What is it?
One afternoon, you’re at work when your stomach starts cramping, and you make a run for the bathroom. You make it just in time! This happens several more times before you finally decide to go home. You don’t really become concerned until you notice there’s blood in your stool. You go to the doctor, and he suspects you might be infected with shigella. What is this? How serious is it? What do you need to do to get rid of it?
When exposed to the bacteria shigella, you can end up with an intestinal infection called shigellosis. It’s usually spread through stool. So, many people contract it after accidentally swallowing the bacteria, which most often occurs if you touch your mouth after touching something that is contaminated. It can also happen if you eat food that was contaminated either during growing (ex. if the field contains sewage) or handling (ex. the person is sick and didn’t wash their hands well). Water can be contaminated as well by sewage or if a person with an infection swims in it. It’s highly contagious, so it can be challenging to prevent the spread.
Symptoms usually start a day or two after exposure but can take up to a week to appear. These include nausea, vomiting, stomach pain/cramps, fever, and diarrhea (often containing blood or mucus). These last for about five to seven days but can last longer. It can take weeks or months before your bowel habits return to normal. Some individuals don’t have any symptoms but are still contagious for a few weeks.
Certain things increase your chances of developing shigellosis. One of the primary factors is being in close contact with others, which is why it’s common for an outbreak to occur at child care centers, community wading pools, nursing homes, college dormitories, jails, and military barracks. Since children routinely put their hands in their mouths, it’s easy for them to pass the condition amongst each other. If you live or travel to areas with poor sanitation, your odds of contracting shigella are elevated. Also, any form of oral-anal sexual activity can result in the infection spreading.
Shigella usually doesn’t cause any complications, but sometimes it does. One of the most concerning is dehydration because of the constant diarrhea. Signs of this are lightheadedness, dizziness, sunken eyes, lack of tears, and dry diapers (in children). A possible complication that’s more likely to occur in children is seizures. While they’re more frequent in children who have a high fever, they can happen in children who don’t have this. For adults, another problem is rectal prolapse. This occurs when the large intestine’s mucous membrane (lining of the rectum) moves out through the anus because of the straining during bowel movements or inflammation.
Some rare complications include hemolytic uremic syndrome, toxic megacolon, reactive arthritis, and bacteremia. With hemolytic uremic syndrome, you end up with a low red blood cell count, low platelet count, and acute kidney failure. This means your body is more likely to have issues with bleeding and not being able to stop it. Toxic megacolon is when your colon becomes paralyzed, not allowing you to pass gas or have a bowel movement. If not treated, it can result in your colon rupturing, causing peritonitis (a life-threatening infection). Reactive arthritis is when a shigella infection triggers your joints to become inflamed, causing pain. It also can cause eye irritation and painful urination. Bacteremia is when the infection enters your bloodstream.
The primary focus of treating shigella is to replace the fluids you’re losing through diarrhea. The best way to do this is to drink water or suck on ice chips. If needed, you can try sports drinks that have electrolytes added to them. For children, you should use oral rehydration solutions, such as Pedialyte. If the dehydration is severe, you might need to be hospitalized to receive intravenous (IV) fluids.
When it comes to anti-diarrheal medication, like loperamide, diphenoxylate, and atropine, avoid using them because they can actually decrease your body’s ability to clear the bacteria, making your symptoms worse. If you’ve had a lab test that confirms you have shigella, your doctor may recommend bismuth subsalicylate because it can help to decrease the frequency of stools and shorten the length of your illness. This is available over-the-counter as Pepto-Bismol or Kaopectate. It’s important to note that children, pregnant women, or people allergic to aspirin should not take these.
As far as antibiotics go, they aren’t used unless your infection is severe because several types of shigella have become resistant to them. Typically, they are provided to infants, older adults, and those with compromised immune systems. They may also be given if there is a high chance an individual could spread the disease.
When it comes to preventing a shigella infection, there are several things you can do. The most important is to wash hands frequently and thoroughly with soap and water for at least 20 seconds. It’s also crucial to teach children proper handwashing techniques and watch small children wash their hands to ensure they’re doing it correctly. If you’re changing a child’s diaper, throw it away promptly and disinfect the diaper-changing area after use. If your child has diarrhea, keep them home from childcare, play groups, or school. If you have diarrhea, don’t prepare food for others. If you must, be sure to wash your hands as much as possible and wear gloves. Avoid sexual activity with anyone who has diarrhea or who recently recovered from diarrhea. Also, avoid swallowing water from ponds, lakes, or untreated pools. If you have diarrhea, don’t go swimming until you have fully recovered.
Shigella isn’t pleasant to deal with and, in some cases, can be concerning. The good news is that the majority of the time, it’ll go away without complications. If you have any questions or concerns about shigella, please speak with your doctor. If you would like more information, please visit the Centers for Disease Control and Prevention’s Shigella page at https://www.cdc.gov/shigella/general-information.html