Chris Cronkite Dr. Kinnes Microbiology02 18 Oct.

2012

Shigellosis
Bacterial Disease Importance of Disease Foodborne illness Spreads rapidly in overcrowded conditions with poor sanitation An estimated 150 million cases occur worldwide annually o Ingestion of only ten organisms can cause infection o Major cause of infant mortality in developing countries Causal Organism Bacteria of several serovars of the genus Shigella o S. dysenteriae (serovar A) o S. flexneri (serovar B) o S. boydii (serovar C) o S. sonnei (serovar D)causes 80% of cases in the United States Gram-negative, non-motile, bacilli Method of Transmission Transmitted by the fecal-oral route Spread by contaminated food, fingers, flies, feces, and fomites o Playing, bathing, and washing in contaminated water plays a major role o Poor handwashing most common cause of infection in areas of good sanitation Lifecycle Nonspore forming Reproduce intracellularly by binary fission and invade neighboring epithelial cells Symptoms Infection process o Ingested through contaminated water or food o Survives the acidity of the stomach, passes through small intestine o Pathogens invade host cells Induce cells to create special filaments for invading adjacent host cells Resulting symptoms o Incubation period of one to four days o Abdominal cramps, fever, profuse diarrhea with blood and mucus suddenly appear o Severity of symptoms range from most serious (serovar A) to least (serovar D) o Ulceration and bleeding of intestinal lining, sometimes to deep intestinal layers o Fever-eliciting endotoxin produced o Symptoms persist two to seven days Can cause severe dehydration and fluid/electrolyte imbalances Prevention and Specific Treatment

Prevention o Proper sanitation easiest prevention o Many people are infected but asymptomatic Carrier state lasts less than a month Any breakdown in sanitation can lead to transmission o Oral vaccines containing strains of S. flexneri and S. sonnei effective Treatment o Necessary in children and debilitated patients o Imperative to restore fluid and electrolytes Hydration fluids used o Fluoroquinolones or trimethoprim/sulfamethoxazole used for treatment Complications Diarrhea can cause protein deficiencies (kwashiorkor) and vitamin B12 deficiencies o Compounded with loss of electrolytes, can result in neurological damage S. dysenteriae o Produces Shiga toxin (neurotoxin) o Responsible for high fatality rate due to convulsions and comas