4. Eating contaminated foods, or drink contaminated
water or milk and by hand to mouth transfer of
contaminated 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.
5. INCUBATION PERIOD
1 day, usually less than 4 days.
PERIOD OF COMMUNICABILITY
During infection and until microorganism is absent
from feces usually within a few weeks even without
specified 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
6. 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.
7. 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 and
serving of food particularly those eaten raw.
•Adequate provision for safe washing facilities
•Fly control and screening to protect foods against fly
contamination.
•Protection of purified water supplies and construction of
safe privy.
•Control of infected individual contacts and environment.
•Reporting to local health officers.
•Isolation of patients during acute illness.
•Rigid personal precautions by attendants.
8. 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