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Shigella Infection: Symptoms, Causes, Complications, Diagnosis And Treatment

A bacterial infection, shigellosis (shigella infection) affects the digestive system. The intestinal disease is caused by a family of bacteria known as shigella. The Shigella spreads to the human body through contaminated water and food or through contact with contaminated faeces.

Children under age 5 are most likely to get shigella infection, although it can occur at any age. It is commonly reported in young children, mainly because they tend to put their fingers in their mouths often, therefore, are more likely to ingest the bacteria [1] .

Symptoms Of Shigellosis

Constant and continuous diarrhoea is the primary symptom of the condition. The signs usually begin a day or two after contact with shigella, but may take up to a week to develop. The most common symptoms are as follows [2] :

  • Diarrhoea, often containing blood or mucus
  • Abdominal pain or cramps
  • Fever
  • Vomiting

Causes Of Shigellosis

The infection develops when the bacteria enters your digestive system. The bacteria release toxins that irritate the intestines [3] .

  • Touching your mouth without washing your hands
  • Eating contaminated food
  • Swallowing contaminated water

Risk Factors For Shigellosis

  • Age
  • Living arrangements and activities such as coming into close contact with other people spread the bacteria from person to person. Shigella outbreaks are more common in childcare centres, community wading pools, nursing homes, jails etc.
  • Time spent in areas that lack sanitation
  • Men who have sex with men because of direct or indirect oral-anal contact

Complications Of Shigellosis

In most cases, the infection does not pose any severe complications. However, in some cases, the condition can cause the following complications [4] :

  • Dehydration
  • Seizure
  • Rectal prolapse (straining during bowel movements may cause the mucous membrane or lining of the rectum to move out through the anus)
  • Toxic megacolon (your colon becomes paralysed, preventing you from having a bowel movement or passing gas)
  • Hemolytic uraemic syndrome (caused by bacteria called E. coli, can lead to a low red blood cell count, low platelet count and acute kidney failure) [5]
  • Reactive arthritis

Diagnosis Of Shigellosis

The primary symptom of the condition is diarrhoea, which can indicate various other diseases as well. In order for the doctor to confirm shigellosis, a sample of your stool will be taken to be tested in a laboratory for the presence of shigella bacteria or their toxins [6] .

Treatment For Shigellosis

The infection usually runs its course in five to seven days. The central treatment will be replacing the lost fluids from diarrhoea.

  • Antibiotics: For severe shigella infection, antibiotics may help shorten the duration of the illness. However, doctors advise against antibiotic consumption because some shigella bacteria are drug-resistant, therefore only if the infection is severe, consume antibiotics [7] .
  • Fluid and salt replacement: For healthy adults, drinking water may be enough to counteract the dehydrating effects of diarrhoea. Children may benefit from an oral re-hydration solution. For individuals who are severely dehydrated, medical attention is required.

If you have extreme nausea and vomiting, you may need intravenous fluids and medication.

Prevention Of Shigellosis

Researches are still being conducted to develop a Shigella vaccine. In the meantime, medical professionals advise adopting the following steps to prevent the onset of the condition [8] :

  • Supervise small children when they wash their hands
  • Wash your hands frequently and thoroughly
  • Disinfect diaper-changing areas after use
  • Avoid swallowing water from ponds, lakes or
    untreated pools
  • Avoid sexual activity with anyone who has diarrhoea or who recently recovered from diarrhoea
  • Don't prepare food for others if you have diarrhoea
  • Dispose of soiled diaper properly

Consequently, once you have been infected by the same bacteria, you are not likely to contract the infection again [9] .

View Article References
  1. [1] Kotloff, K. L., Riddle, M. S., Platts-Mills, J. A., Pavlinac, P., & Zaidi, A. K. (2018). Shigellosis. The Lancet, 391(10122), 801-812.
  2. [2] Bennish, M. L., & Ahmed, S. (2020). Shigellosis. In Hunter's Tropical Medicine and Emerging Infectious Diseases (pp. 492-499). Content Repository Only!.
  3. [3] Taneja, N., & Mewara, A. (2016). Shigellosis: epidemiology in India. The Indian journal of medical research, 143(5), 565.
  4. [4] Baker, K. S., Dallman, T. J., Ashton, P. M., Day, M., Hughes, G., Crook, P. D., ... & Tomita, T. (2015). Intercontinental dissemination of azithromycin-resistant shigellosis through sexual transmission: a cross-sectional study. The Lancet infectious diseases, 15(8), 913-921.
  5. [5] Arnold, S., McCloskey, M., Shaheen, S., Hulverson, M., & Choi, R. (2018). Development of novel in vitro and in vivo models to evaluate antibiotic efficacy against shigellosis. The FASEB Journal, 32(1_supplement), 570-4.
  6. [6] Parsaei, P., Bahmani, M., Naghdi, N., Asadi-Samani, M., Rafieian-Kopaei, M., & Sepehri-Boroujeni, M. (2016). Shigellosis phytotherapy: A review of the most important native medicinal plants in Iran effective on Shigella. Der Pharmacia Lettre, 8(2), 249-255.
  7. [7] Serafino Wani, R. L., Filson, S. A., Chattaway, M. A., & Godbole, G. (2016). Invasive shigellosis in MSM. International journal of STD & AIDS, 27(10), 917-919.
  8. [8] Walker, B. (2016). Shigellosis. Nursing2019, 46(9), 66-67.
  9. [9] Behar, A., Baker, K. S., Bassal, R., Ezernitchi, A., Valinsky, L., Thomson, N. R., & Cohen, D. (2018). Microevolution and Patterns of Transmission of Shigella sonnei within Cyclic Outbreaks Shigellosis, Israel. Emerging infectious diseases, 24(7), 1335.
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