Bacillary dysentery is an infectious intestinal disease caused by bacteria that leads to significant inflammation. The condition is recognized by severe diarrhea and is a notable health concern, particularly in regions with inadequate sanitation facilities.
Causes and Transmission of Bacillary Dysentery
The primary cause of bacillary dysentery, also known as shigellosis, is a group of bacteria called Shigella. This group includes four species that infect humans: Shigella sonnei, Shigella flexneri, Shigella boydii, and Shigella dysenteriae. While Shigella is the most common cause, other bacteria like Campylobacter, certain strains of E. coli, and Salmonella can produce similar symptoms. Ingesting as few as 10 to 100 bacterial organisms can be enough to cause illness.
Transmission occurs through the fecal-oral route. This means bacteria from an infected person’s stool must enter another person’s mouth. This can happen directly through person-to-person contact, a factor in places with close quarters like daycare centers and nursing homes, or indirectly by consuming contaminated food or water.
Because the bacteria can be shed for weeks after symptoms resolve, individuals who appear healthy can still transmit the disease.
Identifying the Symptoms and Potential Complications
The onset of bacillary dysentery is abrupt, with symptoms appearing one to three days after infection. Initial signs include a high fever, abdominal pain, and cramping. A hallmark of the condition is frequent, small-volume episodes of diarrhea. The stool is different from regular diarrhea, as it often contains visible blood, mucus, or pus from the bacteria invading the colon’s lining.
Individuals may also experience nausea, vomiting, and a persistent sensation known as tenesmus. Tenesmus is the feeling of needing to pass stools even when the bowels are empty, caused by inflammation in the rectum. While many infections are mild, the disease can range in severity, and some people may be infected without showing any symptoms.
While most cases resolve within a week, some can lead to serious health issues. The most frequent complication is dehydration, resulting from the substantial fluid and electrolyte loss due to persistent diarrhea and vomiting. In rarer instances, more severe complications can arise. These include post-infectious arthritis, where joint pain develops after the infection has cleared, and toxic megacolon, a dangerous widening of the large intestine. A particularly dangerous complication associated with Shigella dysenteriae type 1 is Hemolytic Uremic Syndrome (HUS), a condition that involves kidney failure and the destruction of red blood cells.
Diagnosis and Medical Treatment
A diagnosis of bacillary dysentery is confirmed through laboratory analysis of a stool sample. A stool culture allows technicians to grow and identify the specific bacterium responsible for the infection. This step is important for confirming the diagnosis and guiding appropriate treatment. Blood tests may also be used to assess the patient’s level of dehydration and overall health status.
Treatment for bacillary dysentery focuses on supportive care to manage symptoms and prevent complications. The primary element of this care is rehydration to replace the fluids and electrolytes lost through diarrhea and vomiting. This is accomplished by drinking oral rehydration solutions (ORS). In cases of severe dehydration, intravenous (IV) fluids may be necessary.
While many mild infections resolve on their own without medication, antibiotics are often prescribed for severe cases. Antibiotic treatment can help shorten the duration of the illness, reduce the severity of symptoms, and limit the period during which an infected person can spread the bacteria to others. The choice of antibiotic is carefully considered by healthcare providers and often depends on local patterns of antibiotic resistance, as some strains of Shigella have become resistant to common drugs. Anti-diarrheal medications are avoided as they can worsen the illness.
Prevention Strategies
Preventing the spread of bacillary dysentery revolves around hygiene and food safety practices. The most effective measure is frequent and thorough handwashing with soap and clean water. It is important to wash hands after using the toilet, after changing diapers, and before preparing or eating food.
Safe food preparation is another strategy. This includes:
- Cooking foods, especially meats, to a safe internal temperature.
- Washing fruits and vegetables thoroughly.
- Preventing cross-contamination by using separate utensils and cutting boards for raw and cooked foods.
- Storing food at proper temperatures, either refrigerated or kept hot, also inhibits bacterial growth.
Ensuring the safety of drinking water is necessary, especially in areas with questionable sanitation or when traveling. Water should be boiled, filtered, or chemically treated if its source is not known to be safe. Avoiding ice from unknown sources and consuming only bottled beverages from reliable sources are also wise precautions.