Public Health Communications
Golden? Jefferson County Department of Health and Environment?s (JCDHE) Epidemiological team in conjunction with the Jefferson County Sheriff?s Office (JCSO) medical staff at the jail have worked tirelessly to discover the cause of a gastrointestinal disease at the Jefferson County Jail. The outbreak, which peaked on July 5-6, was caused by a Shiga toxin-producing E. coli bacteria and resulted in 10 hospital referrals and affected a minimum of 135 of the 1238 inmates (11%) housed at the facility. Twenty-two sick inmates have tested positive to date for one of two toxins associated with the infection. While the peak of illness has passed, a much smaller secondary wave from person-to-person spread has been identified, beginning on approximately July 16. Further control measures to reduce personal hand contact and to increase disinfection of housing areas are in place. ?We are quite anxious to see the end of this outbreak,? said Dr. Mark Johnson, Executive Director of the health department, ?but recognize we must remain vigilant.?
While the bacteria that caused the outbreak has similarities to E. coli 0157:H7?(the cause of similar illness resulting in nationwide recalls of hamburger and spinach in recent years) the bacteria causing illness at the jail appears most likely to have come from one or more infected food handlers. The absence of similar illness outbreaks in the community, across the region and nationwide, make it highly unlikely that foods were contaminated outside the jail setting. Rather, it is more likely that one or more ill inmates handled food while symptomatic and without taking proper precautions (e.g., strict hand-washing) to avoid contamination of the food being prepared. All food served at the jail is now being prepared by outside workers who have not had an opportunity for exposure to the infection. ?While some former inmate food handlers have tested positive for the toxin produced by the E. coli bacteria, it is impossible to state whether they or a previously infected worker who may well have been released some time ago, might have been the source.? said Dr. Gayle Miller, JCDHE Epidemiologist.
Illness in this outbreak is characterized by severe abdominal cramping, diarrhea ? often bloody ? and more rarely vomiting and a low-grade fever. The illness generally lasts 5-10 days and those infected usually recover without complications, although rare serious complications can occur. Antibiotics, which may kill the bacteria but do not effect the toxin that causes the bulk of symptoms, are generally not considered appropriate for this illness. Medical treatment at the jail is aimed at easing immediate symptoms, providing pain relief for cramping and providing plenty of fluids including intravenous fluids if needed. Jefferson County Sheriff Ted Mink said, ?We are working very closely with the Epidemiological Response team from JCDHE to ensure the health of all of our inmates.?
No hospitalizations have occurred to date with the small secondary wave of illness. Dr. Miller again underscored the challenges in control of person-to-person spread in a jail environment, ?This type of organism is difficult to control in a large population who come in contact with each other on a frequent basis.? Isolation of ill patients from the rest of the jail population, and thoroughly washing down and disinfecting the kitchen and eating areas and individual cells are measures continually being implemented. Previous food handlers are being tested and medically evaluated, but are not expected to return to food handling duties in the near future to ensure that the illness is brought under control and relying instead on outside workers.
The Sheriff's Office has established an information hotline at 303-271-5898 in order to provide timely and accurate information about the progress of this incident.
Any inmates who were recently discharged from the jail, or their family members, who are experiencing intestinal illness including stomach cramps, diarrhea and/or nausea are urged to call the Jefferson County Department of Health and Environment at 303-239-7052.
For more information on Shiga toxin-producing Escherichia coli (STEC) please visit the Colorado Department of Public Health and Environment web site at: http://www.cdphe.state.co.us/dc/epidemiology/STEC_fs.html