbreak provides support for a task force to promote aggressive community education.

Learning Objectives: At the conclusion of the session, the participant(learner) in this session will be able to

• Describe the role of a community task force during an outbreak of diarrheal illness in the community.
• Identify members of a community appropriate for a task force.
• Identify situations in which a community task force is beneficial to reducing transmission of communicable disease.

Keywords: Community Collaboration, Diarrhea

Presenting author's disclosure statement:
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.