Eating contaminated foods, or drink contaminated water or milk and by hand to mouth transfer ofcontaminated materials; by files, by objects soiled with feces of a patient or carrier Shigella can be transmitted through food, including salads , raw vegetables, milk and dairy products, and meat. Contamination of these foods is usually through the fecal-oral route. Fecally contaminated water and unsanitary handling by food handlers are the most common causes of contamination. Apart from hand-to-mouth infection, Shigellosis is transmitted through fomites, water and mechanical vectors like houseflies.
INCUBATION PERIOD 1 day, usually less than 4 days.PERIOD OF COMMUNICABILITY During infection and until microorganism is absentfrom feces usually within a few weeks even withoutspecified therapy. A few individuals become carriers for a year or two and rarely longer SUSCEPTABILITY, RESISTANCE AND OCCURRENCE Disease is more common and more severe in children than in adults. A relative and transitory strain-specific immunity follows recovery
SIGNS AND SYMPTOMS Most who are infected with Shigella develop diarrhea, fever, and stomach cramps starting a day or two after they are exposed to the bacteria. The diarrhea is often bloody. Shigellosis usually resolves in 5 to 7 days. • Diarrhea (up to 20 or 30 watery A severe infection bowel movements in 1 day). with high fever may Tends to be more severe in be associated children, with sudden onset.with seizures in child • Blood, mucus or pus in the stool.ren less than 2 years • Abdominal cramps. old • Fever. and chills. • Nausea or vomiting. Loss of appetite. • Muscle aches or pain. • Dehydration.
LABORATORY DIAGNOSIS Rectal swabbing under direct vision through a sigmoidoscope METHODS OF PREVENTION AND CONTROL•Sanitary disposal of human feces•Sanitary supervision of processing , preparation andserving of food particularly those eaten raw.•Adequate provision for safe washing facilities•Fly control and screening to protect foods against flycontamination.•Protection of purified water supplies and construction ofsafe privy.•Control of infected individual contacts and environment.•Reporting to local health officers.•Isolation of patients during acute illness.•Rigid personal precautions by attendants.
PUBLIC HEALTH NURSING RESPONSIBILITIES •Encourage medical care for any case of diarrhea. •Obtain stool specimens from any person found with undiagnosed diarrhea and request examinations for pathogens. •Instruct patients and family on procedures of proper disposal of human excreta. TREATMENT DIET• Chloramphenicol• Ampicillin • Low fiber plenty of fluids, easily• Tetracycline digestible foods.• Trimethoprim- • Nursing care should be based sulfamethoxazole on prescribed treatment by the• Opiates should be physician. avoided