Summary
Shigella are small, ubiquitous gram-negative bacteria belonging to the enterobacteria family and are strictly limited to human hosts. There are four species: S. dysenteriae, S. flexneri, S. boydii and S. sonnei, all of which cause bacillary dysentery. In western Europe, cases of shigellosis are either imported or limited to small familial epidemics and usually food-borne. They are mostly due to S. sonnei. The virulence of shigellas is a result of their ability to invade the intestinal epithelium by passing between contiguous epithelial cells, leading to the destruction of the intestinal mucosa. Clinically, after an incubation period of 2-3 days, dysenteric syndrome appears, with 10-30 glairy, bloody watery stools per day, a high temperature (40°C) and abdominal pain. Examination of the intestinal mucosa with endoscopy shows multiple ulcerations. Diagnosis is based on evidence of the bacilli in stools. Treatment is with antibiotics, quinolone and cotrimoxazol, and with rehydration to alleviate symptoms. Strict isolation of affected individuals is essential to limit epidemics. The disease is notifiable. *Author: Dr E. Aslangul (August 2006)*.
