Shigella is the formal name for the virus, a type of enteric bacteria that can affect humans and other primates. Ingesting the Shigella bacteria produces the disease known by medical professionals as shigellosis. It’s a gastrointestinal infection that can produce abdominal pain, bloody diarrhea, fever and the strange sensation of feeling like you have to defecate even after you’ve emptied your bowels.
Reports indicate Shigella is developing resistance to standard antibiotics and is spreading rapidly throughout the globe, thanks to travelers.
It is the third most-common cause of gastroenteritis among the United States population, and worldwide, the Centers for Disease Control and Prevention estimate that there are 165 million cases per year. That accounts for 600 deaths in the United States and an estimated 300,000 illnesses, with more than 6,000 of those requiring hospitalization. It’s even worse in international countries with poorer medical facilities and may account for more than million deaths. Although it mainly lasts for just a few days, some symptoms can last for months.
What is this deadly bacteria? It is highly contagious and is easily transmitted to others, even those who may have encountered only a tiny amount of infected fecal matter, the main source of transmission.
The bacterium was named after the scientists who first discovered it at the end of the 19th century. Japanese scientist Kiyoshi Shiga was looking into the causes of an outbreak of dysentery in his country when he first discovered it in 1896. The research scientist dedicated his life to eradicating the rod-shaped bacteria, one of several dysentery bacilli.
There are four subgroups of Shigella bacteria, all with different biochemical traits. The most common in the United States is s.sonnei, sometimes called Group D Shigella, which is the cause of more than 75 percent of domestic cases.
New strains have developed over the years, and the danger is that the newest of them seem resistant to common antibiotics, including ciprofloxacin, the most common treatment medical professionals use for gastrointestinal problems.
The CDC reported that it uncovered more than 240 cases of Cipro resistance in cases of shigellosis between May 2014 and February 2015. That opens the potential for larger, more uncontrolled outbreaks of the disease.
How Is It Spread?
Most cases of shigellosis come from ingesting food or water that has been in contact with infected fecal matter. It can be transmitted through ingestion, skin or contact during sexual activity and can spread rapidly in enclosed environments like cruise ships, prisons, daycare centers, schools, nursing homes and gyms. Because the infected remain contagious from shortly after the moment they start showing symptoms and can remain contagious for days after recovery, it’s a particularly virulent disease.
Children are particularly at risk of contracting the disease, and the blame goes mainly to poor personal hygiene and a lack of immunity to the most common form of the bacteria. When you combine poor handwashing with children, many of whom are still in diapers, then you have a ripe setting for spreading the disease. Children’s aquatics locations are particularly susceptible for the same reasons.
Contaminated food from workers infected with the bacteria who fail to wash their hands adequately is another issue. A quick soap and rinse after using the bathroom facilities is usually not adequate to remove droplets that may spatter on your hands. A thorough soaping of the entire hand surface and a careful rinse with hot water is necessary to make sure there are no lingering traces of potentially infectious bacteria.
It’s estimated that about one-third of shigellosis in the United States is caused by ingestion of contaminated food. It is recommended that international travelers drink only bottled water and rely more on hot foods when visiting other countries.
Shigella Symptoms
You will know you have acquired the infection anywhere from 12 hours to 96 hours after ingesting fecal material. It’s a gradual build, usually starting mildly and then turning severe. Diarrhea may be bloody or contain mucus. A high fever and aches and pains are also part of the onset.
Strangely, there is a small subset of patients who exhibit no symptoms but who are highly contagious and capable of passing on the virus. Scientists have no explanation for that condition.
As with many illnesses, shigellosis is usually over within a week’s time, and the majority of patients don’t need to visit a hospital unless they already have an underlying condition, are elderly or very young children.
Those who engage in anal sex are considered particularly at risk for contracting shigellosis. There is no clear indication established other sexually transmitted diseases like HIV and the risk of catching shigellosis. However, in those who are already infected with HIV, shigellosis may recur and sufferers may face severe consequences because of already-burdened immune systems.
When recovering from shigellosis, it may be several months before the patient returns to full health. Less than 3 percent of patients later develop a condition known as Reiter’s Syndrome, which can result in eye irritation, joint pain and urination inflammation. It is believed Reiter’s Syndrome is the body's reaction to shigellosis, in that the immune system keeps attacking the body after finishing its fight with the bacteria.
Fortunately, the majority of people who get shigellosis develop a mild immunity to the strain that infected them. That doesn’t last a lifetime but can afford several infection-free years. Keep in mind that the immunity is only for the particular bacteria that first caused the problem, and other forms of shigella infection can be acquired.
As with any bacterial disease transmitted by fecal contact, you can avoid it by being thorough in your cleaning. Wash your hands frequently and carefully, wear gloves when disposing of dirty diapers or linens, and certainly make sure that any raw vegetables or fruits are very carefully and thoroughly washed. Just these few small steps likely will help keep you and your family thriving.