Travel Health - Dealing with Travelers' Diarrhea Caused by Shigellosis Bacteria
Guide to Common Travel Health Problems - Travelers Diarrhea
Caused by The Bacteria : Shigellosis (Bacillary Dysentery)
diarrhea medications and electrolyte diarrhea remedies
The effects of Diarrhea (alternative spelling: diarrhoea) can last for days or weeks, causing
Shigellosis (Bacillary Dysentery) - Overview
Shigellosis is a infection of the colon (large intestine) caused by Shigella bacteria. Shigellosis is
Symptoms of Shigellosis
Some people who have ingested Shigella bacteria do not become ill. Others develop only a
fever, or a brief fever together with mild diarrhea. About 25% develop high fever, abdominal
cramping, and severe, watery diarrhea that can contain blood, mucus, and pus with 10 to 30
bowel movements each day. This, together with tenesmus (a persistent urge to have a bowel
movement) can lead to rectal prolapse (abnormal protrusion of the rectum). Other symptoms
may include dry mouth and lips, dry skin, sunken eyes, severe thirst, and rapid pulse.
Rarely, Shigella bacteria can enter the bloodstream and spread to parts of the body other than
the digestive tract. When this happens, there can be seizures and symptoms of meningitis
(inflammation of the membranes covering the brain), arthritis, rashes or other symptoms.
In otherwise healthy patients with mild shigellosis symptoms should pass within 5-7 days.
However, in very young children, the elderly, or others with chronic illnesses, shigellosis can be
severe and lead to life-threatening dehydration and other complications within a few days.
Diagnosis of Shigellosis
The diagnosis of shigellosis s based on physical examination and the results of laboratory tests.
These tests include taking a rectal swab or a stool sample. If there are signs of dehydration
or significant blood loss, additional blood tests may be necessary.
Prevention of Shigellosis
Practice good hygiene, especially frequent hand-washing, especially after changing a baby,
especially if the baby has diarrhea. Only drink treated or boiled water when traveling to
developing countries. Never eat unpeeled fruit and and always peel the fruit yourself. Eat only
foods that are freshly prepared and still hot.
Treatment of Shigellosis
Mild cases of shigellosis are often not treated with antibiotics, unless there are very young or
very old members in a household who could acquire the infection. Severe cases of shigellosis
are normally treated with fluids to correct dehydration plus antibiotics, which will differ based on
the source of the infection. Shigellosis contracted in North America and Western Europe normally
responds to common antibiotics such as azithromycin, ampicillin, tetracycline or ciprofloxacin.
According to the Annals of Internal Medicine, published by the American College of Physicians,
azithromycin is effective in the treatment of moderate to severe shigellosis caused by
multidrug-resistant Shigella strains.
However, the Public Health Agency of Canada say that although another antibiotic nalidixic acid
was widely used as the first-line antimicrobial against Shigella in many countries, they now
recommend ciprofloxacin based on its safety, efficacy and reduced cost. Saying that ciprofloxacin
is now the recommended first-line antibiotic for shigellosis and the use of nalidixic acid should be discontinued, even in areas where it is still effective against Shigella.
Infections acquired during travel to a developing country are more likely to be resistant to these
common antibiotics, and newer or less commonplace antibiotics may be needed.
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