Shigella Outbreak at Shannon Beach. By: Juliann Kibby & Carine Belizaire
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1 Shigella Outbreak at Shannon Beach By: Juliann Kibby & Carine Belizaire
2 Shannon Beach GoogleEarth
3 Sandy Beach is now Shannon Beach September 13, 2008 Sandy Beach was renamed Shannon Beach Named after Senator Charles E. Shannon Shannon represented Winchester, Medford, & Somerville between Picture taken by Juliann Kibby
4 Shannon Beach Managed by the Department of Conservation and Recreation (DCR) Open to the public for swimming between Memorial Day and Labor Day Access to a swimming beach, picnic area, parking lot, grassy field, walking paths, playground, and restrooms. Facilities closed at 6 PM
5 Beach Area Bathroom & Changing Room Facilities Nearby Playground Pictures taken by Juliann Kibby
6 Picnic Areas Walking Paths Parking Lot Pictures taken by Juliann Kibby
7 Indication of rich life in water? Pictures taken by Juliann Kibby
8 DCR Water Testing Regular weekly water quality testing is done during the time the beach is open for swimming Indicates water is safe for swimming Swimming is not allowed because it could potentially cause health risks
9
10 What is Shigellosis? Infectious disease caused by a group of bacteria called Shigella Symptoms - diarrhea, fever, stomach cramps. (1-2 days after exposure) Rarely requires hospitalization Result from poor hygiene habits or sewage contaminating water
11 Our Goals Determine what the possible causes were that lead to the Shigella outbreak in 2009 Propose solutions to prevent this from occuring again & to protect the health of the public & beach environment
12 Methodology Contacted sources from EPA & MyRWA for history on the beach and data reports - researched area & issue Failed to hear back from DCR but called a hotline where we expressed our concerns Made visits to the site to monitor change Met up frequently to discuss information gathered & suggest solutions.
13 Source Investigations Mass Department of Public Health (MDPH) Interviewed confirmed cases Tested weekly for Enterococci & E.Coli beginning in May of 2009 MDPH Bureau of Environmental Health (BEH) Collected additional water & sand samples for testing on Aug. 17, 2009 prior to beach closing 5 locations throughout beach area. Sand tested for Shigella & water tested for Enterococci & E.Coli 25 surface swab samples taken after beach closing testing for Shigella
14 Source Investigations Mystic River Watershed Association (MyRWA) Anecdotal reports - described poor sanitary conditions of the beach - our personal observations supported these conditions Hotspot sampling testing for possible sewage contamination Samples from shoreline, nearby sewage pipes, & from the middle of the river Contamination in the Aberjona River
15 Massachusetts DPH 31 confirmed cases
16 Enterococci & E.Coli Fecal bacterial indicators of possible sewage contamination in water Enterococci levels shall not exceed a geometric mean of 33 organisms per 100 ml E. Coli levels shall not exceed a geometric mean of 126 organisms per 100 ml
17 Sand Sampling Locations by MDPH-BEH All negative results!
18 Additional Water Samples by MDPH-BEH
19 Swab Samples by MDPH-BEH All negative results!
20 Unsanitary Trash On Shoreline Pictures taken by Juliann Kibby
21 Overfilled trash barrel and no dog bags! Pictures taken by Juliann Kibby
22 Aberjona River - Winchester, Ma Hotspot results predicted possible high bacteria levels at the beach from sewage overflows in the river during storms Combined Sewer Overflows (CSOs) Sanitary Sewer Overflows (SSOs) Since July 2000, MyRWA has been monitoring water quality across the watershed Data proves prediction to be FALSE
23 Mystic River Watershed Association, Baseline Index
24 Mystic River Watershed Association, Baseline Index
25 Aberjona River - Winchester, Ma Low chance it is source of outbreak Water quality data does not match Storms events did not exist during period of concern Distance from beach to opening of river Presence of 2 forebays between locations Tendency of bacteria to attach to solids and settle out of water column
26 What s Going on Now? June of 2010 MyRWA makes a visit Majority people of Latino background Several barrels lined with plastic Outside working drinking fountain 2 port-o-potties with toilet paper & hand sanitizer May of 2011 We make a visit Off season, facilities locked No outdoor way for hand washing & drinking fountain turned off 1 overflowed barrel 3 port-o-potties with toilet paper & hand sanitizer Beach rules posted in English only Trash scattered along beach
27 Challenges No established protocol for Shigella testing DCR cleaned facilities between time the beach closed & swab samples taken Not all cases followed up Language & cultural barriers Biased answers in interviews Hotspot bias Have not been able to yet witness the beach during peak season
28 Enough Evidence to Close Beach! Environmental sampling & laboratory testing could not locate source Confirmed cases & poor sanitary conditions make it clear the area was connected Poor conditions make it a desirable site for transmission & spreading No cases later than Aug. 24, 2009 supports hypothesis that Shannon Beach was the likely source of the outbreak MyRWA & personal observations also support poor sanitary conditions
29 What can be done? Educate! Restore Facilities Continue water quality testing Increase staff to help maintain area Maintain, clean, and supply restrooms & porto-potties Ill people should not use the area Rules & regulations in other languages More barrels & regular changing of bags
30 EDUCATE! Inform public & require participation! Better hygiene & sanitary practices Eliminate direct pollution Reduce, Reuse, Recyle Flush responsibly Conserve water
31 Restore Facilities Environmental justice issue? MyRWA advocating for upgraded facilities Clivus multrum composting toilets Do not pollute the environment Biosolid waste is sanitized Motion sensor lights, sinks, soap dispensers, & hand dryers Save energy & water Prevent the spread of bacteria & germs Feminine napkin & diaper disposal boxes
32 Pictures taken by Juliann Kibby
33 - More trash barrels needed throughout beach & park area - Increase staff to consistently change trash
34 Discussion Environmental sampling & laboratory testing could not locate source Confirmed cases & poor sanitary conditions make it clear the area was connected Poor conditions make it a desirable site for transmission & spreading No cases later than Aug. 24, 2009 supports hypothesis that Shannon Beach was the likely source of the outbreak MyRWA & personal observations also support poor sanitary conditions Changes to the beach area need to be made in order to improve conditions - informing the public, educating the youth, building new facilities, increasing staff, and adding more barrels can all help in making the beach a healthier environment
35 Acknowledgments A special thank you to... Professor Anamarija Frankic Fellow class members of EEOS 476 Patrick Herron, Water Quality Monitoring Director from the MyRWA Karen Simpson from the EPA Other organizations including DPH and DCR for creating source investigation reports and providing a background on the beach area
36 References Agha, Dr. Rabia, and Dr. Marcia B. Goldberg. Clinical Manifestations and Dagnosis of Shigella Infections in Adults. 10 Dec Bacterial Assessment: 2009 Shigella outbreak at Shannon Beach, Winchester, MA, July 8, 2010 Technical Report Mystic River Watershed Association, Arlington,MA. "Baseline Monitoring." Mystic River Water Association. Mystic River Watershed Association, Web. 4 May < Brynes, Mark E. Sampling and Surverying Radiological Environments. Boca Raton, FL: CRC Press LLC, Commercial Composting Toilets. Humanure Handbook. Jenkins Publishing, May 2011 DCR Closes Shannon Beach and Playground Facility. Department of Conservation and Recreation, Massachusetts: August 21, 2009 Freshwater Inland Beachs. Department of Conservation and Recreation. Commonwealth of Massachusetts, April Hassett, George B. "Sandy Beach is Shannon Beach now." Somerville News 18 Sep 2008: 9 May < Herron, Patrick. Communication. 15 Feb MDPH Report on Shigella at Shannon Beach, July 15, Massachusetts Department of Public Health,Boston, MA. "National Center for Zoonotic, Vector-Borne, and Enteric Diseases. CDC. Centers for Disease Control and Prevention, 16 Nov Web. < Redlinger, Thomas, Jay Graham, Veronica Corella-Barud, and Raquel Avitia. "Dry-Composting Toilets." Applied and Envrionmental Microbiology (2001):
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