What is shigellosis?

Shigellosis is an infection of the stomach and intestine that occurs when Shigella bacteria grow in the large intestine. Another name for shigellosis is bacillary dysentery.

Shigellosis can be a problem where sanitation is poor and large groups of people, including carriers of the disease, are crowded together. It is becoming increasingly common in day care centers and homosexual populations.

In children and the elderly, 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 spread through the feces (bowel movements) of people who carry the bacteria in their intestines. Carriers may or may not have symptoms.

You can acquire the disease by eating or drinking from anything contaminated with the bacteria, or 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 after the incubation period, which is 12 to 72 hours. The incubation period is the time between the invasion of the body by the bacteria and the first appearance of symptoms.

Symptoms include:

• fever that may reach 104 degrees F (40 degrees C)

• abdominal cramps

• nausea and vomiting

• frequent diarrhea with blood, mucus, and pus.

How is it diagnosed?

To diagnose shigellosis, the doctor will review your symptoms, examine you, and often take a sample of your feces for lab testing.

How is it treated?

The doctor may prescribe an antibiotic, but mild infections will clear without antibiotics. If the doctor does prescribe antibiotics, it is important to take the full prescription or the infection may return and be more difficult to treat.

You will need to replace lost body fluids by drinking lots of clear fluids for 2 or 3 days. Eat small but frequent meals of soft and easily digestible food. Avoid whole milk, dairy products, and fatty foods.

Normally the problem stays in the intestine, however in the most serious cases, meningism (irritation of membranes covering the brain and spinal cord), coma, and seizures may occur. If this happens, the doctor will hospitalize you and treat you for shock and any related problems.

How long will the effects last?

Healthy adults will feel better within a week. Taking antibiotics will shorten the duration of the illness to 1 or 2 days.

How can I take care of myself?

Ask your doctor 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.)

If you have cramps or abdominal pain, it may help to put a hot water bottle or electric heating pad (set on low) on your abdomen.

Let your bowel rest by drinking only clear liquids such as water, juice, weak tea, boullion, and Gatorade. Popsicles are also good to suck on. It is important to drink often so that you do not become dehydrated. Suck on ice chips if you feel too nauseated to drink fluids. Do not eat solid foods because they can cause cramps.

When your symptoms are gone, add soft foods--such as cooked cereal, rice, potato, eggs, plain gelatin, and applesauce-- and carbonated drinks to your diet. Avoid milk products for at least another day. Return to your normal diet after 2 or 3 days of the soft-food diet, but avoid fresh fruit and vegetables, alcohol, and highly seasoned or spicy foods for several days.

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 don't improve or if you develop new symptoms, tell your doctor.

How can I help prevent the spread of shigellosis?

If you are infected, you can help prevent the spread of this disease by:

• washing your hands with soap and very warm water after using the bathroom and before eating or preparing food

• not preparing food for others

• washing and storing your linens and towels separately from those used by others

• washing and storing your glasses, plates, and utensils separately from those used by others.