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    Understanding shigellosis and how to prevent it

    Shigellosis is an intestinal disease caused by a group of bacteria known as Shigella. If left untreated, shigellosis can be potentially life-threatening. Outbreaks of this bacterial infection occur at times and it’s important to know about this condition, how it is transmitted, and what can be done to prevent it from spreading.

    Around the world, shigellosis occurs in at least 80 million people resulting in around 700,000 deaths every year.

    Causes of this bacterial infection

    Shigellosis develops after accidentally ingesting the Shigella bacteria and this may occur when:

    ·         Eating food contaminated with the organisms. People who work with food may contaminate the products they work with and others then eat the food. Food that grows in areas where sewage spills into may also be contaminated with the bacteria.

    ·         Changing clothes or diapers of children who have shigellosis. When people who work with clothes contaminated with Shigella don’t wash their hands adequately enough, they may end up contaminating themselves or others. If this occurs in a hospital or child-care facility the consequences may be severe.

    ·         Drinking water contaminated with the Shigella organism. Water can become contaminated with the bacteria if it’s exposed to sewage or people with shigellosis swimming in it.

    Who is at risk?

    The following individuals are at a risk of contracting this infection:

    ·         Toddler’s between 2 and 4 years of age.

    ·         Those traveling to or living in developing countries that lack basic sanitation.

    ·         Those who live in close quarters, group housing, or take part in activities with others who are diagnosed with shigellosis. Outbreaks of shigellosis occur in locations such as community pools, child-care centers, nursing homes, military barracks, and jails.

    ·         Individuals who partake in direct or indirect sexual acts involving oral-anal contact.

    What are the signs and symptoms of the disease?

    The clinical presentation of shigellosis usually starts at around one or two days after contact with Shigella but it may also take up to a week to develop. Patients may present with abdominal cramps or pains, fever, and diarrhea that may contain blood and mucus.

    Complications that may develop

    Shigella doesn’t usually lead to complications, but when it does it can result in the following:

    ·         Dehydration due to persistent diarrhea.

    ·         High fevers associated with the condition can result in convulsions due to the fever or the bacteria itself.

    ·         Straining during bowel movements may lead to a rectal prolapse.

    ·         The toxins produced by Shigella may result in damage to the red blood cells and platelets resulting in their levels dropping. Acute kidney failure may also develop.

    ·         A condition known as toxic megacolon may develop where the large bowel becomes paralyzed and doesn’t function properly.

    Management and prevention

    Shigellosis may take five to seven days to resolve on its own and the affected individual is treated conservatively by managing the fevers with pain medications, such as acetaminophen and ibuprofen, and replacing lost electrolytes and fluids through the intake of water and oral rehydration products.

    Children who have diarrhea that causes moderate to severe dehydration, with signs of lethargy and not wanting to drink, diarrhea with blood in it, or diarrhea in the presence of a fever above 101 degrees F should be taken to a primary care doctor or find best doctor on xpertdox or emergency room for immediate medical attention. Such patients may need to be admitted to a hospital to receive intravenous fluids.

    Severe Shigella infections are treated with antibiotics and these medications are reserved for those who have a confirmed case of shigellosis. The sensitivity to the antibiotics is determined to avoid prescribing medication that the bacteria may be resistant to. Antibiotics are also reserved for infants, the elderly, and immunocompromised patients such as those with HIV.

    Shigellosis can be prevented by:

    ·         Checking to make sure that small children are washing their hands properly.

    ·         Making sure to wash hands thoroughly and frequently, especially when working with food and people diagnosed with the infection.

    ·         Getting rid of soiled diapers in the correct manner and disinfecting changing areas after they are used.

    ·         Not preparing food when having diarrhea.

    ·         Keeping children who have diarrhea at home and away from their child-care center or school.

    ·         Avoiding drinking or accidentally swallowing water from untreated pools, lakes, or ponds.

    ·         Not partaking in sexual activities with anyone who has diarrhea or who has recently recovered from a bacterial gastrointestinal infection.

    References

    Information compiled using the following source:

    Hale TL, Keusch GT. Shigella. In: Baron S, editor. Medical Microbiology. 4th edition. Galveston (TX): University of Texas Medical Branch at Galveston; 1996. Chapter 22. Available from: https://www.ncbi.nlm.nih.gov/books/NBK8038/

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