Diarrhea: Shigella

Sunday, July 3, 2011



Diarrhea: Shigella

Shigella is a bacteria that can infect the digestive tract and cause symptoms ranging from diarrhea, abdominal pain, vomiting, and nausea, to more serious complications. This infection called shigellosis, can sometimes disappear in the course of the disease, antibiotics can shorten the course of the disease.


Shigellosis, which is most common during the summer months, typically affects children aged 2-4 years, and rarely infects infants younger than 6 months.
The infection is highly contagious and can be prevented by good hand washing.
 
Signs and Symptoms
Shigella bacteria produce toxins that can attack the surface of the colon, causing swelling, injury to the intestinal wall, and bloody diarrhea.

The severity of the diarrhea sets shigellosis apart from regular diarrhea. In children with shigellosis, the first time large bowel movements frequent and watery. Then a bowel movement may be fewer, but there is blood and mucus in it.
Other symptoms of shigellosis include:
  • Abdominal pain
  • High fever
  • Loss of appetite
  • Nausea and vomiting
  • Pain during bowel movements

In very severe cases of shigellosis, a person may have seizures, stiff neck, headache, fatigue, and confusion. Shigellosis can also lead to dehydration and other complications rarely occur, such as arthritis, skin rashes, and kidney failure.
Some children with severe cases of shigellosis may need to be hospitalized.

Contamination
Shigellosis is very contagious. A person can be infected through contact with something contaminated by stool from an infected person. This includes toys, surfaces in the toilet, and even food prepared by someone who is infected. For example, kids who touch a contaminated surface such as a toilet or toy and then put their fingers in their mouths can become infected. Shigella can even be carried and spread by flies that contact with infected feces.

Because it does not take many Shigella bacteria to cause infection, the disease can spread easily in families and children. The bacteria may also spread in water supplies in areas of poor sanitation. Shigella can still be deployed in 4 weeks after symptoms of the disease is complete (although antibiotic treatment can reduce the expenditure of Shigella bacteria in feces).

Prevention
The best way to prevent the spread of Shigella is by washing your hand frequently with soap, especially after using the toilet and before eating. This is especially important in child care.
If you are caring for a child who has diarrhea, wash hands before touching other people and before handling food. (Anyone with diarrhea should not prepare food for others.) Be sure to frequently clean and disinfect any toilet used by someone with shigellosis.

Diapers of a child with shigellosis should be disposed of in a sealed garbage can, and the diaper area should be cleaned with disinfectant after use. Children (especially those still in diapers) with shigellosis or with diarrhea of any cause should be kept away from other children.
Handling, storage, and preparation of food can also help prevent Shigella infections. Cold foods should be kept cold and hot foods should be kept hot to prevent bacterial growth.
 
Diagnosis and Treatment
To confirm the diagnosis of shigellosis, your doctor will take a stool sample from your child to be tested for Shigella bacteria. Blood tests and other tests can also rule out other possible causes of symptoms, especially if your child has a large amount of blood in the stool.

Some cases of shigellosis require no treatment, but antibiotics will be given to shorten the illness and to prevent the spread of the bacteria to others.
If the doctor prescribes antibiotics, give them as prescribed. Avoid giving free medicines for vomiting or diarrhea, because they can prolong the illness. Acetaminophen can be given to reduce fever and make your child more comfortable.

To prevent dehydration, follow your doctor's instructions about what your child should eat and drink. Your doctor may recommend a special drink called an oral dehydration solution, to replace body fluids quickly, especially if the diarrhea has lasted 2 or 3 days or more.
Children who are dehydrated medium-weight or who have other more serious illnesses may need to be hospitalized to be monitored and receive treatment such as intravenous fluids or antibiotics.
 
When to Call the Doctor
Call your doctor if your child has signs of a Shigella infection, including diarrhea with blood or mucus, accompanied by abdominal pain, nausea and vomiting, or high fever.
Children with diarrhea can quickly become dehydrated, which can lead to serious complications. Signs of dehydration include:
  • Thirst
  • Fussy
  • Restlessness
  • Decreased consciousness (difficulty awakened)
  • The mouth, tongue, and dry lips
  • Sunken eyes
  • Dry diaper for several hours in infants or rarely urinating
If you see these signs, contact your doctor immediately.

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