Summary about Disease
Bacillary dysentery, also known as shigellosis, is an infectious disease caused by bacteria of the Shigella genus. It primarily affects the intestines, leading to inflammation and ulceration of the colon. The disease is characterized by diarrhea, fever, stomach cramps, and painful passage of stools containing blood and mucus. It is highly contagious and spread through the fecal-oral route.
Symptoms
Common symptoms of bacillary dysentery include:
Diarrhea (often bloody)
Abdominal cramps and pain
Fever
Nausea and vomiting
Tenesmus (a feeling of needing to pass stool, even when the bowels are empty)
Dehydration
Causes
Bacillary dysentery is caused by bacteria of the Shigella genus. *Shigella* infection spreads primarily through the fecal-oral route. This means the bacteria are passed in the stool of an infected person and can then be ingested by another person, often through:
Contaminated food
Contaminated water
Direct contact with an infected person (e.g., not washing hands properly after using the toilet)
Contact with contaminated surfaces
Medicine Used
Treatment for bacillary dysentery typically involves:
Rehydration: Oral rehydration solutions (ORS) are crucial to replace fluids lost through diarrhea and vomiting. In severe cases, intravenous fluids may be necessary.
Antibiotics: Antibiotics are often used to shorten the duration of the illness and reduce the risk of complications. Common antibiotics prescribed include:
Azithromycin
Ciprofloxacin
Ceftriaxone
Other antibiotics may be used depending on the Shigella species and antibiotic resistance patterns.
Anti-diarrheal medications: Anti-diarrheal medications like loperamide are generally not recommended as they can prolong the illness.
Is Communicable
Yes, bacillary dysentery is highly communicable. It spreads easily through the fecal-oral route.
Precautions
To prevent the spread of bacillary dysentery, the following precautions are essential:
Handwashing: Frequent and thorough handwashing with soap and water, especially after using the toilet, before eating, and after contact with potentially contaminated surfaces.
Food Safety: Proper food handling and preparation, including washing fruits and vegetables thoroughly and cooking food to the appropriate temperature.
Water Safety: Drinking safe water, either bottled or properly treated. Avoid drinking water from potentially contaminated sources.
Sanitation: Maintaining proper sanitation and hygiene practices, including proper disposal of feces.
Isolation: Infected individuals should be isolated to prevent the spread of the disease.
Avoid Sharing: Avoid sharing personal items like towels and utensils with infected individuals.
How long does an outbreak last?
The duration of a bacillary dysentery outbreak can vary significantly depending on factors such as:
Effectiveness of control measures (e.g., sanitation, hygiene promotion)
Number of people affected
Specific setting (e.g., daycare, community)
Promptness of diagnosis and treatment An outbreak can last from a few weeks to several months if not properly controlled. Localized outbreaks in settings like daycare centers might be shorter if control measures are implemented quickly. Larger outbreaks in communities with poor sanitation can last longer.
How is it diagnosed?
Bacillary dysentery is diagnosed through:
Stool Culture: A stool sample is collected and sent to a laboratory to identify the presence of Shigella bacteria.
Clinical Evaluation: A doctor will assess the patient's symptoms, medical history, and perform a physical examination.
Fecal Leukocyte Test: Checking for the presence of white blood cells in the stool can indicate bacterial infection.
Polymerase Chain Reaction (PCR): This test can detect Shigella DNA in stool samples and is becoming increasingly common for rapid diagnosis.
Timeline of Symptoms
The timeline of symptoms in bacillary dysentery typically unfolds as follows:
Incubation Period: Usually 1-3 days after exposure to the Shigella bacteria.
Initial Symptoms: Watery diarrhea and fever often start abruptly.
Progression: Within a few days, the diarrhea may become more frequent and contain blood, mucus, and pus. Abdominal cramps and tenesmus also develop.
Duration: Without treatment, symptoms can last from a few days to several weeks.
Recovery: With appropriate treatment, symptoms usually improve within a few days.
Important Considerations
Antibiotic Resistance: Shigella* bacteria are increasingly developing resistance to commonly used antibiotics. Antibiotic susceptibility testing should be performed to guide treatment decisions.
Complications: Severe dehydration, seizures (especially in young children), bacteremia (bacteria in the bloodstream), toxic megacolon, and reactive arthritis are possible complications of bacillary dysentery.
Public Health Importance: Bacillary dysentery is a significant public health concern, especially in areas with poor sanitation and hygiene. Outbreaks require prompt investigation and control measures.
Travelers: Travelers to regions with poor sanitation should take precautions to avoid infection, including drinking safe water and practicing good hand hygiene.
Vulnerable Populations: Young children, the elderly, and individuals with weakened immune systems are at higher risk of severe illness and complications.