According to a Public Health Warning, on Saturday afternoon, October 17, 2015, the Santa Clara County Public Health Department was notified by a local hospital of 5 patients with fever and diarrhea who had all eaten at the same restaurant. Subsequent case finding has revealed a total of over two dozen individuals with fever and diarrhea who ate at Mariscos San Juan restaurant (205 N. 4 Street) in downtown San Jose on Friday October 16 or Saturday October 17. The restaurant was closed on Sunday morning and remains closed.
Of the ill persons, over a dozen have tested positive for Shigella by PCR, and one has a blood culture growing Shigella sonnei; almost all of the reported cases have required hospital admission, and 11 are in intensive care. There are other individuals who were seen and not admitted or who were ill but did not seek medical attention.
Shigella infection can be subclinical, but typically causes watery or bloody diarrhea with abdominal pain, fever, tenesmus, and malaise. Shigella is very infectious with just 10 -100 organisms are sufficient to cause disease. Transmission occurs via the fecal – oral route and can be spread by eating food prepared by an infected food handler or by direct person – to – person contact. Sexual transmission may also occur. Young children, the elderly, and HIV – infected individuals with CD4 count < 200 are more likely to have severe symptoms including dehydration, bacteremia, and seizures.