Shigellosis is an infectious disease caused by a group of bacteria called Shigella. Most who are infected with Shigella develop diarrhea, fever and stomach cramps starting a day or two after they are exposed. The diarrhea is often bloody.
Shigellosis usually resolves in five to seven days. In some people, especially young children and the elderly, diarrhea can be so severe that the patient needs to be hospitalized. A severe infection with high fever may also be associated with seizures in children less than two years old. Some persons who are infected may have no symptoms at all, but may still pass the Shigella bacteria to others.
How can Shigella infections be treated?
Shigellosis can usually be treated with antibiotics. Unfortunately, some Shigella bacteria have become resistant to antibiotics and using antibiotics to treat shigellosis can actually make the germs more resistant in the future.Continue Reading What is Shigellosis?

Public Health Dispatch: Outbreak of Shigella sonnei Infections Associated with Eating a Nationally Distributed Dip — California, Oregon, and Washington, January 2000
A multistate outbreak of Shigella sonnei infections with at least 30 culture-confirmed cases in California, Oregon, and Washington has been linked to eating a nationally distributed five-layer dip. Symptom onsets occurred during January 10-23, 2000; case-finding is ongoing. The implicated product is manufactured by SeÒor Felix’s Mexican Foods* (Baldwin Park, California) and distributed under the brand names SeÒor Felix’s 5-Layer Party Dip (sold in 16-ounce, 20-ounce, and 41-ounce containers), Delicioso 5-Layer Party Dip (33-ounce containers), and Trader Joe’s 5-Layer Party Dip (20-ounce containers). The dip consists of layers of bean, salsa, guacamole, nacho cheese, and sour cream.Continue Reading Outbreak of Shigella sonnei Infections

During June 2001–March 2003, outbreaks of Shigella sonnei infections were reported in Delaware, Maryland, New Jersey, North Carolina, South Carolina, and Virginia (Figure). Five- to fortyfold increases in statewide shigellosis rates were observed during this period. These increases were attributed primarily to outbreaks in multiple day care settings that became prolonged and communitywide. S. sonnei isolates from these states, as well as from New York City and Philadelphia, were similar genetically by pulsed-field gel electrophoresis (PFGE). Many of these isolates lacked the capacity to ferment rhamnose, which is unusual for S. sonnei. This report summarizes these outbreaks and describes the laboratory characteristics that link them. The findings underscore the importance of rapid and coordinated public health responses to isolated outbreaks of shigellosis.
Shigellosis is a nationally reportable disease. During June 2001–March 2003, approximately 3,081 laboratory-confirmed cases of S. sonnei were reported from the six states through the Public Health Laboratory Information System (PHLIS). Each state or city health department investigated outbreaks independently and submitted case counts, including cases not reported through PHLIS; demographic information and laboratory data also were submitted. A day care–related case was defined as S. sonnei infection in a child attending day care or in a close contact of a child attending day care. The extent of laboratory testing, including PFGE, varied substantially from state to state on the basis of available resources and health department policies. Selected isolates and PFGE patterns were submitted to the National Molecular Subtyping Network for Foodborne Disease Surveillance (PulseNet) for comparison among states.Continue Reading Day Care–Related Outbreaks of Rhamnose-Negative Shigella sonnei — Six States, June 2001–March 2003

11/12/04
Health officials in Ingham County say they’re making some progress in tracing the source of the Shigella outbreak. I t was declared on October 19th, when 3 cases of the contagious intestinal illness were confirmed at Lansing’s Willow Elementary.
The number of cases peaked Tuesday with 61 confirmed and 35 probable cases. B oth health and school leaders met to discuss their progress. While they do not know exactly what caused the outbreak,they say the research done so far says it was not from any of the food the schools served for lunch.
Dr. Dean Sienko: “Evaluating every food item, both with the kids that were sick and the kids that were not sick, we couldn’t find any association with the foods.”
Taco meat, vegetables and apple sauce were among 15 district foods listed for analysis by the department. Dr. Dean Sienko says, while they cannot rule out food entirely as a cause, they have no evidence to say it was a factor.Continue Reading Progress In Tracking Shigella Source

October 22, 2004
Health official finds no evidence of intestinal illness outside schools
By Tom Lambert
Lansing State Journal
There’s no evidence the intestinal illness shigella has spread to the general public, Ingham County’s top medical examiner said Thursday after contacting local doctors and emergency rooms.
The Lansing School District is now possibly dealing with 32 cases of shigella – 29 at Willow Elementary and potentially three more at Sheridan Road Elementary.
Four of the Willow cases have been confirmed by laboratory tests as shigella, said Dr. Dean Sienko, Ingham County’s medical director.
The outbreak has parents, Lansing school officials and outlaying school districts uneasy and looking to the county Health Department for answers.Continue Reading 32 cases of shigella possible in Lansing

Thomas L. Hale
Gerald T. Keusch
General Concepts
Clinical Manifestations
Symptoms of shigellosis include abdominal pain, tenesmus, watery diarrhea, and/or dysentery (multiple scanty, bloody, mucoid stools). Other signs may include abdominal tenderness, fever, vomiting, dehydration, and convulsions.
Structure, Classification, and Antigenic Types
Shigellae are Gram-negative, nonmotile, facultatively anaerobic, non-spore-forming rods. Shigella are differentiated from the closely related Escherichia coli on the basis of pathogenicity, physiology (failure to ferment lactose or decarboxylate lysine) and serology. The genus is divided into four serogroups with multiple serotypes: A (S dysenteriae, 12 serotypes); B (S flexneri, 6 serotypes); C (S boydii, 18 serotypes); and D (S sonnei, 1 serotype).
Pathogenesis
Infection is initiated by ingestion of shigellae (usually via fecal-oral contamination). An early symptom, diarrhea (possibly elicited by enterotoxins and/or cytotoxin), may occur as the organisms pass through the small intestine. The hallmarks of shigellosis are bacterial invasion of the colonic epithelium and inflammatory colitis. These are interdependent processes amplified by local release of cytokines and by the infiltration of inflammatory elements. Colitis in the rectosigmoid mucosa, with concomitant malabsorption, results in the characteristic sign of bacillary dysentery: scanty,. unformed stools tinged with blood and mucus.Continue Reading Shigella

School Asks Parents To Keep Sick Children Home
October 12, 2004
CLOVERDALE, Ind. — Health officials this week declared a shigellosis outbreak in southern Putnam and northern Owen counties after six cases were confirmed and 24 other people showed signs of having the disease.
The first case, noticed last week, involved a Cloverdale kindergartner. Symptoms of the contagious disease are diarrhea, vomiting, fever and stomach cramps.
In some shigellosis patients, especially children and senior citizens, diarrhea can lead to hospitalization, according to the Web site of the Centers for Disease Control and Prevention. Symptoms usually conclude within a week.Continue Reading Shigellosis Outbreak Declared In Two Indiana Counties