Shigella bacteria cause a diarrheal illness that can occur in children. Four species of Shigella bacteria (S boydii, S dysenteriae, S flexneri, and S sonnei) have been identified as infecting the lining of the intestines. These bacterial illnesses are highly contagious. They are spread through the feces of people with the infection, particularly in close contact environments such as within families and in child care centers. They can also be contracted by consuming contaminated food or water or by touching an object on which the bacteria may be present. Children aged 2 to 4 years are particularly vulnerable to developing the disease. The incubation period is usually 2 to 4 days.
Signs and Symptoms
A Shigella infection can cause mild watery or loose stools with no other symptoms, or it can be more serious, with fever, abdominal cramps or tenderness, crampy rectal pain (tenesmus), and mucous-filled and sometimes bloody stools.
When to Call Your Pediatrician
Call your pediatrician if you notice blood in your child’s stool, there’s no improvement in her diarrhea, or she is showing signs of dehydration.
How Is the Diagnosis Made?
A pediatrician may order laboratory tests in which a culture of the child’s feces is examined for evidence of Shigella bacteria.
If your child’s symptoms are mild, your pediatrician may decide that it’s not necessary to prescribe medicine to treat the infection. These children generally get better rapidly without any medicine. However, antibiotics such as cefixime, ampicillin, or trimethoprim sulfamethoxazole may be prescribed in more severe cases. These drugs can kill Shigella bacteria in the child’s stools, shorten the duration of the diarrhea, and lower the chances of spreading the illness.
If your child is having lots of watery diarrhea, be sure to give her extra fluids to avoid dehydration. It is important that the fluids contain salt because salts are lost in the diarrhea. Rehydration fluids are sold over the counter, but you can also make these at home. Talk to your pediatrician to be sure you have the correct amount of salt and water. In severe cases, intravenous fluids may be required.
Do not self-prescribe antidiarrheal medicines, which can actually make your child worse.
What Is the Prognosis?
In most cases, Shigella infections run their course in 2 to 3 days. Occasionally, complications may develop, including bacteremia (bacteria in the blood), hemolytic uremic syndrome (a disorder characterized by kidney failure and anemia), and Reiter syndrome (painful urination, joint achiness).
If your child attends a child care facility, make sure staff members practice good hygiene, including frequent hand washing, particularly before food preparation and after diaper changes, and regularly disinfect toys. At home as well as at these child care settings, food should be stored, handled, and prepared according to good sanitation guidelines. People with a diarrheal illness should not be involved in preparing food for others.