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Cause: Bacteria in the genus Shigella, typically S. sonnei. Other species including S. flexneri, S. boydii, or S. dysenteriae are more common in developing countries.

Illness and treatment: Symptoms include fever, watery or bloody diarrhea, abdominal pain, fatigue and headache. Most persons will recover without treatment. Antibiotics may be used to shorten the duration of intestinal excretion of the organism.

Sources: Humans are the only reservoir, transmitting through feces-contaminated food or water or through person-to-person transmission, including oral-anal sex. Outbreaks are occasionally associated with child care or food service facilities.

Additional risks: Ingesting very few organisms can cause infection. Outbreaks occur under conditions of crowding and poor hygiene, putting institutions for children, mental hospitals, prisons, and refugee facilities at additional risk.

Prevention: Wash hands carefully including cleaning under the nails with soap and water after defecation or changing diapers and before food handling.

Recent Washington trends: Each year there are 115 to 185 reports.

Purpose of Reporting and Surveillance

  • To prevent further transmission from cases.
  • To identify outbreaks and potential sources of ongoing transmission.
  • To prevent further transmission from such sources.

Legal Reporting Requirements

  • Health care providers: notifiable to local health jurisdiction within 24 hours
  • Health care facilities: notifiable to local health jurisdiction within 24 hours
  • Laboratories: Shigella species notifiable to local health jurisdiction within 24 hours; specimen submission required – culture (2 business days)
  • Local health jurisdiction: notifiable to Washington State Department of Health (DOH) Office of Communicable Disease Epidemiology (CDE) within 7 days of case investigation completion or summary information required within 21 days.