Shigellosis

SHIGELLOSIS

Shigellosis, also known as bacillary dysentery, is a common food-borne infection that causes diarrhea with fever, toxemia, and general prostration. Blood and mucous are often mixed with the loose, watery stools, indicating severe inflammation of the intestinal lining. The causative organisms are several varieties of the genus Shigella. Infection is transmitted by active or convalescent cases (e.g., person to person). Food handlers working in unhygienic kitchens or restaurants sometimes become the index case for large epidemics. The incubation period is short, from one to three days, so it can be relatively easy to trace the source of an outbreak. The diarrhea and other symptoms usually run their course in a week or so, but the infectious agents can persist in feces for several weeks—which is the reason that food handlers should not be allowed to return to work, preferably for several weeks or until stool examinations for Shigella organisms are negative.

Control of shigella dysentery can be difficult, especially in settings such as military campaigns. Meticulous hygiene in all aspects of food handling and meal preparation are essential; everyone in the kitchen must scrupulously observe the rules for hand washing with warm water and soap after visiting the toilet and before handling food. The use of disposable plastic gloves is desirable, but these must be changed frequently. Flies must be kept out of kitchen areas.

Shigellosis is a notifiable disease in many jurisdictions, so local public health authorities will ensure that suspect premises and all persons working in such premises are inspected. Cases are treated by fluid and salt replacement, and often benefit from antibiotics.

JOHN M. LAST

(SEE ALSO: Communicable Disease Control; Food-Borne Diseases; Regulations Affecting Restaurants)