Shigellosis

What is shigellosis?

Shigellosis is a bacterial infection. Approximately 300 cases are reported in Wisconsin each year. Most cases are seen in the summer and early fall and occur as single cases or outbreaks.

Who gets shigellosis?

Anyone can get shigellosis but it is recognized more often in young children. Those who may be at greater risk include children in day care centers, foreign travelers to certain countries, institutionalized people, and active homosexuals. Animals are not infected with nor do they carry Shigella.

How is shigellosis spread?

Shigella bacteria are found in the intestinal tract of infected people who in turn may contaminate food or water. The bacteria are spread by eating or drinking contaminated food or water or by direct or indirect contact with fecal material from an infected person.

What are the symptoms?

Individuals infected with Shigella may experience abdominal cramping, fever and mild or severe diarrhea, often with fever and traces of blood or mucous in the stool. Some infected people may not show any symptoms.

How soon do symptoms appear?

The symptoms may appear 1 to 7 days after exposure but usually within 1 to 3 days.

When and for how long is a person able to spread shigellosis?

Shigella bacteria can be spread for as long as the organism can be isolated from a person's stool. Most people pass Shigella in their feces (stool) for one to two weeks. Certain antibiotics may shorten the carrier phase.

Should infected people be isolated or excluded from school or work?

Since the bacteria is passed in the feces of an infected person, people with active diarrhea or those who are unable to control their bowel habits should be isolated. Most infected people may return to work or school when their diarrhea ceases, provided that they carefully wash their hands after toilet visits.

Food handlers, children or staff in day care and health care workers must obtain the approval (this includes 2 negative stool cultures) of the local or state health department before returning to their routine activities. Ill household members of a case that are food handlers, health care workers, or who are in day care should also be cultured.

How is shigellosis treated?

Most people with shigellosis will recover on their own. Some may require fluids to prevent dehydration. Antibiotics are occasionally used to treat severe cases or to shorten the carrier phase which may be important for food handlers, children in day care, or institutionalized individuals.

What can be done to prevent the spread of shigellosis?

Handwashing with soap and running water is the single most important preventive measure to interrupt the transmission to shigellosis, especially during an outbreak. Because young children are most likely to be infected with Shigella and are also most likely to infect others, a strict policy of supervised handwashing for young children after toileting and before eating is particularly important.

Each year, Medical College of Wisconsin physicians care for more than 180,000 patients, representing nearly 500,000 patient visits. Medical College physicians practice at Children's Hospital of Wisconsin, Froedtert Memorial Lutheran Hospital, the Milwaukee VA Medical Center, and many other hospitals and clinics in Milwaukee and southeastern Wisconsin.