bacteria cause. Shigella
and is found in water polluted with human feces.
include abdominal pain; cramps; diarrhea; fever; vomiting; blood,
pus, or mucus in stools and tenesmus. The onset time is 12 to 50
organisms attaching and penetrating epithelial cells of the intestinal
mucosa cause the disease. They multiply, and spread to adjacent
cells resulting in tissue destruction. Some strains produce enterotoxins
and Shiga toxins (very much like the verotoxin of E.
coli O157:H7). Infections are associated with mucosal
ulceration, rectal bleeding, drastic dehydration; fatality may be
as high as 10-15% with some strains. Reiter's disease, reactive
arthritis, and hemolytic uremic syndrome are possible complications
contaminated water and unsanitary handling by food handlers are
the most common causes of contamination Foods implicated include:
salads (potato, tuna, shrimp, macaroni, and chicken), raw vegetables,
milk and dairy products, and poultry. Contamination is usually through
the faecal-oral route..
the elderly, and the infirm are susceptible to the severest symptoms.
Shigellosis is a very common for AIDS patients and non-AIDS homosexual
48(14):1999 , MMWR
45(11):1996 , MMWR