Shigellosis

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Shigellosis, also known as bacillary dysentery in its most severe manifestation, is a foodborne illness caused by infection by bacteria of the genus Shigella. Shigellosis rarely occurs in animals other than humans and other primates like monkeys and chimpanzees. The causative organism is frequently found in water polluted with human feces, and is transmitted via the fecal-oral route. The usual mode of transmission is directly person-to-person hand-to-mouth, in the setting of poor hygiene among children.[1] In some strains ten to fifteen (10-15)% of people affected will die. In the developing world, Shigella causes approximately 165 million cases of severe dysentery and more than 1 million deaths each year, mostly in children. Shigella also causes approximately 580,000 cases annually among travelers and military personnel from industrialized countries.[2]

Contents

Symptoms

Symptoms may range from mild abdominal discomfort to full-blown dysentery characterized by cramps, diarrhea, fever, vomiting, blood, pus, or mucus in stools or tenesmus.[3] Onset time is 12 to 50 hours.

Infections are associated mucosal ulceration, rectal bleeding, drastic dehydration; fatality may be as high as 10-15% with some strains. Reiter's disease and hemolytic uremic syndrome are possible sequelae that have been reported in the aftermath of shigellosis.

Shigella can be transmitted through food. Food known to do so includes salads (potato, tuna, shrimp, macaroni, and chicken), raw vegetables, milk and dairy products, and meat. Contamination of these foods is usually through the fecal-oral route. Fecally contaminated water and unsanitary handling by food handlers are the most common causes of contamination.

An estimated 18,000 cases of shigellosis occur annually in the United States. Infants, the elderly, and the infirm are susceptible to the severest symptoms of disease, but all humans are susceptible to some degree. Individuals with Acquired Immune Deficiency Syndrome (AIDS) are more frequently infected with Shigella.[4] Shigellosis is a more common and serious condition in the developing world.

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