Shigellosis

What is shigellosis?

Shigellosis is an infection caused by Shigella bacteria. These bacteria live in the intestine of infected persons and are highly infectious.

What are the symptoms of shigellosis?

The symptoms of shigellosis include fever, diarrhea that may contain blood and/or mucous, stomach cramps, nausea and vomiting, and an urge to pass stool. Symptoms may be mild to severe, or you may have no symptoms at all. Symptoms will typically occur 1 to 3 days after becoming infected. It will often take 4 to 7 days to get better. People are infectious while they are sick and up to 4 weeks after illness.

How does shigellosis spread?

Shigella bacteria can be found in the stool of a person with an infection. The bacteria can spread from person to person when tiny bits of infected stool get into another person’s mouth, food or water. Exposure to infected stool can occur in day care settings, through contaminated food and water, or through sexual contact. Outbreaks of shigella can also occur in settings with crowded living conditions, and among people experiencing homelessness.

In day care settings

Shigella bacteria can be spread in day care settings among caretakers and young children, especially toddlers who are not fully toilet trained. It can spread when hands are not carefully washed after using the bathroom or changing a diaper, then preparing food and drinks or caring for other children. Family members and playmates of children with an infection are at risk of becoming infected.

Contaminated food or water

Food can become contaminated by food handlers with an infection who do not wash their hands with soap and water after using the washroom. You can become ill if you eat contaminated food. You can also get shigellosis if you drink or swim in contaminated water. Water may become contaminated if sewage runs into it or if someone with shigellosis swims in it.

Sexual contact

Certain types of sexual contact can spread Shigella bacteria. This includes oral-anal (mouth to anus) contact, getting stool on your fingers and then touching your mouth, or by putting objects in your mouth that may have tiny bits of stool on them.

How can I prevent spreading shigellosis?

Proper hygiene and safe food handling and preparation practices are key to preventing the spread of shigellosis. Follow the advice below to help stop the spread of shigellosis.

In day care settings

• Wash your hands often, and carefully, with soap and water, especially after visiting the washroom, changing diapers, and before handling or eating food. For more information on hand washing, visit HealthLinkBC File #85 Hand washing: Help stop the spread of germs
• Ensure children have their hands washed properly in day care centers and at home. This is very important for children who are not toilet trained, children in diapers, and those who have diarrhea
• Dispose of dirty diapers properly
• Disinfect diaper changing areas with diluted household bleach (5.25 percent hypochlorite). You can make a sanitizing solution as follows:
  • Add 80mL (5tbs) of household bleach to 4L of warm water (1/3 cup of bleach to a gallon of water)
  • Mix 20mL (4tsp) of household bleach into 1L (4 cups) of water
• Children with shigellosis must be kept out of day care centers until they have been advised by public health that they can return

Contaminated food or water

• Follow basic food safety precautions and drinking water treatment to help prevent the spread of shigellosis. For more information, visit HealthLinkBC File #59a Food safety: Easy ways to make food safer
• If you are travelling in developing countries, make sure you drink water from a safe source (for example, treated or boiled water) and eat only cooked hot food and fruit and vegetables that you peel yourself. For more information, visit HealthLinkBC File #41e Traveller's diarrhea
• Avoid swallowing water if you are swimming or bathing in untreated water

Sexual contact

• Do not have unprotected oral-anal contact, especially if your partner has symptoms of shigellosis. Use a dam, plastic wrap or cut open a condom when having oral-anal sexual contact
• Right after sex, thoroughly wash your hands and any other body parts or items that may have touched stool, such as the penis or sex toys. Use warm running water and soap
• Wash your hands often using warm running water and soap. Clean under the nail and keep them short
• Use disposable gloves when hands have contact with the anal area
• For more information on how you can reduce your chance of getting Shigella through sexual contact, visit HealthLinkBC File #08o Preventing sexually transmitted infections (STIs)

What is the treatment for shigellosis?

Most people with shigellosis have mild illness and do not need medical care. In most cases, it takes less than 7 days to recover.

Shigellosis can be treated with antibiotics to speed recovery and to help prevent others from getting infected. However, if you only have mild symptoms, you will generally recover without antibiotic treatment.

If you have severe symptoms such as blood in your stool or you are dehydrated, see your health care provider. If you have diarrhea, drink lots of fluids to avoid dehydration.

People infected with shigellosis who prepare food, or who care for children, the sick, the elderly or other dependents should not go to work until they have been advised by public health that they can return to work. A stool test may be required to ensure you are negative for Shigella before returning to work.