Alert
Shigellosis
April 15, 2008

What is Shigella?

Shigella is an infection of the intestines caused by bacteria called Shigella.   

Some people infected with Shigella have diarrhea, fever, and stomach cramps starting 1 to 4 days after they have swallowed the bacteria.  Symptoms may last 5 to 7 days. Some people have no symptoms. Severe cases in children under 2 years old may cause dehydration or seizures.

How is it spread?

The bacteria leaves the body in the stool (bowel movements) of an infected person. If the infected person has not washed his/her hands well after going to the bathroom, hands, food, or other objects (toys, pens, etc.) can be contaminated with that stool. The infection spreads to others when someone puts any of these objects in his/her mouth – such as the contaminated food, pen or toys.

An infected person without symptoms can also spread the infection.

Flies can also spread Shigella when they have contact with infected stool and then contaminate drinking water or food.

What are the symptoms?

Illness usually begins 1 to 4 days after swallowing the bacteria and may last 4 to 7 days. Sometimes people have no or few symptoms.

Symptoms include:

• Diarrhea (may be watery or bloody)
• Fever
• Stomach cramps
• Nausea or vomiting
• Severe cases may cause dehydration (loss of fluids) or seizures (in young children).

How is it diagnosed and treated?

Shigella can be identified from a stool sample. Antibiotics can be prescribed to shorten both the duration of illness and the length of time bacteria are passed in the stool.  Sometimes people get better without antibiotics.

How can it be prevented?     

• 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 ( See Special Precautions below)
• Disinfect diaper changing areas after using them ( See Special Precautions below)
• Undiagnosed children with diarrhea should stay home until diarrhea has stopped for 24 hours.
• Supervise handwashing of toddlers and small children after they use the toilet, especially in daycare centers and homes with children who have not been fully toilet trained.  
• Do not prepare food for others while ill with diarrhea.
• Keep kitchen work surfaces clean (area should be wiped down with a disinfectant such as diluted household bleach 1:10 dilution made fresh daily, Lysol* or anti-bactericidal wipes)

Special precautions for those infected:

Children in diapers:

• When a child in diapers has Shigella, those who change the diapers should discard soiled diapers in a closed-lid garbage can. If one is not available, double bagging of the soiled diaper is acceptable. They should immediately wash his or her hands and the child’s hands carefully with soap and warm water.   
• After each use, the diaper changing area should be wiped down with a disinfectant such as diluted household bleach 1:10 dilution made fresh daily, Lysol* or anti-bactericidal wipes.
• Children in diapers with Shigella should not be in contact with uninfected children.

Food handlers, child care, and healthcare:

Infected food handlers, child care workers, children attending childcare, and patient care providers should be excluded from their regular activities until they have completed at least 5 days of their antibiotic treatment and 2 stool samples have tested negative for Shigella bacteria.

For more information (sources):

Communicable Disease Reporting System (CDRS)

Centers for Disease Control and Prevention (CDC)