The disease is caused due to ingestion of food or drinks infected by feces of an infected person especially in areas of poor sanitation and crowded living. It may also be open food contaminated by flies or vegetables grown using sewage as fertilizer.
Bacillary dysentery is more prevalent in areas where the facilities of sanitation are inadequate for example refugee camps. Contamination of drinking water supply by sewage is the main risk factor for the development of bacillary dysentery. Disease may be transmitted by sick food handlers.
There are four species of Shigella responsible for causing dysentery S. sonnei, S. boydii, S. flexneri and S. dysenteriae.
Shigella infection is highly contagious, particularly for children. Spending time in a child care setting or a long term care facility, especially where staff or child handlers don't wash their hands adequately, can be a high risk factor.
Loose watery stool, abdominal cramps and blood in stool are the symptoms of bacillary dysentery. This may be accompanied by fever, malaise, tiredness and fatigability.
There may be nausea and vomiting prior to dysentery. Blood in stool is the characteristic of bacillary dysentery which differentiates it from diarrhea. The symptoms generally appear within two days of the infection.
Bacillary dysentery is diagnosed on the basis of medical history, history about recent foods, traveling, physical examination and in some cases blood test and stool test. Shigella and its type can be identified in stool. Further its susceptibility to the antibiotics can also be predicated based on laboratory tests.
Mild forms of disease do not require any treatment. They are often self-limiting. In severe cases antibiotics are given to treat the dysentery.
Intake of lots of fluids and minerals is important as they are lost due to dysentery. Patients who can not take fluids orally, they should be administered intravenously.
Diet should be either low fiber or only liquid diet. Dairy products, high fiber foods, fatty foods and seasoned foods should be avoided for few days.
By taking proper antibiotic treatment (if required) and adequate fluids and diet the prognosis of this disease is good. The patient gets well within 5-7 days. Malnourished children and immuno-compromised people should be treated aggressively.
The people recover rapidly from the disease only it takes time, sometimes several months, for the bowel habits to return to normal.
The toxin produced by S. dysenteriae type 1 can damage the lining of intestine and kidneys and can cause life threatening kidney failure called as hemolytic uremic syndrome.
Other complications are seizures, blindness, paralysis, high blood pressure, encephalopathy with headache, stiff neck, lethargy, confusion and Reiter’s syndrome (irritation of eyes, joint pain and painful urination).
If dysentery is with high grade fever above (102 F) fever and dehydration, severe rectal and abdominal pain, headache, dizziness or dark colored urine then it is better to rush to the health care provider. In any case blood in stool is a symptom of severe disease and needs treatment so one should not to wait for other symptoms to develop to get medical advice.
Proper handling, preparation and storage of food are important things. Eating properly cooked and hot food; drinking bottled water; eating pasteurized dairy products; avoiding ice, tap water and raw foods are some of the ways of preventing bacillary dysentery.
Washing hands, vegetables and fruits before preparing foods is important. Adequate measures of sanitation and cleanliness are helpful in preventing dysentery. Washing hands with soap after toilet and changing diapers also protect from such diseases.
Special care should be taken for children. Special attention needs to be given towards washing their hands especially after playing, toilet and before food.
