Sunday morning in Flint / Matthew Smith

October 7, 2016; New York Times

One year since a public health emergency was declared in Flint due to lead-contaminated water, the struggle continues for residents of the hard-hit city. The most recent issue they’re facing is an outbreak of shigellosis, a highly contagious bacterial infection that is transmitted through the accidental ingestion of infected fecal material and causes diarrhea, fever, and abdominal pain.

Matt Karwowski, a medical epidemiologist with the CDC, says, “There is definitely some question about whether changes in hand-washing and hygiene practices may be playing a role. People in Flint have been concerned about the safety of their water supply, and that may be playing a role in their hygiene practices.”

The crisis in Flint began when city officials decided to switch from water derived from Lake Huron to the Flint River. Shortly after the switch, in 2014, residents began complaining that the water’s color was off and that it tasted bad. Earlier this year, a state of emergency was announced in Michigan, and the state’s chief medical executive indicated that Flint residents should use lead filters or drink bottled water until further notice. The National Guard was activated and has been distributing bottled water and baby wipes since the beginning of 2016. It is a tragic story closely watched by NPQ.

However, these reactions have actually created an environment in which the shigella bacteria can thrive. The CDC advises frequent hand washing with warm, soapy water to prevent transmission of shigellosis. Unfortunately, even with a lead filter, hot water contains more lead than cold water, so residents have been advised to use cold water for consumption. Further, many residents are still too scared to touch the water at all since they developed rashes from the water in 2014 and 2015. Delano Whidbee, a Flint resident and father of two young girls, says, “With the kids, we use baby wipes,” even though they have filters on their showerheads and faucets. Baby wipes are available for free at bottled water distribution sites, but they are not chlorinated and offer little protection against shigella.

An alarming number of shigellosis cases have arisen in Genesee County. Data from the Michigan Department of Health and Human Services shows that Genesee County has the highest number of shigellosis cases in the entire state. Further, of the 84 cases in Genesee County, 53 are within Flint city limits. County health records show that since the water crisis in Flint, there has been a steady increase of shigellosis, particularly among children.

To combat this outbreak, the CDC has initiated a “wash your hands” campaign for Genesee County. While this could address the spread of shigellosis, it does little to combat the underlying cause of the outbreak, which is that residents are still too scared to use the water and legitimately do not trust city officials who originally told them the lead contaminated water was safe.—Sheela Nimishakavi