Shigellosis is also known as 'baciliary dysentery'. It is an intestinal infection that is a major public health problem in many developing countries, where it causes about 5 to I0 per cent of childhood diarrhea. Most cases are seen in the summer and early fall and occur as single cases or outbreaks.

Shigellosis rarely occurs in animals; it is principally a disease of humans and other primates such as monkeys and chimpanzees.

Causes

Shigella germs are found in the intestinal tract of infected people who in turn may contaminate food or water. The shigella germ is spread by eating or drinking contaminated food or water or by direct contact with an infected person. The bacteria penetrate the lining of your intestine, causing swelling and possibly causing sores to develop. Poor hand-washing habits and eating contaminated food may cause the condition. Shigellosis is often found in day care centers, nursing homes, refugee camps, and other places where conditions are crowded and sanitation is poor.

Vegetables can be contaminated if they are harvested from a field with sewage in it. Also, flies can breed in infected feces and then contaminate food.

Symptoms

In some people, especially young children and older adults, the diarrhea can be so severe that hospitalization is needed. Some people who are infected may have no symptoms at all but may still spread shigellosis to others. Symptoms include :-

Diarrhea (often bloody)

Abdominal pain and cramps

Fever

Symptoms usually begin 1 to 3 days after exposure (range, 12 hours to 4 days).

Rarely, Shigella bacteria can affect other organs in the body aside from the digestive tract. This can lead to arthritis, skin rashes, kidney failure, or neurological problems such as seizures, stiff neck, headache, lethargy, confusion, and hallucinations.

Treatment

Antimicrobial treatment may include Bactrim (trimethoprim-sulfamethoxazole) or Cipro (ciprofloxacin), usually for 7 to 10 days. Appropriate treatment kills the Shigella bacteria that might be present in the patient's stools, and shortens the illness. Unfortunately, some Shigella bacteria have become resistant to antibiotics and using antibiotics to treat shigellosis can actually make the germs more resistant in the future.

Antidiarrheal drugs such as diphenoxylate or loperamideSome Trade Names IMODIUM may prolong the infection and should not be used.

Those who are infected with Shigella who are already malnourished need special attention, as do infants under 12 months old, and those already dehydrated. The most severely ill should be cared for in hospital and the others should be followed up at least once every 48 hours until they are better.