At least 43 cases of shigellosis (primarily Shigella sonnei group D) have been diagnosed among the Observant Jewish community in Borough Park and Williamsburg since Nov. 14, according to the New York City Health Department.

Young children are primarily affected, with 79% of case-patients under six years old.

Health officials say outbreaks of shigellosis have occurred in this community every 3-5 years since the 1980s. Some outbreaks have involved hundreds of cases.

The Health Department recommends strict hand-washing after using the toilet, after diapering, before eating, and before preparing food. Young children should not attend daycare when they are ill. Children with shigellosis should not return to daycare until their symptoms resolve, and two stool specimens obtained at least 24 hours apart are negative for Shigella by culture.

New York City Health officials say all isolates to date from this outbreak are resistant to ampicillin, and one third are resistant to sulfamethoxazole/trimethoprim.

Shigellosis is an acute bacterial disease of the intestines caused by several species of the bacterium, Shigella. It is typified by loose stools, frequently containing blood and mucus (dysentery), accompanied by fever, vomiting, fever, vomiting, cramps and occasionally toxemia.

It can cause bacillary dysentery because of the invasive ability of the organism that may result ulcerations and abscesses of the intestines.

It rarely spreads to the bloodstream.

More severe complications may include convulsions in children, Reiter’s syndrome and hemolytic uremic syndrome depending on the species of Shigella implicated.

This diarrheal disease is found worldwide with the vast majority of cases and deaths being in children. Outbreaks usually occur where there are crowded conditions and where personal hygiene is poor: prisons, day care centers and refugee camps are three examples.

It is transmitted primarily by fecal-oral person to person means. It can also occur through contaminated food or water. Those primarily responsible for transmission are people that fail to wash their hands thoroughly after defecation.

Because shigella is resistant to gastric acid, a person can be infected with as little as 10 organisms.

After being infected, symptoms usually appear 1-3 days later. It can be transmitted during the acute phase of infection until approximately four weeks after illness when the organism is no longer present in the feces. Asymptomatic carriers can also infect others.

Diagnosis is confirmed through bacteriological culture of feces. Treatment of shigellosis may include fluid and electrolyte replacement if there are signs of dehydration.

Antibiotics can shorten the course of infection, the severity of illness and the period of time a person may excrete the pathogen. Because of some antibiotic resistance, an antibiotic susceptibility test should be performed to determine which antibiotic would be effective.

Borough Park is a neighborhood in the southwestern part of the borough of Brooklyn. It is home to one of the largest Orthodox Jewish communities outside of Israel. For more infectious disease news and information, visit and “like” the Infectious Disease News Facebook page