Shigellosis

Shigellosis is a bacterial infection caused by different species of Shigella bacteria. It is characterized by runny stools that have blood or pus in it along with fever, nausea and abdominal cramps. There are four species of Shigella that are commonly associated with human infections: S. dysenteriae, S. flexneri, S. boydii and S. sonnie.

Where does it occur?

It occurs worldwide.

How is it transmitted?

It is transmitted primarily by ingesting fecal material of an infected individual through soiled hands. It is also transmitted through fecally contaminated food and water. One can get sick by ingesting as few as 10-100 bacteria.

Is it contagious from person to person?

It is contagious from person to person by ingesting fecal material of an infected individual through soiled hands.

What is the risk for travelers?

Generally the risk is low, but increased in travelers to developing nations who eat adventurously.

How soon after exposure will one develop symptoms?

Symptoms generally develop 1-3 days after ingestion, but may take up to a week.

What are the signs and symptoms?

Symptoms can start with fever and abdominal cramping followed by large volume diarrhea. Subsequently the volume of stools decreases, but may see pus or blood in it and experience pain with bowel movements. Symptoms may resolve by itself in a week without treatment in mild cases.

Rarely one can see complications of massively enlarged colon, perforation, pneumonia and sepsis. A complication called hemolytic uremic syndrome with destruction of red blood cells and kidney failure can also be seen occasionally.

After the diarrheal illness has resolved a subset of people may develop Reiter’s syndrome characterized by arthritis of large joints of the pelvis and hips.

Are there any lab tests to diagnose the illness?

Isolation of the shigella bacteria from feces confirms the diagnosis.

Is there any treatment?

Antibiotics in the fluoroquinolone family like ciprofloxacin, levofloxacin, moxifloxacin are effective.

What preventive measures can be taken?

Practice strict hand washing and eat only in places that have a modicum of sanitation. Follow food safety and water safety precautions.

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