Shigellosis is a serious enteric illness that causes diarrhea, stomach ache, and fever. Compared to other causes of bacterial gastroenteritis, it is more likely to cause severe symptoms such as bloody diarrhea and severe pain.
Shigellosis is an acute diarrheal infection in the bowels caused by the Shigella group of bacteria. Compared to other causes of bacterial gastroenteritis, it is more likely to cause severe symptoms such as bloody diarrhea and severe pain. As with many enteric illnesses, sanitation, overcrowding and hygiene are important factors for the spread of shigella. Frequent hand washing, following good food safety practices, providing safe drinking water and by following other practices that break the fecal-oral links of illness can help prevent shigella infection.
Symptoms include:
- diarrhea, often with blood and/or mucus
- cramps
- fever
- nausea
- vomiting
- toxins (or "poisons") in the blood (toxemia)
- an urge to have a bowel movement, with no passage of stool (also called "tenesmus")
Symptoms usually start one to three days after exposure. Most people get better within 7 seven days without needing antibiotics, but sometimes it can take longer. A person with shigellosis may experience mild or severe symptoms, or no symptoms at all.
If you have serious symptoms, you should see your doctor.
Shigellosis is very infectious and spreads easily. People with shigellosis have the bacteria in their diarrhea stools while they have symptoms and for up to one or two weeks after symptoms improve. During this time, they can spread it to others. Shigella bacteria are more resistant to stomach acid compared to other bacteria, which makes them highly infectious. Outbreaks of shigella have been known to occur in childcare centres, settings with crowded living conditions, and among people experiencing homelessness. Some shigella clusters are related to sexual contact involving stool exposures, for example anal sex.
Most shigella infections happen when the bacteria from stools pass from one person’s hands to the mouth of another person. This is more likely to happen when people don’t have reliable access to clean water or good sanitation. For example, the transmission may happen after:
- being exposed directly to infected stool or indirectly with objects contaminated with stool; for example: in childcare centres, if hands are not washed each time after changing diapers
- putting objects that have tiny bits of stool on them, such as food, pens, or cigarettes into your mouth
- sexual contact, especially oral-anal (mouth to anus) sexual contact
- being exposed to contaminated water or food by:
- eating food contaminated by food handlers with shigellosis, or by flies picking up contamination from the toilet
- drinking water that is contaminated by the feces of infected animals or people (e.g., water improperly treated in developing countries)
- swimming at beaches where the water is contaminated
People with diarrhea usually recover completely, although it may be several months before their bowel habits are entirely normal.
Shigella flexneri can cause a form of arthritis that can last months or years in a few people.
Shigellosis is detected by testing of stool samples.
Persons with mild infection usually recover quickly without antibiotic treatment. If you have diarrhea, drink lots of fluids to avoid dehydration. If you need advice, call 811 or your primary care provider if you experience:
- fever
- abdominal pains or cramps, and
- diarrhea or loose stools, especially if blood is present
If you have serious symptoms, you should see your primary care provider. An appropriate antibiotic treatment kills the bacteria and may shorten the illness by a few days.
If you have shigellosis (or if you have any symptoms of gastrointestinal illness like diarrhea or vomiting) and you work in a high-risk occupation (e.g., you are a food handler, caregiver or work in a childcare), you should stop working and contact a professional at your local public health office to discuss staying away from work until you have recovered.
Children attending childcare centres will need to be removed from the childcare centre.
Workers and children in high-risk settings who have been excluded from work and/or childcare can return after they have been advised to do so by public health.
Frequent and careful
hand washing is important for everybody. Make sure children wash their hands properly in childcare centres and at home (they may need help).
This is especially important for children who are not completely toilet-trained (including children in diapers).
When possible, young children with shigella infection who are still in diapers should not be around or play with uninfected children.
Basic food safety precautions and drinking water treatment help prevent shigellosis.
At swimming beaches, having enough bathrooms near the swimming area helps keep the water from becoming contaminated.
- Drink only treated or boiled water. Boiling water for one full minute will eliminate most pathogens, including shigella. Drinking water from sealed water bottles is also an option.
- Eat only cooked hot foods or fruits you peel yourself
- Learn more about
Travelers’ Diarrhea.
Be aware of ways that tiny bits of stool can get into your mouth. These include:
- Biting your nails
- Eating unwrapped candy, nuts, chips, fruit or other food
- Sharing cups, bottles, utensils, plates or other household equipment
- Lighting a cigarette with soiled hands
- Washing your hands well and often, with soap and water, is important for all age groups, especially after having a bowel movement, changing diapers, and before preparing food or drinks.
- Watch and help children when they wash their hands. This is really important for children who are not completely toilet-trained (including children in diapers).
- Get rid of dirty diapers properly.
- Disinfect diaper changing areas with diluted household bleach (one teaspoon [five ml] bleach per litre of water), or an effective, purchased "off the shelf" disinfectant spray or wipes. The container should show a drug identification number.
- Children with shigellosis must be kept out of childcare centres until it is shown that they are no longer infected.
- People who handle food, or who care for children, the sick, the elderly or other dependents, cannot go to work until they have cleared the infection.
