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Shigella: Everything you need to know about the causes, symptoms and treatment

The Telegraph logo The Telegraph 04/09/2018 Aisha Majid

a person standing in front of a building: John and Susan Cooper who died after falling ill at a Red Sea hotel in Egypt. Two other guests evacuated from the hotel have contracted a shigella infection. © Provided by Telegraph Media Group Limited John and Susan Cooper who died after falling ill at a Red Sea hotel in Egypt. Two other guests evacuated from the hotel have contracted a shigella infection. Following the sudden deaths of a British couple at a holiday resort in Egypt last week, two of the  guests evacuated from the hotel where the couple were staying have said they have been infected with the bacteria Shigella.

They were among some 300 guests evacuated from the Steigenberger Aqua Magic hotel in Hurghada following the sudden deaths of John and Susan Cooper from Burnley, Lancashire, who died within hours of each other.

Samples tested in a British lab showed that the mother and her young daughter, from the north west, were suffering from infection with the bacteria, which can be transmitted through food or water. It is believed that they caught the infection while staying at the resort. Others are also thought to have been infected.

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What is shigella?

Shigella - a group of bacteria similar to E. coli -  is a highly contagious and common cause of food poisoning. The bacteria causes the infectious disease known as shigellosis.

There are four different types of shigella. Shigella sonnei and shigella flexneri are the kinds more commonly found in the UK.

Shigella boydii and shigella dysenteriae are more common in developing countries - cases of infection with these types of the bacteria found in the UK tend to be among travellers coming back from holiday. Shigella dysenteriae type 1 can be deadly.

Shigella bacteria, computer illustration. © Provided by Getty Shigella bacteria, computer illustration. What are the symptoms of shigellosis?

According to the US Centers for Disease Control and Prevention (CDC), most people who are infected with the bacteria develop diarrhoea, fever, and stomach cramps one to two days after they have been exposed. Mild cases of the infection usually clear up in five to seven days.

Some people who are infected with shigella do not show any symptoms but they are still able to transmit the bacteria to other people.

In more serious cases shigella can cause dysentery - an infection of the intestines that causes bloody or mucus-containing diarrhoea.

How is shigella spread?

Shigella is highly contagious and it takes just a few of the germs to make someone sick. The germs are found in the faeces of infected people while they have diarrhea and for up to two weeks after the diarrhea has gone away.

The germs are spread when someone touches their mouth with hands that have been in contact with the shigella bacteria or eats food with the germ on it. 

You can get shigella bacteria on your hands after touching surfaces or objects that have been contaminated with germs from the stool of someone with the infection, eating food made by someone who has shigellosis, handling nappies of an infected child, swallowing infected water or having sexual contact with someone who is infected or is recovering from a recent infection.

How many people catch shigella each year?

Shigella causes some 165 million cases of disease worldwide each year - mostly among children under five in less wealthy countries.

Countries in sub-Saharan Africa, Central America and Asia have in the past been hit by pandemic waves of the disease.

2,327 laboratory-confirmed cases of shigella infection were reported in England, Wales and Northern Ireland in 2014 compared to 1,991 cases the previous year. At least 20 per cent of cases were related to travel.

Confirmed cases in the UK have risen in recent years - according to Public Health England (PHE) this is most likely due to a rise in infections among gay and bisexual men. 

Clusters of cases have in the past also been reported in schools and day care centres - however, there is currently no warning of a general outbreak in the UK. 

Is it deadly?

More than one million people are estimated to die from shigella infections each year.

Most cases clear up without issues but serious complications could include severe dehydration, seizures (particularly in children),  kidney failure and paralysis of the colon preventing bowel movement or passing gas which could cause the colon to rupture open if left untreated. 

Related: Avoid These 10 Foods If You Don’t Want Food Poisoning (Provided by The Active Times)

Who gets shigella?

Young children are the most likely to get shigellosis, but anyone can be infected. According to PHE, cases among adults in the UK (not just those returning from holiday) have risen in recent years and the majority of reported cases in the UK are now seen in people over the age of 16.

People who go on holiday to developing countries could contract types of shigellosis that are not easily treated by antibiotics.

There have also been outbreaks of shigella among gay and bisexual men who can transmit the bacteria during sex.

How can you prevent the spread of shigella?

There is still no vaccine to prevent shigella infection so practicing good hygiene is one of the main ways to help prevent the germ from spreading.

According to Mayo Clinic in the US, hygiene measures you can take to prevent the bug from transferring to others include frequent and careful handwashing with soap, not preparing food for other people if you have diarrhoea, keeping children with diarrhoea home from school,  cleaning nappy changing areas after use and disposing of dirty nappies in covered, lined bins and not swallowing water from ponds, lakes or untreated pools.  

When should you see the doctor?

Severe or persistent cases of shigellosis are usually treated with antibiotics.

You should pay a visit to your  GP if symptoms do not improve after a few days or are severe - for example if your or your child's diarrhea is bloody, if the diarrhoea is causing weight loss or dehydration or if it is accompanied by a fever higher than 38 C. Let your doctor know if you have been abroad.  

Protect yourself and your family by learning more about Global Health Security

Related: Diarrhea: how to prevent and treat it (Provided by Espresso)

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