Shigellosis
Disease Details
Family Health Simplified
- Description
- Shigellosis is an infectious disease caused by a group of bacteria called Shigella, leading to diarrhea, fever, and stomach cramps.
- Type
- Shigellosis is an infectious disease caused by a group of bacteria called Shigella. It is not genetically transmitted; rather, it is typically spread through direct contact with the bacteria in the stool of an infected person, contaminated food or water, or by contact with contaminated surfaces.
- Signs And Symptoms
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Signs and symptoms may range from mild abdominal discomfort to severe dysentery characterized by cramps, diarrhea, with slimy-consistent stools, fever, blood, pus, or mucus in stools or tenesmus. Onset time is 12 to 96 hours, and recovery takes 5 to 7 days.
Infections are associated with mucosal ulceration, rectal bleeding, and drastic dehydration. Reactive arthritis and hemolytic uremic syndrome are possible sequelae that have been reported in the aftermath of shigellosis.The most common neurological symptom includes seizures. - Prognosis
- Shigellosis is typically a self-limiting disease, meaning it often resolves on its own within 5 to 7 days. However, in some cases, especially in young children, the elderly, and immunocompromised individuals, the infection can be more severe and require medical treatment. Complications such as dehydration, hemolytic-uremic syndrome, and reactive arthritis can occur but are relatively rare. With appropriate rehydration and, if necessary, antibiotic treatment, the prognosis is generally good.
- Onset
- The onset of shigellosis symptoms usually occurs 1 to 2 days after exposure to the Shigella bacteria.
- Prevalence
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Shigellosis is an infectious disease caused by a group of bacteria called Shigella.
### Prevalence
- **Global Prevalence:** Shigellosis is estimated to cause around 80-165 million cases of disease annually worldwide. Outbreaks are more common in areas with poor sanitation and limited access to clean water.
- **United States Prevalence:** In the U.S., there are approximately 500,000 cases each year.
- **High-Risk Areas:** The disease is more prevalent in developing countries, particularly in regions with inadequate water supply and sanitation.
It remains a significant public health concern, especially among children under five years of age who are the most affected demographic. - Epidemiology
- Insufficient data exist, but it is estimated to have caused the death of 34,000 children under the age of five in 2013, and 40,000 deaths in people over five years of age. Shigella also causes about 580,000 cases annually among travelers and military personnel from industrialized countries.An estimated 500,000 cases of shigellosis occur annually in the United States. Infants, the elderly, and the critically ill are susceptible to the most severe symptoms of disease, but all humans are susceptible to some degree. Individuals with acquired immune deficiency syndrome (AIDS) are more frequently infected with Shigella. Shigellosis is a more common and serious condition in the developing world; fatality rates of shigellosis epidemics in developing countries can be 5–15%.Orthodox Jewish communities (OJCs) are a known risk group for shigellosis; Shigella sonnei is cyclically epidemic in these communities in Israel, with sporadic outbreaks occurring elsewhere in among these communities. "Through phylogenetic and genomic analysis, we showed that strains from outbreaks in OJCs outside of Israel are distinct from strains in the general population and relate to a single multidrug-resistant sublineage of S. sonnei that prevails in Israel. Further Bayesian phylogenetic analysis showed that this strain emerged approximately 30 years ago, demonstrating the speed at which antimicrobial drug–resistant pathogens can spread widely through geographically dispersed, but internationally connected, communities."
- Intractability
- Shigellosis is generally not considered intractable. It is a bacterial infection caused by Shigella species, and most cases can be effectively treated with antibiotics. Supportive care, including hydration and rest, is also important. However, antibiotic resistance can complicate treatment in some cases, making it essential to choose the appropriate antibiotic based on susceptibility testing. Overall, with prompt and appropriate medical care, shigellosis can usually be managed successfully.
- Disease Severity
- Shigellosis is typically considered a moderate to severe infection. It often manifests with symptoms such as diarrhea, fever, and stomach cramps, which can be particularly severe in young children, the elderly, and immunocompromised individuals. In severe cases, it can lead to complications such as dehydration, hemolytic uremic syndrome (HUS), and reactive arthritis. Prompt medical attention and appropriate treatment are crucial to manage the disease effectively.
- Healthcare Professionals
- Disease Ontology ID - DOID:12385
- Pathophysiology
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Shigellosis is an infectious disease caused by a group of bacteria called Shigella.
Pathophysiology: Shigella primarily invades the epithelial lining of the colon, leading to an intense inflammatory response. The bacteria induce cell death and tissue destruction through the secretion of various toxins, including Shiga toxin, which inhibits protein synthesis in host cells. This results in symptoms like diarrhea, abdominal pain, fever, and often the presence of blood and mucus in stools. The infection effectively disrupts the normal absorption and secretory functions of the intestinal tract.
Nan: It appears you might have included an incomplete term or abbreviation. If "nan" is intended to refer to 'not applicable' or another concept, please provide additional context for a more precise response. - Carrier Status
- Carrier status for shigellosis can exist, as individuals who have recovered from the infection can continue to excrete Shigella bacteria in their stool for several weeks, potentially spreading the illness even if they no longer have symptoms.
- Mechanism
- Upon ingestion, the bacteria pass through the gastrointestinal tract until they reach the small intestine. There they begin to multiply until they reach the large intestine. In the large intestine, the bacteria cause cell injury and the beginning stages of Shigellosis via two main mechanisms: direct invasion of epithelial cells in the large intestine and production of enterotoxin 1 and enterotoxin 2.Unlike other bacteria, Shigella is not destroyed by the gastric acid in the stomach. As a result, it takes only 10 to 200 cells to cause an infection. This infectious dose is several orders of magnitude smaller than that of other species of bacteria (e.g., cholera, caused by the bacterium Vibrio cholerae, has an infectious dose between 108 and 1011 cells).
- Treatment
- Treatment consists mainly of replacing fluids and salts lost because of diarrhea. Replacement by mouth is satisfactory for most people, but some may need to receive fluids intravenously. Antidiarrheal drugs (such as diphenoxylate or loperamide) may prolong the infection and should not be used.
- Compassionate Use Treatment
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For shigellosis, compassionate use and experimental treatments might be considered in situations where standard treatments are ineffective or not available. Here’s an overview:
1. **Compassionate Use Treatments**: These are typically reserved for patients with severe or life-threatening forms of shigellosis who have exhausted all other treatment options. In such cases, unapproved drugs that show promise in clinical trials might be accessed via special regulatory programs.
2. **Off-label Treatments**: Off-label use of antibiotics that are not specifically approved for shigellosis but have shown efficacy in other bacterial infections might be considered. Examples include:
- **Azithromycin**: Though not specifically approved for shigellosis, it may be used off-label based on susceptibility tests.
- **Ciprofloxacin**: This is an antibiotic that might be used off-label for strains resistant to first-line treatments.
3. **Experimental Treatments**:
- **Fecal Microbiota Transplantation (FMT)**: While primarily used for recurrent Clostridium difficile infection, FMT is being explored experimentally for treating resistant cases of shigellosis.
- **Bacteriophage Therapy**: The use of bacteriophages, viruses that infect and kill specific bacteria, is an area of ongoing research.
- **Novel Antibiotics**: New antibiotics under development, such as zoliflodacin, may be available through clinical trials or experimental protocols.
- **Probiotics and Microbiome-based Therapies**: Research is also ongoing into the use of probiotics and other microbiome-centered approaches to treat or prevent shigellosis.
It’s important for these treatments to be considered on a case-by-case basis, taking into account the patient's specific situation, the resistance patterns of the causative Shigella strain, and the availability of these therapies. - Lifestyle Recommendations
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Lifestyle recommendations for managing and preventing shigellosis include the following:
1. **Good Hand Hygiene**: Wash hands thoroughly with soap and water, especially after using the restroom, changing diapers, and before preparing or eating food.
2. **Safe Food Practices**: Avoid eating food prepared by someone who is sick. Ensure that food is cooked properly and avoid raw or undercooked foods.
3. **Drink Safe Water**: Use potable water for drinking, brushing teeth, and making ice. Avoid drinking untreated or unfiltered water.
4. **Proper Sanitation**: Ensure proper disposal of diapers and disinfect diaper-changing areas. Implement clean bathroom practices to limit the spread of bacteria.
5. **Avoid Close Contact**: Refrain from close physical contact with individuals who have shigellosis until they have fully recovered to prevent the spread of the infection.
6. **Stay Home When Sick**: If infected, stay home from work, school, or daycare to prevent spreading the infection to others.
7. **Sexual Practices**: Avoid oral-anal contact during sexual activity to reduce the risk of transmission.
8. **Travel Precautions**: When traveling to areas with poor sanitation, be cautious with food and water intake and follow strict hygiene practices.
These recommendations help manage symptoms and reduce the spread of shigellosis. - Medication
- Shigellosis is a bacterial infection caused by Shigella species. Primary treatment includes maintaining hydration. Antibiotics may be prescribed in more severe cases, with common choices being ciprofloxacin, azithromycin, or ceftriaxone. Always consult a healthcare provider for diagnosis and appropriate treatment.
- Repurposable Drugs
- For shigellosis, some drugs that have been suggested for repurposing include azithromycin, ciprofloxacin, and ceftriaxone. These antibiotics are typically used to treat a range of bacterial infections and have shown efficacy against Shigella species. Note that antibiotic resistance is a growing concern, and treatment regimens should be guided by current clinical guidelines and susceptibility testing.
- Metabolites
- Shigellosis, caused by Shigella bacteria, involves various metabolites during its infection process. Notably, Shigella produces Shiga toxin, a virulence factor. Additionally, metabolic profiling of Shigella has shown alterations in central carbon metabolism, including glycolysis, the pentose phosphate pathway, and the tricarboxylic acid (TCA) cycle. The bacteria also exhibit changes in amino acid metabolism and fatty acid biosynthesis. Understanding these metabolic changes helps in deciphering the pathogenic mechanisms of Shigella and developing targeted treatments.
- Nutraceuticals
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Nutraceuticals are food-derived products that provide health benefits beyond basic nutrition. For shigellosis, specific nutraceuticals that may be beneficial include:
1. **Probiotics**: Certain strains of probiotics can help maintain gut health and may aid in the recovery from shigellosis by restoring the beneficial gut flora.
2. **Prebiotics**: These non-digestible fibers promote the growth of beneficial bacteria in the gut, potentially improving gut health during and after infection.
3. **Zinc**: Supplementing with zinc may help enhance the immune response and speed up recovery from diarrheal diseases, including shigellosis.
4. **Curcumin**: Found in turmeric, curcumin has anti-inflammatory and antimicrobial properties, which might help alleviate some symptoms of shigellosis.
"Nan" was likely short for "nanotechnology," but it needs a bit more detail for a full explanation. If you meant something different, providing more context would be helpful. - Peptides
- Shigellosis is an infectious disease caused by a group of bacteria called Shigella. Peptides have potential therapeutic roles in shigellosis by serving as antimicrobial agents, which can inhibit the growth of Shigella bacteria. Nanotechnology can be used to deliver these peptides more effectively, enhance their stability, and target them directly to infection sites, potentially improving treatment outcomes.