Shigella Outbreak Response Guide for Elderly Care Facilities

Immediate Response: Isolation and Resident Assessment

Upon suspected or confirmed Shigella cases, immediately isolate affected residents in separate rooms with dedicated bathrooms when possible. Shigella spreads through fecal-oral contact, so strict hand hygiene protocols are essential—CDC guidelines recommend frequent handwashing with soap and water over alcohol-based sanitizers for this pathogen. Notify your facility's infection control team and medical director immediately, and document all symptomatic residents (diarrhea, abdominal cramps, fever) in medical records. Screen all staff and other residents for symptoms daily during the outbreak period, and restrict symptomatic employees from working until they've been symptom-free for 24 hours without medication.

Health Department Notification and Coordination

Contact your local health department immediately—Shigella is a reportable disease in all U.S. states. Provide detailed information including resident names, symptoms, onset dates, and any suspected food or person-to-person transmission sources. The health department will conduct an epidemiological investigation, which may include stool sample collection and testing through their laboratory partners. Assign one staff member as the primary liaison to the health department to ensure consistent communication and faster response times. Document all health department instructions, testing results, and recommendations in a centralized log that includes dates, times, and names of officials contacted.

Documentation, Food Source Investigation, and Staff Communication

Maintain detailed records of all confirmed cases, including symptom onset dates, test results, and clinical outcomes—this information may be subpoenaed by public health authorities. Review food service records for the 1-3 days preceding symptom onset to identify potential sources (focus on high-risk foods like deli meats, fresh produce, and foods held at improper temperatures). Communicate transparently with staff about outbreak protocols without disclosing resident identities; emphasize the importance of hand hygiene, appropriate PPE use, and reporting any symptoms immediately. If families contact you, provide factual information about cases in your facility (aggregate numbers only) and reinforce that outbreak protocols are in place to prevent further spread.

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