Shigellosis (Shigella)

Shigella are bacteria (germs) that cause diarrhea. It is mostly found in feces (poop) or in food or water that is contaminated by a person who has the disease.

The most common way people get Shigella is from eating or drinking contaminated food or water. Shigella can also be spread during sexual activity through the fecal-oral (poop-mouth) route.

A person with Shigella infection can still have bacteria in their poop for up to four weeks after symptoms have gone away. If you or someone you know has or recently had diarrhea, be sure to take steps to help prevent the spread of disease.

Shigella spreads easily; swallowing just a small amount of Shigella germs can make you sick. Some ways Shigella can get into your mouth and make you sick are:

  • Getting Shigella on your hands and touching your mouth or food. Shigella can get on your hands by:
    • Touching surfaces contaminated with Shigella bacteria, such as toys, bathroom doorknobs, changing tables, and diaper pails.
    • Changing the diaper of a child with diarrhea.
    • Taking care of a person with diarrhea, including cleaning up after the person uses the toilet.
  • Eating food made by someone with Shigella.
  • Swallowing contaminated drinking water or contaminated water that you swim or play in, such as lake or swimming pool water that is not regularly treated.
  • Exposure to poop during sexual contact with someone with diarrhea or who has recently recovered from diarrhea. This can happen during sexual activity through:
    • Anal or oral sex, or anal play (rimming, fingering).
    • Handling contaminated objects, such as sex toys, used condoms or barriers, and douching material.

Symptoms usually start around one to three days after being exposed to Shigella bacteria but can start anywhere from 12 hours to seven days after exposure. Symptoms usually last four to seven days. Most people recover on their own but sometimes the infection can be more serious and require hospitalization especially if they have a weakened immune system.

Symptoms can include:

  • Diarrhea which may be long-lasting or bloody
  • Stomach pain or cramps
  • Fever
  • Nausea and vomiting
  • Feeling the need to pass stool (poop), even when the bowels are empty

You can reduce your chance of getting Shigella by following these tips:

  • Carefully wash your hands with soap and water:
    • Before preparing food or eating.
    • After going to the bathroom, changing a diaper, or cleaning up after someone who went to the bathroom.
  • Take care when changing diapers.
    • As soon as you change a diaper, throw it away in a covered, lined garbage can.
    • Clean up any leaks or spills from the diaper right away.
    • Wash your hands and the child’s hands with soap and water right away.
  • Avoid swallowing water from ponds, decorative fountains, water features, lakes, creeks, rivers or swimming pools.
  • When traveling internationally, follow safe food and water habits and wash hands often with soap and water.
  • Practice good hygiene before any sexual activity:
    • Always wash your hands, genitals, and anus before and after sex.
    • Use latex gloves for fingering or fisting and dental dams during oral-anal sex.
    • Avoid sharing sex toys and ensure that they are properly cleaned and disinfected after each use.
    • Change condoms between anal and oral sex.
  • If you or your partner has been diagnosed with shigellosis, do not have sex. To reduce the chance of Shigella spreading, wait at least two weeks after diarrhea ends to have sex.

Anyone can get Shigella but men who have sex with men, young children, people experiencing homelessness, and people travelling to countries with poor sanitation are at higher risk of infection.

People with weakened immune systems can get a more serious illness.

A serious Shigella infection can spread into the blood, which can be life-threatening.

If you think you have Shigella, it is important to:

Take Care of Yourself

  • Drink lots of fluids and get plenty of rest
  • Seek medical attention if symptoms continue or worsen
  • Antibiotics are only given if you have serious illness or a weakened immune system
  • People with bloody diarrhea should not use anti-diarrheal medicines, such as loperamide (Imodium) or diphenoxylate with atropine (Lomotil). These medicines may make the illness worse.

Take Steps to Prevent Spread

  • Stay home while you are sick, especially if you are a food handler, healthcare worker, child care worker or work with people at higher risk of infection.
  • Wash your hands often with soap and water (or an alcohol-based hand sanitizer if soap and water are not available)
  • Do not prepare or share food with others while you are sick
  • Avoid sexual contact with others while you are sick
    • To reduce the chance of spreading Shigella, wait at least two weeks after diarrhea ends to have sex
    • Avoid oral-anal contact during sexual activity for four to six weeks
  • Avoid public swimming facilities such as pools, hot tubs, and splash pads while you are sick

Additional Precautions for People Experiencing Homelessness

  • Separate living/sleeping areas from toileting areas
  • Where possible, always use a toilet
  • Dispose of garbage (e.g., used wipes or toilet paper) in a garbage bag and place in a trash can
  • If poop gets on your clothes or bedding, clean clothing and bedding right away or find new clothing or bedding
  • Change to clean clothes, towels and bedding or use laundry services for clothing, towels and bedding at least once a week using hot water with heated dry cycle
  • Shower often when possible
  • Do not share personal items, such as cigarettes, food, water, sex toys, needles, syringes, clothing and bedding

Diagnosis

Your doctor will test you for Shigella infection if they think you have the bacteria. Shigella infection is diagnosed with laboratory tests of the stool (poop).

Treatment

Most people with Shigella, including those infected with antibiotic-resistant Shigella, recover on their own by drinking lots of fluids and getting lots of rest. Antibiotics may be prescribed in serious cases.

Resources

For More Information:

  • Talk to your health care provider or call Toronto Public Health at 416-338-7600.
  • Call Health Connect Ontario (811) to connect to a registered nurse day or night for free, secure, and confidential health advice.