Causative agent
Bacillary dysentery is an intestinal infection caused by a group of Shigella bacteria which can be found in human gut.
Clinical features
The illness is characterized by sudden onset of fever, diarrhoea with abdominal cramps and nausea or vomiting. The stool may contain blood and mucus. Mild and asymptomatic illness can occur. Complications include toxic dilatation of large intestine and acute kidney disease.
Mode of transmission
Bacillary dysentery is transmitted directly by faecal material of a patient/carrier or indirectly through contaminated food and water. Infection may occur after consuming a small number of the germs. Therefore, chance of spread among household members or in institutions can be very high. It occurs more commonly amongst young children.
Incubation period
Usually 1 - 3 days, but can be up to 7 days.
Management
Infected persons in institutions should be isolated. They should observe personal hygiene to avoid infecting other persons. Treatments include fluid replacement and antibiotics.
Prevention
1. Keep the premises and kitchen utensils clean. Dispose rubbish properly.
2. Keep hands clean and fingernails trimmed.
3. Wash hands properly with soap and water before eating or handling food, and after toilet or changing diapers.
4. Drinking water should be from the mains and preferably boiled.
5. Purchase fresh food from reliable sources. Do not patronize illegal hawkers.
6. Avoid high-risk food like shellfish, raw food or semi-cooked food.
7. Wear clean washable aprons and caps during food preparation.
8. Clean and wash food thoroughly. Scrub and rinse shellfish in clean water and immerse them in clean water for sometime to allow self-purification. Remove the viscera if appropriate.
9. Store perishable food in refrigerator, well covered.
10. Handle and store raw and cooked food especially seafood separately (upper compartment of the refrigerator for cooked food and lower compartment for raw food) to avoid cross contamination.
11. Clean and defrost refrigerator regularly and keep the temperature at or below 4oC.
12. Cook food thoroughly.
13. Do not handle cooked food with bare hands; wear gloves if necessary.
14. Consume food as soon as it is done.
15. If necessary, refrigerate cooked leftover food and consume as soon as possible. Reheat thoroughly before consumption. Discard any addled food items.
16. Exclude infected persons and asymptomatic carriers from handling food and from providing care to children.
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