Shigellosis

What is shigellosis?

Shigellosis is a bacterial infection of the stomach and intestine. Another name for shigellosis is bacillary dysentery.

Shigellosis can be a problem where sanitation is poor and large groups of people are crowded together. It is becoming more common in day care centers and nursing homes.

In children and older adults, the illness can be severe and can be accompanied by dehydration (loss of body fluids), imbalance of chemicals in the body, and by shock.

How does it occur?

The disease is caused by Shigella bacteria. It is spread through the feces (bowel movements) of people who carry the bacteria in their intestines. Carriers may or may not have symptoms.

You can get the disease by eating or drinking from anything contaminated with the bacteria. You can also get it by touching something contaminated (such as a plate), then touching your mouth. Flies can also spread the disease.

What are the symptoms?

Attacks of shigellosis are sudden and severe. The symptoms start about 12 hours to 3 days after you are exposed to the bacteria.

Symptoms include:

• fever that may reach 104°F (40°C)
• abdominal cramps
• nausea and vomiting
• frequent diarrhea with blood, mucus, and pus.

How is it diagnosed?

Your health care provider will review your symptoms and examine you. A sample of bowel movement may be sent to the lab for testing.

How is it treated?

Your provider may prescribe an antibiotic, but mild infections will get better without antibiotics. If you are taking an antibiotic, be sure to take all of it. Otherwise, the infection may come back and be harder to treat.

Normally the infection stays in the intestine. However, in the most serious cases, meningismus (irritation of membranes covering the brain and spinal cord), coma, and seizures may occur. If this happens, you will need to stay at the hospital, where you will be treated for shock and related problems.

How long will the effects last?

If you are generally in good health, you will feel better within a week. Taking antibiotics may shorten the illness to a few days.

How can I take care of myself?

If you have abdominal pain, it may help to put a hot water bottle or electric heating pad (set on low) on your abdomen. Be careful not to burn your skin.

Ask your health care provider if you can take aspirin, acetaminophen, or ibuprofen to control your fever. (Anyone under age 21 who may have a viral illness should not take aspirin because aspirin increases the risk of Reye's syndrome.)

You may want to let your bowel rest for a few hours by drinking only clear liquids such as water, weak tea, bouillon, and apples juice, or oral rehydrating or electrolyte solutions. You may also drink soft drinks without caffeine (such as 7 UP) after letting them lose some of their carbonation (go flat). Make sure you drink often so you do not become dehydrated. Becoming dehydrated can be very dangerous, especially for children, older adults, and some people who have other medical problems. Suck on ice chips or Popsicles if you feel too nauseated to drink fluids.

It is OK to keep eating as long as it does not seem to worsen the diarrhea or stomach cramps. Foods that are easiest to digest are soft starchy foods, such as bananas, cooked cereal, rice, plain noodles, eggs, gelatin, toast or bread with jelly, and applesauce. Avoid milk products and caffeine for a few days. Return to your normal diet after 2 or 3 days, but for several days avoid fresh fruit (other than bananas), alcohol, greasy or fatty foods such as cheeseburgers or bacon, and highly seasoned or spicy foods. Avoid most fresh vegetables. Cooked carrots, potatoes, and squash are fine. If eating seems to worsen the diarrhea, let your bowel rest for a few hours by drinking just clear liquids.

Be cautious about taking nonprescription antidiarrheal medicines such as loperamide (Kaopectate or Imodium) or the prescription medicine Lomotil. These medicines can actually make the illness more severe, especially if the diarrhea is bloody. If you take one of these medicines, make sure you use only the dose recommended on the package. If you have chronic health problems, always check with your health care provider before you use any medicine for diarrhea.

Until your recovery is complete, avoid contact with others. Rest in bed or limit your activities until fever and weakness are gone.

If your symptoms do not improve or if you develop new symptoms, tell your health care provider.

How can I help prevent the spread of shigellosis?

To help prevent the spread of this disease when you are infected:

• Wash your hands with soap and very warm water after using the bathroom and before eating or preparing food
• Do not prepare food for others.
• Wash and store your linens and towels separately from those used by others.
• Wash and store your drinking glasses, plates, and utensils separately from those used by others.