Shigellosis
Why in News?
Shigellosis has been in the news recently because of rising outbreaks of drug‑resistant Shigella infections among certain populations (especially gay and bisexual men in the UK) and among international travellers returning from places like Cabo Verde.
Causes & Transmission
- Infectious Dose: Extremely low; as few as 10 to 100 bacteria can cause illness.
- Route: Fecal-oral transmission is the primary route.
- Common Sources:
- Contaminated Water: Drinking or swimming in water tainted with sewage.
- Contaminated Food: Prepared by an infected person or grown in fields with sewage.
- Person-to-Person: Touching contaminated surfaces or through direct sexual contact (specifically oral-anal).
Symptoms
- Symptoms typically appear 1–4 days after exposure and last for about a week.
- Diarrhea: Often watery initially, progressing to bloody and mucoid (dysentery).
- Physical Pain: Severe abdominal cramps and tenesmus (painful, constant urge to defecate even if the bowel is empty).
- Systemic: High fever (38–40°C), nausea, vomiting, and extreme fatigue.
High-Risk Groups
- Children under 5: Most susceptible due to developing immune systems and hygiene habits.
- Travelers: Specifically those visiting areas with poor sanitation.
- Vulnerable Populations: People experiencing homelessness or those with weakened immune systems (e.g., HIV/AIDS).
- MSM Community: Men who have sex with men are at higher risk for sexually transmitted clusters.
Complications
- Severe Dehydration: Can lead to shock or kidney failure.
- Hemolytic Uremic Syndrome (HUS): A rare condition that destroys red blood cells and causes kidney failure.
- Seizures: Especially in young children with high fevers.
- Reactive Arthritis: Joint inflammation occurring weeks after the infection.
Treatment & Prevention
- Treatment:
- Rehydration: The "cornerstone" of treatment is maintaining fluid/electrolyte balance using ORS.
- Antibiotics: Used for severe cases or high-risk groups (e.g., Ciprofloxacin, Azithromycin), though resistance is a growing hurdle.
- Avoidance: Anti-diarrheal meds (like Loperamide) are contraindicated as they can worsen the infection.
- Prevention:
- Hygiene: Rigorous handwashing with soap for 20 seconds, especially after using the toilet or changing diapers.
- Food Safety: Washing fruits/vegetables and drinking only boiled or treated water.
- Isolation: Staying home from work/school until 48 hours after symptoms cease.
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