Shigella Infection

Diarrhoea with blood or mucus is usually the first sign of Shigella. This bacterial infection affects the intestine and symptoms last more than three days. Most people recover from shigellosis within 5 to 7 days without treatment. However, it remains one of the most important health issues, especially when you have children under 5 who are at the highest risk. People can catch the infection through direct contact with infected individuals, eating contaminated food, or swimming in contaminated lakes and rivers. 

This article explains everything about Shigella infection, from symptoms and causes to diagnosis, treatment options, and prevention strategies that work.

What is Shigella Infection?

Shigella infection (shigellosis) is an acute intestinal illness caused by the Shigella bacteria. The bacteria target your digestive system and make your intestines swell up. This infection is different from other bacterial infections because you need just a tiny amount of bacteria (only 10 to 100 organisms) to get sick.

Symptoms of Shigella Infection

Shigella symptoms show up 1-2 days after you get exposed to the bacteria. You might notice:

• Bloody or watery diarrhoea with mucus
• High fever (38-40°C)
• Severe stomach cramps
• Tenesmus (feeling like you need to pass stool even with empty bowels)

These symptoms usually last 5-7 days, but some people might feel sick for up to 4 weeks.

Causes of Shigella Infection

You get shigella infection by swallowing the shigella bacteria (faecal-oral route). You can get infected with Shigella bacteria by:

• Eating food that someone with unwashed hands prepared
• Drinking contaminated water
• Coming in direct contact with infected faecal matter
• Getting it from another person, especially in crowded places
• The bacteria can only survive in humans.

Risk of Shigella Infection

Kids under 5 have the highest risk of getting shigellosis. Other groups that need to be careful include:

• Gay, bisexual men who have sex with men
• People travelling to areas with poor sanitation
• Those with weakened immune systems
• Homeless populations

Complications of Shigella Infection

Most people get better completely, but shigellosis can sometimes lead to serious problems:

• Severe dehydration
• Reactive arthritis (joint pain, eye irritation) 
• Hemolytic uremic syndrome that damages blood vessels and kidneys
• Young children with a high fever might have seizures
• Toxic megacolon (a life-threatening colon enlargement)
• The infection reaches the bloodstream causing sepsis (a fatal condition)

Diagnosis of Shigella Infection

Laboratory confirmation through stool sample testing helps diagnose Shigella. Doctors collect samples directly or guide patients on home collection. The original samples go through tests for blood and faecal leukocytes, followed by specific tests like culture or molecular testing.

Stool culture or modern culture-independent diagnostic tests like PCR help identify the infection. Blood tests can check for complications in patients with severe symptoms.

Shigella Treatment 

Patients usually get better without antibiotics in 5-7 days. Treatment mainly focuses on:

• Drinking plenty of fluids to prevent dehydration
• Bismuth subsalicylate to relieve symptoms
• Antibiotics (ciprofloxacin or azithromycin) only for severe cases (not to be taken without consulting doctor)

Remember that anti-diarrheal medications like loperamide can make symptoms worse.

When to See a Doctor

Immediately contact your doctor if you experience:

• Bloody diarrhoea lasting over 3 days
• High fever (above 39°C)
• Severe abdominal cramping
• Signs of dehydration

Prevention of Shigellosis

The best way to protect yourself against shigellosis is through prevention. You can prevent shigellosis by following some basic hygiene practices. These are:

• Thorough handwashing helps prevent infection, especially after using the bathroom and before preparing food. This practice reduces transmission risk. 
• Caregivers should place soiled diapers in covered bins and clean surfaces that come into contact with stool with disinfectants.
• People should avoid swallowing water from lakes or pools.
• You should eat well-cooked food and thoroughly wash fruits and vegetables before eating.
• Avoid close contact with people who have shigellosis.
• Avoid Street food 

Conclusion

Shigella infection continues to be a major health issue around the world, especially when you have young children and at-risk populations. Most cases clear up without antibiotics in a week, but this bacterial illness needs serious attention. You should see a doctor if you have bloody diarrhoea, high fever, and severe stomach cramps that last more than three days.

The bacteria can spread through contaminated food, water, or direct contact. This knowledge enables everyone to take simple but effective precautions. While treatment mainly focuses on staying hydrated and managing symptoms, some severe cases need antibiotics under a doctor's care.

Shigellosis spreads quickly, but basic hygiene practices can prevent it. Don't wait to get medical help if you notice worrying symptoms like ongoing bloody diarrhoea or signs of dehydration. We can reduce this common infection's impact through awareness and the right preventive steps.

FAQs

1. What is the main cause of Shigella?

You get shigella infection by swallowing the shigella bacteria through contact with infected faecal matter. This happens through the faecal-oral route. The bacteria can spread when you touch your mouth after changing a nappy, handle contaminated objects, or have intimate contact with an infected person. You can also get infected by eating food that an infected person prepared or consuming items grown in contaminated fields. Swimming or drinking untreated water poses another risk.

2. How serious is a Shigella infection?

Shigella infections can range from mild to life-threatening. A healthy adult usually recovers in 5-7 days without treatment. The illness becomes severe especially when you have young children, elderly people, or those with weakened immune systems. Some complications include severe dehydration, seizures in children, and in rare cases, kidney damage through hemolytic uremic syndrome. The infection can become life-threatening if you have a compromised immune system. 

3. How long is a person contagious with Shigella?

A person stays contagious as long as the Shigella bacteria remain in their stool. This usually lasts up to 4 weeks after getting sick. The infection spreads most easily during bouts of diarrhoea. Some people can pass the bacteria for up to 6 weeks. People without symptoms can spread the infection for months, but proper antibiotic treatment usually reduces this time to days.

4. How to avoid getting Shigella?

Here's how you can prevent shigella infection:

• Wash your hands with soap and water, especially after using the toilet and before preparing food
• Put soiled nappies in covered, lined bins
• Drink only treated or boiled water in areas with questionable water quality
• Wait two weeks after recovery before having intimate contact

Dr. Kamal P. Bhutada

MD, DNB (General Medicine), MNAMS, IDCCM, EDIC
Ganga CARE Hospital Limited, Nagpur

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