Saturday, August 9, 2008

Dysentery In The Developed World

Usually, one thinks of dysentery as being in the same category as cholera – a disease of disaster. But that's not always the case.

Shigella, the microbe responsible for dysentery, is spread through what is euphemistically called the "fecal-oral" route. This spread can occur by fecal contamination of drinking water, through poor personal hygiene, improper hand-washing after coming contact with contaminated feces (perhaps when changing a diaper), or through anal sex with an infected person.

Shigella infections produce a range of gastrointestinal symptoms, including: abdominal pain, cramps, diarrhea – often with blood, pus, or mucus – fever, vomiting, and tenesmus. Dehydration can be life-threatening for young children or the elderly.

The Montreal public health department has reported an unusually large number of recent cases in that city – 13 between mid-June and early August, versus just four cases during the same period last year.

Montreal is not alone in reporting increased incidences of Shigella dysentery. There have been at least three US reports in the last month – in Ohio, Oregon and Florida.

The Columbus Dispatch carried a Shigella report on July 21. Public health officials in that city were focusing on day care centers as the possible source for an outbreak that had sickened at least 100 people since the beginning of June. Day care centers, especially those catering to very young children, often are the source of outbreaks spread through fecal contamination.

The Oregon outbreak has been linked to attendance at a country fair near Veneta. At least 8 people have been infected, according to Food Safety Daily News.

In Florida, Shigella has been working its way through Palm Beach County and parts of South Florida, affecting mainly minority and immigrant communities – many of which are overcrowded. Food Safety Daily News reports that children and the immunocompromised appear to be at highest risk of serious illness.

Shigella has been spread by food in the past, but always as a result of contamination by a food handler or from contaminated water used to wash or prepare a food item. The best defense against this microbe is careful attention to proper sanitation and good personal hygiene.

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