Taiwan health officials are reporting a cluster of shigellosis, or bacillary dysentery cases in travelers to Bali.
According to the CDC:
In early September 2017, an over-30-year-old male who resides in northern Taiwan traveled to Bali, Indonesia with 18 tour group members. On the following day the case returned, he sought medical attention after developing symptoms, including fever, diarrhea and nausea, and was diagnosed with shigellosis. After a further investigation conducted by the health authority, a female group member who is over 20 years old had also experienced symptoms, including vomiting and diarrhea and was also diagnosed with shigellosis. According to the cases, they consumed mostly cooked food while in Bali. However, they had seafood at a restaurant with poor hygiene. Hence, it was determined that these two cases constitute a cluster. As of now, none of the contacts residing in the same household with the 2 cases has developed suspected symptoms. Moreover, the local health authority has collected specimens from the other 13 tour group members who experienced symptoms for laboratory testing.
Taiwan CDC reminds travelers to pay attention to food and water hygiene when traveling overseas, consume only thoroughly cooked food, drink only boiled water or bottled beverage, wash hands frequently, and maintain personal hygiene.
Shigellosis is an acute bacterial disease of the intestines caused by several species of the bacterium, Shigella. It is typified by loose stools, frequently containing blood and mucus (dysentery), accompanied by fever, vomiting, cramps and occasionally toxemia.
More severe complications may include convulsions in children, Reiter’s syndrome and hemolytic uremic syndrome depending on the species of Shigella implicated.
It is transmitted primarily by fecal-oral person to person means. It can also occur through contaminated food or water. Those that are primarily responsible for transmission are those that fail to wash their hands thoroughly after defecation.
Because Shigella is resistant to gastric acid, a person can get infected with as little as 10 organisms.
After getting infected symptoms usually appear 1-3 days later. It can be transmitted during the acute phase of infection until approximately four weeks after illness when the organism is no longer present in the feces. Asymptomatic carriers can also infect others.
Diagnosis is confirmed through bacteriological culture of feces. Treatment of shigellosis may include fluid and electrolyte replacement if there are signs of dehydration.
Antibiotics can shorten the course of infection, the severity of illness and the period of time a person may excrete the pathogen. Because of some antibiotic resistance, a antibiotic susceptibility test should be performed to determine which antibiotic will be effective.
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