It is late on a Sunday night and your son is clutching his stomach complaining of pain. He feels warm so you test his temperature and he definitely has a fever. He says he needs to use the bathroom and you are shocked to see that he has passed bloody diarrhea. You rush him to the emergency room in hopes that whatever he has is easily treated. A few days later you discover that your son actually has an antibiotic-resistant Shigella and that one of the few treatments available is not only more expensive but also more harmful than the antibiotics formerly used while not being as effective. You wonder how in the world your son contracted this disease which is spread through fecal matter. Could it have been at the party for new international students you attended on Friday night? Undoubtedly it would have been at that party. If you had only known of this bacterial infection common to the developing world then you could have taken steps to prevent it in your son.
The problem is that there are are some misconceptions regarding certain diseases in the U.S and where they are likely to originate. The CDC usually does a pretty good job looking at disease outbreaks and relaying to the public information by which they can protect themselves. However, unless the public is regularly checking the CDC website for themselves, they may not be aware of current disease outbreaks as the popular news websites don’t regularly post those type of stories. Sometimes these sites direct the information only to the segment of the population that they believe is affected. People who are not related to that specific segment of the population may be harmed by not getting the information they need to protect themselves and their families.
A good example of this is the recent outbreak of drug resistant Shigella that made news when it affected Kansas City. With a little research one can find that it has been affecting parts of the United States since May 2014. By February 2015 it had already been found in 32 states. By April the CDC decided it was important to let the public know how the outbreak started and how people could protect themselves. According, to their research about 50 percent of the cases originated in the homeless population and the other cases originated with international travelers. This multi-drug resistant Shigella has specifically been traced back to mostly international travellers from India and Dominican Republic. This information is not surprising once one looks at the rate of Shigella in those areas. They are both developing areas which do not have modern sewage systems.
It is also interesting that the CDC acknowledges that in the US the main outbreaks are occurring among child care facilities, gay men, and the homeless. At this same time some major news sources are mainly discussing Shigella spreading among children in child care settings. They are ignoring the fact that Shigella is also spread by international travelers, gay/bisexual men and the homeless. This is something that the general population should be aware of!
What should we learn from this information? First, this means that people traveling to developing countries should follow the advice from the CDC on how to avoid contracting Shigella. Second, residents of the US should be cautious of those immediately returning or coming from developing countries because the traveler could be infected with Shigella. The incubation period is about two days but a person may still infect others long after they are no longer showing signs of sickness. This is one reason Shigella is so contagious and at times difficult to contain.
This subject is important to me personally because I am related to one of the at risk groups by being married to a man from a developing country. When we travel internationally we are always aware of what we should be doing to protect ourselves from various diseases. However, we know that not everyone who travels internationally is as conscientious as we are. I am aware of this because many of my international friends travel back to the country of their origin, then spent part of their vacation sick from things as Shigella. They thought that since the country was their childhood home, they did not have to take the same precautions (drinking bottled water, not eating salads/fruit) that other travelers needed to take.
The media must be more diligent in informing the public concerning the entire risks of disease epidemics so that the populace can help stem the spread of infections and stop the outbreak.