Shigellosis Food Poisoning

_______________________________________________________________________

KEY POINTS

• Shigellosis is an infection caused by bacteria that usually enters the body through contaminated food.
• Dehydration caused by diarrhea and vomiting can be dangerous, especially for children.
• Your child needs to drink enough liquid to replace the fluids and minerals lost.
• Treatment may include antibiotic medicine or IV fluids until your child’s symptoms get better.

________________________________________________________________________

What is shigellosis?

Shigellosis is an infection caused by bacteria called Shigella. Because the bacteria usually enter the body through contaminated food, it is also called food poisoning.

The illness can be severe for children and older adults. It can cause dehydration (loss of too much fluid from the body), imbalance of chemicals in the body, and shock.

What is the cause?

Shigella bacteria can live in the intestines of humans and primates, including monkeys and chimpanzees. People can carry the bacteria without looking or acting sick. Bowel movements can spread the bacteria to soil or water. Vegetables can be contaminated by contact with this soil or water. Contaminated food usually looks and smells normal.

Your child may get infected if:

• Your child eats contaminated food
• Your child eats food that has been handled by someone who is infected
• Your child eats or drinks dairy products that have not been pasteurized (heated to kill bacteria)
• Your child swallows water from a well, lake, stream, or city water that has not been treated to kill germs
• Your child has contact with flies that are carrying the disease

What are the symptoms?

Attacks of shigellosis are sudden and severe. The symptoms start about 12 hours to 3 days after your child is exposed to the bacteria.

Symptoms may include:

• High fever that may reach 104°F (40°C)
• Cramps or tenderness in your child’s belly
• Diarrhea with blood, mucus, and pus
• Pain in the rectum

If the infection spreads to the nervous system it can cause meningitis. Meningitis is an infection of the covering of the brain and spinal cord. Symptoms of meningitis may include:

• Headache
• Stiff neck
• Confusion
• Loss of balance
• Seizures
• Coma

Meningitis can be fatal.

How is it diagnosed?

Your healthcare provider will ask about your child’s symptoms and medical history and examine your child. A sample of bowel movement may be sent to the lab for testing.

How is it treated?

Mild infections may get better without antibiotic medicine, but your child’s provider may prescribe an antibiotic medicine to keep others from getting infected. If your child is generally in good health, your child will usually feel better within a week.

If your child has a severe infection, or it spreads to the brain or kidneys, your child will need to stay at the hospital for treatment.

Follow your healthcare provider’s instructions. Make sure that your child takes all medicines exactly as prescribed. If your child stops taking the medicine too soon, the infection may come back. If your child has side effects from the medicine, talk to your child’s provider.

Here are some things you can do to help your child feel better:

• Rest your child’s stomach and bowel but make sure that your child keeps getting liquids. You can try giving your child water, ice chips, frozen ice pops, or half-strength lemon-lime soft drinks (half water, half soft drink). Avoid liquids that are acidic such as orange juice, or caffeinated such as coffee.
• If your child has severe diarrhea, your child’s body can lose too much fluid and get dehydrated. Dehydration can be dangerous, especially for children. Your child may also be losing minerals that the body needs to keep working normally. Your healthcare provider may recommend an oral rehydration solution (ORS), which is a drink that replaces fluids and minerals. You can buy these products at drug and grocery stores.
• Your child may want to eat soft, plain foods. Good choices are soda crackers, toast, plain pasta, rice, cooked cereal, applesauce, and bananas. It’s best for your child to eat slowly and avoid foods that are hard to digest or may irritate the stomach including foods with acid such as tomatoes or oranges, spicy or fatty food, meats, and raw vegetables. Your child may be able to go back to a normal meal plan in a few days.
• Don’t give your child aspirin, ibuprofen, or other nonsteroidal anti-inflammatory drugs (NSAIDs) without checking first with your healthcare provider. NSAIDs, such as ibuprofen, naproxen, and aspirin, may cause stomach bleeding and other problems. Check with your healthcare provider before you give any medicine that contains aspirin or salicylates to a child or teen. This includes medicines like baby aspirin, some cold medicines, and Pepto-Bismol. Children and teens who take aspirin are at risk for a serious illness called Reye’s syndrome.

Ask your healthcare provider:

• How and when you will get your child’s test results
• How long it will take to recover
• If there are activities your child should avoid, and when your child can return to normal activities
• How to take care of your child at home
• What symptoms or problems you should watch for and what to do if your child has them

Make sure you know when your child should come back for a checkup. Keep all appointments for provider visits or tests.

How can I help prevent shigellosis?

Shigellosis can be a serious health threat to you and the people around you. It cannot be treated with many of the antibiotic medicines that are usually used to treat infections. Prevention is most important. These steps can help prevent food poisoning:

• Make sure you cook all foods well, especially beef, chicken, turkey, pork, seafood, and eggs. Pork should be heated to an internal temperature of at least 160°F (71°C). For whole chickens and turkeys a temperature of 180°F (82°C) is recommended for thigh meat and 170°F (77°C) for breast meat.
• Wash your hands and clean any dishes or utensils before you prepare, cook, serve, or eat food. Keep kitchen counters and other food preparation surfaces clean. Replace used dishcloths and kitchen towels with clean ones often.
• If you take care of young children, wash your hands often and dispose of diapers carefully so that bacteria can't spread to other surfaces or people.
• Cover any sore or cut on your hands before preparing food. Use rubber gloves or cover the sore with a clean bandage.
• Make sure the milk, cheese, and juice products your child eats and drinks have been pasteurized.
• Rinse fresh vegetables and fruits before you cook them or before your child eats them.
• Thaw frozen meats in the refrigerator or a microwave. Do not let meat stand at room temperature.
• Keep juices from raw meat, poultry, and seafood away from other foods.
• Refrigerate any food your child will not be eating right away.
• Remind or help your child to wash his or her hands before eating, after going to the bathroom, or after touching animals.
• When your child travels to places where contamination is more likely, your child should:
  • Eat only hot, freshly cooked food.
  • Don't eat from street vendors or raw vegetables or unpeeled fruit.
  • Drink only bottled (with intact seal) water and liquids.
  • Avoid tap water and ice, or drink water only after it has been boiled.