About Shigellosis
Shigellosis is an intestinal illness caused by a group of bacteria called SHIGELLA. SHIGELLA is very infectious and spreads easily through eating or drinking contaminated food or water and through direct contact with someone who is sick or has recently been sick with SHIGELLA, including sexual contact. Thorough and frequent hand washing with soap and water can help prevent shigellosis and spreading it to others. Common symptoms include diarrhea (sometimes bloody), abdominal cramps, nausea, fever and feeling the need to pass stool even when the bowels are empty or tenesmus. Symptoms usually begin within two days after exposure to SHIGELLA and typically last for five to 7 days. Many people may have mild disease that gets better without medical treatment and will recover fully. However, some people, especially young children, older adults, and persons with weakened immune systems, may have severe disease that requires hospitalization. A small number of people can develop complications such as bloodstream infections, seizures, kidney failure, or arthritis.
How does Shigella spread?
SHIGELLA is very infectious and spreads easily. An infected person sheds SHIGELLA bacteria in their stool while they are sick and often for more than a week afterwards and can spread the bacteria if they do not wash their hands well after using the toilet. SHIGELLA spreads from person-to-person through close personal contact (such as contact with infected diapered children) or exposure to the feces of an infected person during sexual contact. It also spreads by eating foods or liquids contaminated by an infected person or swallowing untreated recreational water (such as lakes or water park play fountains) contaminated with SHIGELLA.
Health care providers are required by law to report cases of shigellosis to the local health department. To prevent the spread of SHIGELLA, local health departments are required to restrict the activities of people with shigellosis who work in certain settings, such as daycare, food-related businesses, and health care workers who have direct patient contact until they are no longer infectious. Furthermore, daycare, food-related businesses and healthcare workers must be cleared by the local health department before they can return to work.
Who is at risk?
While shigellosis can affect anyone, some groups are at higher risk:
- Children <5 years old. Outbreaks can occur in school and childcare settings
- People traveling to places where water and food may be unsafe
- Gay, bisexual, and other men who have sex with men (GBMSM). Although rates are higher among GBMSM, risk is present for any sexual activity involving stool exposure
- People who are experiencing homelessness
Prevention
How can shigellosis be prevented?
Please keep the following guidance in mind:
- Clean hands frequently with soap and water, or, if this is not available, hand sanitizer. Wash hands after using the bathroom, after changing diapers, and before preparing food or drinks or eating.
- Help toddlers and small children wash their hands properly.
- Keep children with diarrhea out of childcare settings.
- Avoid swallowing water when swimming
- Do not prepare food for others or participate in recreational water activities (like swimming) if you have diarrhea.
- Avoid unprotected direct oral-anal contact and wash hands, areas of the body, or objects that may have had contact with fecal material.
- If you or your partner has been diagnosed with shigellosis, do not have sex for at least two weeks after diarrhea ends
- Thoroughly wash fruit and vegetables that will be eaten raw.
- If traveling to developing countries, drink only boiled or treated water and eat only cooked hot foods or fruits and vegetables that you peel yourself after thorough washing with treated/boiled water.
Testing and Treatment
How is shigellosis diagnosed and treated?
A health care provider diagnoses shigellosis by collecting a sample of stool and sending it to a microbiology laboratory. Shigella may also be found in the blood, but this is not common. Although some patients do not require medical treatment, more severely ill patients may need intravenous rehydration and antibiotics.
Extensively drug-resistant (XDR) SHIGELLA
XDR SHIGELLA infections have been rising across California. Healthcare providers should tailor shigellosis antibiotic treatment to available antimicrobial susceptibility testing (AST).
Learn More
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