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Shigella Infection
Introduction
Shigella infection (shigellosis) is an intestinal disease caused by a family of bacteria known as shigella. The main sign of shigella infection is diarrhea, which often is bloody.
The bacteria remain active during the illness and for a week or two after you recover. It's possible for you to carry the shigella germ without developing symptoms, but then pass the illness to others.
Shigella can be passed through direct contact with the bacteria in the stool, such as in a child care setting where staff members don't wash their hands adequately when changing diapers or assisting toddlers with toilet training. Shigella bacteria also can be passed in contaminated food or by drinking or swimming in contaminated water.
Children between ages 2 and 4 are most likely to get shigellosis. Shigella infection is far more common in developing nations, especially where there's overcrowding and poor sanitation.
If you're in good health, a mild case of shigellosis is likely to clear up on its own. When shigella infection requires treatment, doctors generally prescribe antibiotics.
Signs and symptoms
Signs and symptoms of shigellosis usually begin a day or two after exposure to shigella. Diarrhea, often bloody, is the most common sign of shigellosis. Other signs and symptoms may include:
- Abdominal cramps.
- Fever.
Different types of shigella bacteria cause shigellosis. Group D shigella (Shigella sonnei) causes more than two-thirds of shigellosis in the United States, with group B (Shigella flexneri) accounting for the rest. The bacteria penetrate the lining of your intestine, causing swelling and possibly causing sores to develop.
Poor hygiene and inadequate hand washing can cause shigella to spread from an infected person. Toddlers in the process of toilet training may contract shigellosis, and then pass it to family members and playmates.
Eating contaminated food can cause shigellosis. Food that looks and smells normal may become contaminated as a result of:
- Handling by an infected person who fails to wash adequately after using the toilet.
- Growing in a field that contains sewage.
- Coming into contact with flies that breed in infected feces.
In developing nations, some types of the shigella germ can cause deadly epidemics.
Treatment
Shigella infection usually runs its course in five to seven days. Replacing lost fluids from diarrhea may be all the treatment you need, particularly if your general health is good and your shigella infection is mild. More severe cases may require further treatment.
Treatments include:
- Antibiotics. For severe shigella infection, which may last for weeks, antibiotics may shorten the duration of the illness. However, some shigella bacteria, particularly those contracted in developing nations, have become drug resistant. So it's better not to take antibiotics unless your shigella infection is severe, in which case your doctor may prescribe an antibiotic such as sulfamethoxazole with trimethoprim (Bactrim, Septra, others), ofloxacin (Floxin) or ciprofloxacin (Cipro). Antibiotics may also be necessary for infants, older adults and people who have HIV infection, as well as in situations where there's high risk of spreading the disease.
- Fluid and salt replacement. For generally healthy adults, drinking water may be enough to counteract the dehydrating effects of diarrhea. Children may benefit from an oral rehydrating solution, such as Pedialyte, available in drugstores. These solutions contain water and salts in specific proportions to replenish both fluids and electrolytes — minerals such as sodium, potassium and calcium that maintain the balance of fluids in your body.
Children and adults who are severely dehydrated need treatment in a hospital emergency room, where they can receive salts and fluids through a vein (intravenously), rather than by mouth. Intravenous hydration provides the body with water and essential nutrients much more quickly than oral solutions do.
Drugs intended to treat diarrhea, such as loperamide (Imodium) and diphenoxylate with atropine (Lomotil), can make your condition worse. Don't take them.
Prevention
Hand washing
Good hygiene, particularly thorough and frequent hand washing, is the best way to prevent the spread of shigella infection. Follow these instructions:
- Wet your hands with warm, running water and apply liquid or clean bar soap. Lather well.
- Rub your hands vigorously together for at least 15 seconds.
- Scrub all surfaces, including the backs of your hands, wrists, between your fingers and under your fingernails.
- Rinse well.
- Dry your hands with a clean or disposable towel.
- Use a towel to turn off the faucet.
Additional preventive actions
Other measures you can take to prevent the spread of shigella infection:
- Supervise small children when they wash their hands.
- Dispose of soiled diapers properly.
- Disinfect diaper-changing areas after use.
- Don't prepare food for others if you have diarrhea.
- Keep children with diarrhea home from child care, play groups or school.
Information obtained from National Institute of Health