of Shigella spp. via foods is very efficient, and because
of its low infectious dose, action to remove contamin-
ated food from commerce should be swift.
0015 Probably the most effective means to reduce the
spread of many bacterial and parasitic pathogens is
proper handwashing. Many agencies, including the
World Health Organization, have emphasized ad-
equate hand washing before and during meal prepar-
ation by those that work in food establishments and
the consumer as an effective means in reducing food-
borne outbreaks.
0016 To address the concerns of the introduction of
pathogens during food processing, a program, Hazard
Analysis and Critical Control Point (HACCP), was
established to identify and control specific food-
related practices. This analysis determines where tests
should be implemented to assay for the presence of
foodborne pathogens at critical stages of food produc-
tion. HACCP is an alternative approach to the trad-
itional method of analyzing the final food product.
Although HACCP may be a good monitoring system
for other pathogens commonly known to be associ-
ated with foods, such as Salmonella spp. and E. coli
O157:H7, testing for the presence of shigellae in
foods at this point may not be useful. For example,
contamination of foods with Shigella spp. commonly
occurs between the processing plant and the con-
sumer. However, proper adherence to good manufac-
turing process, such as hand washing and temporary
removal of employees with diarrheal illness, can
reduce outbreaks of shigellosis as well as other
forms of foodborne diseases. As an example, at a
mass gathering, a large outbreak occurred with nearly
half of the attendees (3000 people) developing shigel-
losis from consuming meals prepared where one food
handler was found to be ill.
Survival
0017 Since shigellae are not indigenous to any particular
food, this pathogen may be found in any food matrix.
In the past, foods containing contaminated raw vege-
tables have been implicated in many shigellosis out-
breaks. Other foods that are common vehicles for the
spread of shigellae include tossed salads, potato
salads, chicken, and shellfish. In a recent study, the
survivability of Shigella in packaged vegetables (ster-
ile and unsterile) held at different temperatures (5
C,
10
C, and room temperature) was reported. The
greatest reduction in number of shigellae recovered
was from the first 24 h. However, the data indicate
that shigellae do survive in the vegetables tested,
albeit after a 3 to 7 log reduction, for at least 10
days (although the initial inoculum was high (10
11
),
the final numbers (CFU g
1
) were between 10
4
and 10
8
).
0018In laboratory conditions, Shigella spp. can grow at
temperatures between 6
Cand48
C and at a pH of
between 4.8 and 9.3. In addition, Shigella can survive
at room temperature for up to 50 days in foods such
as milk, flour, eggs, clams, shrimp, and oysters, and
only 5–10 days in acidic foods (e.g., orange juice,
tomato juice, carbonated soft drinks) and 1–2 weeks
in refrigerated, fermented milk. It should be noted
that although shigellae do not survive well in acidic
foods, these organisms are able to survive the acidic
conditions of the stomach.
Detection of Shigella from Foods
0019Foods are not routinely examined for the presence of
shigellae. An outbreak of shigellosis is usually identi-
fied initially from clinical findings and epidemi-
ological investigations. Therefore, 7–10 days may
have passed before the first individual becomes ill.
During this time, the fate and condition of the con-
taminated food is unknown, presenting a challenge to
the laboratory responsible for isolating the etiological
agent. Moreover, the need to rapidly isolate and iden-
tify shigellae in foods is necessary to reduce the spread
of this pathogen.
0020Bacteriological scheme The Bacteriological Analyt-
ical Manual describes one protocol to isolate Shigella
spp. from foods. Twenty-five-gram sample portions
are added to 225 ml of Shigella broth supplemented
with novobiocin (0.5 mgml
1
for S. sonnei;3mgml
1
for other shigellae; this antibiotic is added to suppress
the natural bacterial flora of the food) and held for at
least 10 minutes at room temperature. The broth is
contained in a 500-ml flask and incubated overnight
at 37
C with shaking. Alternative protocols use other
enrichment broths, such as Gram-negative broth,
where food samples are blended in a sterile stomacher
bag, the contents poured into a flask and incubated at
37
C with shaking for 16–20 h.
0021Recovery of injured cells owing to a lengthy time
delay on foods and/or storage conditions before pro-
cessing a sample for analysis is problematic. Bile salts
and desoxycholate have an adverse affect on growth
of impaired cells; therefore, selective media without
these compounds are recommended. Food samples
are added to 100 ml of tryptic soy broth, the pH
adjusted to 7.0, and then blended. After 8 h of incu-
bation at 37
C, 125 ml of enrichment broth are
added and the incubation extended for an additional
16–20 h.
0022After enrichment in broth, cultures can be plated
on selective (low to high) agar medium. To optimize
the recovery of shigellae from foods, two or three
different ranges of selective agar plates should be used
(see Table 3). MacConkey agar is a low-selectivity
SHIGELLA
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