Shigellosis

Shigellosis, known historically as dysentery, is an infection of the intestines caused by Shigella bacteria. Symptoms generally start one to two days after exposure and include diarrhea, fever, abdominal pain, and feeling the need to pass stools even when the bowels are empty. The diarrhea may be bloody. Symptoms typically last five to seven days and it may take several months before bowel habits return entirely to normal. Complications can include reactive arthritis, sepsis, seizures, and hemolytic uremic syndrome. Shigellosis is caused by four specific types of Shigella. These are typically spread by exposure to infected feces. This can occur via contaminated food, water, hands or sexual contact. Contamination may be spread by flies or when changing diapers (nappies). Diagnosis is by stool culture. The risk of infection can be reduced by properly washing the hands. There is no vaccine. Shigellosis usually resolves without specific treatment. Rest, and sufficient fluids by mouth, are recommended. Bismuth subsalicylate may help with the symptoms; however, medications that slow the bowels such as loperamide are not recommended. In severe cases antibiotics may be used but resistance is common. Commonly used antibiotics include ciprofloxacin and azithromycin. A 2005 report by the World Health Organization estimated that shigellosis occurs in at least 80 million people and results in about 700,000 deaths a year globally. Most cases occur in the developing world. Young children are most commonly affected. Outbreaks of disease may occur in childcare settings and schools. It is also relatively common among travelers. In the United States about half a million cases occur a year.