Shigellosis

Shigellosis, known historically as dysentery, is an infection of the intestines caused by Shigella bacteria.^[1][3] 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.^[1] The diarrhea may be bloody.^[1] Symptoms typically last five to seven days and it may take several months before bowel habits return entirely to normal.^[1] Complications can include reactive arthritis, sepsis, seizures, and hemolytic uremic syndrome.^[1]

Shigellosis is caused by four specific types of Shigella.^[2] These are typically spread by exposure to infected feces.^[1] This can occur via contaminated food, water, or hands or sexual contact.^[1][4] Contamination may be spread by flies or when changing diapers (nappies).^[1] Diagnosis is by stool culture.^[1]

The risk of infection can be reduced by properly washing the hands.^[1] There is no vaccine.^[1] Shigellosis usually resolves without specific treatment.^[1] Rest, and sufficient fluids by mouth, are recommended.^[1] Bismuth subsalicylate may help with the symptoms; however, medications that slow the bowels such as loperamide are not recommended.^[1] In severe cases antibiotics may be used but resistance is common.^[1][5] Commonly used antibiotics include ciprofloxacin and azithromycin.^[1]

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.^[2] Most cases occur in the developing world.^[2] Young children are most commonly affected.^[1] Outbreaks of disease may occur in childcare settings and schools.^[1] It is also relatively common among travelers.^[1] In the United States about half a million cases occur a year.^[1]