Shigellosis

What is shigellosis?

Shigellosis (also known as dysentery) is an infection caused by a group of bacteria called Shigella.

What are the symptoms?

Most people have diarrhea, fever and stomach cramps starting 12 to 96 hours after they are exposed. The diarrhea is often bloody. Illness usually lasts five to seven days and resolves on its own. Some people may have mild infection with no symptoms at all. In some cases, the symptoms can be severe and last for several days or weeks.

Kidney failure in both young children and the elderly may occur. Symptoms include irritability, fatigue, paleness of the skin, puffiness around the eyes and ankles, and decreased urine production. The elderly, those who are malnourished, and young children are considered to be more susceptible.

How is it spread?

It can be passed on by:

  • Consuming contaminated foods or beverages, including drinking contaminated liquids, such as recreational water from rivers, lakes, and other coastal waters.
  • Contact with contaminated surfaces, touching surfaces contaminated with Shigella bacteria.
  • Sexual contact – usually from rimming (oral-anal contact) or fingering, but also from other sexual activities where you might come in contact with stool (poop) whether you see it or not. This can include contact from sex toys, used condoms or douching materials.
  • Shigella can also be spread during sexual activity with a sick person.

If you or someone you know has or recently had diarrhea, be sure to take steps to help prevent the spread of disease.

Note: Shigella spreads easily; you do not need to encounter much of the bacteria to make you sick.

How do you prevent shigellosis infection?

  • Hand washing is the best prevention. Make sure hands are washed after using the toilet and changing diapers, and before handling and eating food.
  • Infected people should not work as food handlers or care providers until they have no symptoms for 48 hours.
  • If any of your sex partner(s) have symptoms consistent with shigella, hold off from sexual activity and monitor yourself for symptoms for a few days. The incubation period for shigella is one to seven days. If you have been diagnosed with shigella, do not have sex. Wait at least four weeks after diarrhea ends to have sex.
  • Drink water from a safe supply. When travelling, use bottled water or boil the water for at least one minute if the water supply is unknown (boil for three minutes at a high altitude). Remember that ice cubes can also be contaminated.
  • Avoid swimming in water that may be contaminated.
  • Avoid eating raw shellfish harvested from unknown sources.
  • Protect food against flies and cockroaches.
  • Wash all fruits and vegetables before use.

Frequently asked questions

Most people recover from shigella without antimicrobial treatment. Oral rehydration is the most common treatment, and antibiotics are only recommended if you have severe disease or have a weakened immune system. Talk to a health-care provider if you have questions or symptoms do not resolve in five to seven days for potential testing. Shigella infection is diagnosed with laboratory tests of the stool (poop).

Some things you can do to avoid getting or spreading shigella through sex include:

  • Avoid or limit rimming, fingering new partner (s) who have had sex with someone else in the last week.
  • Wash your hands well and clean your butt and genital areas before and after sex.
  • Pausing to wash your hands during sex if you’ve touched any feces (poop). That could mean moments like:
    • After pulling off a condom after or during anal sex.
    • After applying lube during anal sex
    • After fingering or fisting someone
    • After handling a sex toy that’s been used anally

The goal is to limit the possibility of small (sometimes invisible) amounts of poop from ending up in someone’s mouth (including your own).

  • Avoid engaging in activities where feces may come into contact with your mouth with multiple partners, especially if they’ve had sex with someone else in the last week.
  • Avoid sharing sex toys without washing them thoroughly first between people.
  • If you’re having sex with multiple people and using condoms, always use a new condom for each new person. Wash your hands after removing condoms and disposing of the condoms.

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