Shigellosis

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Shigellosis in Arizona

In 2006, there were 729 cases of shigellosis reported in Arizona. There were 11.7 cases of shigellosis per 100,000 Arizona residents in Arizona in 2006.

What is shigellosis?

Shigellosis is an infectious disease caused by a group of bacteria called Shigella. Those infected with Shigella develop symptoms of loose stools, fever, nausea and stomach cramps starting a day or two after they are exposed to the bacterium. The diarrhea is often bloody.

Who can get shigellosis?

Shigellosis is common in areas and settings where hygiene is poor. Children, especially toddlers aged 2 to 4, are more likely to get shigellosis, due to them not being fully toilet-trained. Shigellosis cases are common in day-care settings and the family members and playmates of these children are at a high risk of becoming infected.

How is shigellosis spread?

Shigella bacteria are found in the intestinal tract of infected people and so can spread to others by either eating or drinking contaminated food or water of that person.  Most Shigella infections are the result of the bacterium passing from diarrheal stools or soiled fingers of the infected person to the mouth of another person mainly due to improper hand-washing after using the bathroom.

What are they symptoms of shigellosis?

Common symptoms of shigellosis include diarrhea, fever, nausea, vomiting and abdominal cramps. In most cases, the stool will also contain blood and mucus. Some cases may not show any symptoms at all, but may still pass the Shigella bacteria to others. Shigellosis usually lasts on average 4 to 7 days.

How soon after infection do symptoms appear?

The symptoms may appear one to seven days after exposure but usually within two to three days.

How long can someone spread shigellosis?

Most people may still pass the Shigella bacteria in their feces one to two weeks after the illness has appeared. Some antibiotics may reduce this time to a few days.

What is the treatment for shigellosis?

People that have mild infections usually recover on their own without any antibiotic treatment. Some may require fluids to prevent dehydration. Antibiotics can be given to treat shigellosis and can shorten the duration and severity of the illness.

What can be done to prevent the spread of shigellosis?

  • Wash hands with soap carefully and frequently, especially after going to the bathroom, after changing diapers, and before preparing foods or beverages
  • Dispose of soiled diapers properly and disinfect diaper changing areas after use
  • Keep children with diarrhea out of child care settings
  • Supervise handwashing of toddlers and small children after they use the toilet
  • Persons with diarrheal illness should not prepare food for others
  • Avoid drinking pool water

Where can I find more information on shigellosis?

The Centers for Disease Control and Prevention website has additional information on shigellosis.

Technical Information

Characteristics

  • Infectious Agent: The genus Shigella is comprised of four species: S. dysenteriae, S. flexneri, S. boydii and S. sonnei.
  • Mode of Transmission: Mainly by direct or indirect fecal-oral transmission, ingestion of contaminated food and water. The infective dose for humans can be as low as 10-100 organisms.
  • Period of communicability:  During acute infection and until the infectious agent is no longer present in feces, usually within 4 weeks after illness. Asymptomatic carriers may transmit infection. Rarely, a carrier state can last for months or longer.
  • Incubation Period:  Usually 1-3 days, but may range from 12 to 96 hours or up to 1 week for S. dysenteriae.
  • Clinical Features
  • : An illness of variable severity commonly manifested by bloody diarrhea, abdominal pain, fever and malaise.
  • Risk Groups: All ages. In the U.S., groups at increased risk of shigellosis include children in child-care centers, international travelers, occupations where personal hygiene is difficult to maintain and those in homes with inadequate water for handwashing.
  • Occurrence: Worldwide.

Arizona Administrative Code: R9-6-365

  1. Case control measures
    1. A local health agency shall exclude a shigellosis case
      with diarrhea from working as a food handler, caring for
      children in or attending a child care establishment, or caring
      for patients or residents in a health care institution
      until either of the following occurs:
      1. Two successive cultures negative for Shigella spp.
        are obtained from stool specimens collected at least
        24 hours apart and at least 48 hours after discontinuing
        antibiotics, or
      2. Treatment is maintained for 24 hours and diarrhea
        has resolved.
    2. A local health agency shall conduct an epidemiologic
      investigation of each reported shigellosis case or suspect
      case. For each shigellosis case, a local health agency shall
      complete and submit to the Department within 10 working
      days after completing an Shigellosis Investigation FormWord.
  2. Contact control measures:
    1. A local health agency shall exclude a shigellosis contact with diarrhea from working as a food handler, caring for children in or attending a child care establishment, or caring for patients or residents in a health care institution until two successive cultures negative for Shigella spp. are obtained from stool specimens collected at least 24 hours apart. If a culture is positive for Shigella spp., a local health agency shall reclassify a contact as a case.

Lab Tests

Lab Criteria for Diagnosis

  • Isolation of Shigella species from a clinical specimen

Lab Tests

Additional Information