Shigellosis

Shigellosis is an infection of the intestine caused by Shigella bacteria. These bacteria are a common cause of diarrhea, especially in countries where sanitation may be poor.

Shigellosis is very infectious and spreads easily. Shigella bacteria are found in the feces (stool) of a person with shigellosis and are spread by direct person-to-person contact through the fecal-oral route. This means that feces (usually tiny, invisible amounts) from the person with shigellosis must get into the mouth of another person for the infection to spread. This can happen when you:

• eat food or drink water that has become contaminated, especially if it was handled by someone who was ill with shigellosis and did not properly wash their hands before handling the food.
• swallow water you swim or play in, such as lake water or improperly treated swimming pool water.
• touch surfaces and objects contaminated with Shigella, such as toys, bathroom fixtures, changing tables, diapers and diaper pails and then touch your mouth.
• take care of a person who has shigellosis.
• have sex with someone who has shigellosis or who has recently recovered from shigellosis, which includes anal or oral sex, anal play (rimming, fingering), handling contaminated objects such as sex toys, used condoms or barriers, and douching material.

Some people who have shigellosis may not show any symptoms but can still spread the infection to others. Shigellosis may also continue to be spread from one person to another for up to four weeks after symptoms end. Anyone can get shigellosis, but gay, bisexual, and other men who have sex with men, young children, and people travelling to countries with poor sanitation are at higher risk of infection.

Symptoms can range from mild to severe, and usually appear one to three days after a person is in contact with the bacteria. Young children, the elderly, or people with weak immune systems may experience more severe symptoms and complications. In healthy people, symptoms may include:

• diarrhea (sometimes bloody or with mucous)
• abdominal cramps
• fever
• nausea
• vomiting
• dehydration

Antibiotic resistance happens when bacteria like shigella no longer respond to certain antibiotics. Antibiotic-resistant shigella infections may be harder to treat and may last longer, increasing the chance that infection may spread to other people.

Anyone can get an antibiotic resistant Shigella infection, but some people are at greater risk. These people include:

• International travelers
• Gay, bisexual, and other men who have sex with men
• People with weakened immune systems

Take Care of Yourself:

•  Drink lots of fluids and get plenty of rest to prevent dehydration.
• Contact your health care provider if symptoms persist or worsen or before using anti-diarrheal medications because these medications may make your symptoms worse.
• Antibiotics are generally only recommended if you have severe illness or a weakened immune system.

Take Steps to Prevent Spread:

• Stay home while you are sick
• Wash your hands well and often
• Do not prepare or share food with others
• Avoid public swimming facilities such as pools, hot tubs, and splash pads
• Avoid sexual contact with others while you are sick:
  • wait at least seven days after symptoms end to have sex
  • always wash your hands, genitals, and anus before and after sex

Generally, people diagnosed with shigellosis can return to work and school when they feel better and no longer have symptoms. People who handle food as part of their work, those who provide health care services, and those who work in or attend a childcare centre must stay home and away from work or daycare if they are ill with shigellosis. Ottawa Public Health will advise when they may return to work.

Ottawa Public Health (OPH) receives reports of lab-confirmed Shigella infections. OPH conducts an investigation to try to determine the cause or source of infection, provides education to the person diagnosed with shigellosis, and follows up with the person’s health care provider as necessary. OPH also provides education to close contacts of a person diagnosed with shigellosis. OPH will advise people ill with shigellosis when they may return to daycare or work as a food handler, healthcare provider, or daycare caregiver. If a common source of illness is identified, OPH will investigate further to determine if additional public health actions are required.