Shigellosis
| Shigellosis | |
|---|---|
| Classification and external resources | |
| ICD-10 | A03 |
| ICD-9 | 004 |
| DiseasesDB | 12005 |
| eMedicine | med/2112 |
| MeSH | D004405 |
Shigellosis, also known as bacillary dysentery or Marlow Syndrome, 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 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 |
[edit] 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 96 hours, and recovery takes 5 to 7 days.[4]
Infections are associated with mucosal ulceration, rectal bleeding, and drastic dehydration. 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, including 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.[5] Shigellosis is a more common and serious condition in the developing world; fatality rates of Shigellosis epidemics in developing countries can be 5-15%.[6]
The most common neurological symptom includes seizures.[2]
[edit] Prevention
Simple precautions can be taken to prevent getting shigellosis: wash hands before handling food and thoroughly cook all food before eating.
In addition to improved sanitation and hygiene, several vaccine candidates for Shigella are in various stages of development. According to the World Health Organization, candidates in development include live attenuated, conjugate, ribosomal, and proteosome vaccines.[7] There are promising results for a vaccine against serotype 1, which otherwise show large resistance to antibiotics.[8]
[edit] Treatment
Treatment consists mainly of replacing fluids and salts lost because of diarrhea. Oral replacement is satisfactory for most people, but some may need to receive fluids intravenously. In most cases, the disease resolves within four to eight days without antibiotics. Severe infections may last three to six weeks. Antibiotics, such as trimethoprim-sulfamethoxazole (Co-Trimoxazole), norfloxacin, ciprofloxacin, or furazolidone, may be given when the person is very young or very old, when the disease is severe, or when there is a high risk of the infection spreading to other people. Additionally, ampicillin (but not amoxicillin) is effective in treating this disease.[9] The severity of the symptoms and the length of time the stool contains Shigella are reduced with antibiotics. Antidiarrheal drugs (such as diphenoxylate or loperamide) may prolong the infection and should not be used.[10]
[edit] See also
- Diarrhea
- Dysentery
- Diarrheal diseases
- Gay bowel syndrome
- Infectious diarrhea
- Traveler's diarrhea
- Gastroenteritis
[edit] External links
- CDC's Shigellosis Information Page
- WHO Global Alert and Response Disease Outbreak News: Shigellosis
- WHO Institute for Vaccine Research: Shigella
[edit] References
- ^ Clemens, John; Kotloff, Karen; Kay, Bradford (May 1999). "Generic protocol to estimate the burden of Shigella diarrhoea and dysenteric mortalit". World Health Organization: Department of Vaccines and Biologicals. http://www.who.int/vaccine_research/documents/en/shigella1.pdf. Retrieved February 10, 2012.
- ^ a b "Diarrhoeal Diseases: Shigellosis". Initiative for Vaccine Research. World Health Organization. http://www.who.int/vaccine_research/diseases/diarrhoeal/en/index6.html. Retrieved February 10, 2012.
- ^ "Shigellosis". The Merck Manual Home Health Handbook. http://www.merckmanuals.com/home/infections/bacterial_infections/shigellosis.html. Retrieved February 10, 2012.
- ^ "Symptoms Of Shigella Infection". About Shigella. Marler Clark. http://www.about-shigella.com/shigella_symptoms_risks. Retrieved February 10, 2012.
- ^ Angulo, Frederick J.; Swerdlow, David L. (1995). "Bacterial Enteric Infections in Persons Infected with Human Immunodeficiency Virus". Clinical Infectious Diseases 21 (Supplement 1): S84-S93. doi:10.1093/clinids/21.Supplement_1.S8.
- ^ Todar, Kenneth. "Shigella and Shigellosis". Todar's Online Textbook of Bacteriology. http://textbookofbacteriology.net/Shigella.html. Retrieved February 10, 2012.
- ^ "Vaccine Research And Development: New strategies for accelerating Shigella vaccine development". Weekly Epidemiological Record (World Health Organization) 72 (11): 73-80. 14 March 1997. http://www.who.int/docstore/wer/pdf/1997/wer7211.pdf. Retrieved February 10, 2012.
- ^ "Vaccine against shigellosis (bacillary dysentery):a promising clinical trial". Institut Pasteur. January 15, 2009. http://www.pasteur.fr/ip/easysite/pasteur/en/press/press-releases/2009/vaccine-against-shigellosis-bacillary-dysentery-a-promising-clinical-trial. Retrieved February 10, 2012.
- ^ Katzung, Bertram G. (2007). Basic and Clinical Pharmacology. New York, NY: McGraw Hill Medical. pp. 733. ISBN 978-0-07-145153-6.
- ^ "How can Shigella infections be treated?". Shigellosis: General Information. Centers for Disease Control and Prevention. http://www.cdc.gov/nczved/divisions/dfbmd/diseases/shigellosis/#treat. Retrieved February 10, 2012.
