Shigellosis

Shigellosis is a clinical syndrome caused by Shigella species, which are Gram-negative, facultative intracellular, gastric acid-resistant bacteria in the Enterobacteriaceae family ^[1][2]. The sources identify four serogroups: Shigella dysenteriae, Shigella sonnei, Shigella flexneri, and Shigella boydii ^[2]. In the cited literature, shigellosis is framed as an important enteric disease used in CDC surveillance and as a major public-health concern in both developed and developing countries ^[1][3].

The clinical spectrum ranges from acute watery diarrhoea to fulminant dysentery with frequent scant bloody stools, fever, prostration, and abdominal cramps ^[1]. One review also notes mild diarrhoea, haemorrhagic colitis, and haemolytic uremic syndrome among the manifestations linked to Shigella pathogenesis ^[3]. The sources further state that a broad array of uncommon but sometimes severe intestinal and extraintestinal complications can occur ^[1]. No source-backed detail on duration, case definitions, or recovery course is provided in the supplied material.

Shigellosis occurs globally and is reported in people of all ages, but endemic infection among children aged 1–4 years in low-income and middle-income settings accounts for most of the disease burden ^[1]. Globally, it is described as the most common cause of invasive bloody diarrhoea in children younger than 5 years ^[2]. The sources note roughly 164,000 annual deaths attributable to shigellosis and describe marked mortality reduction over the past three decades ^[1]. Intercontinental dissemination of multiresistant Shigella strains, facilitated by travellers and men who have sex with men, is specifically mentioned as an emerging concern ^[1].

The supplied sources support human-to-human transmission risk indirectly through the description of Shigella as highly contagious and by noting that humans are the only natural reservoir ^[1][2]. Infection requires a very low inoculum of only 10–100 organisms ^[2]. No further source-backed detail on specific exposure routes, environmental persistence, or food- and waterborne pathways is provided in the payload.

The sources most clearly identify children aged 1–4 years living in low-income and middle-income settings as bearing most of the disease burden ^[1]. Children younger than 5 years are also highlighted as a key group because shigellosis is described as the most common cause of invasive bloody diarrhoea in that age range ^[2]. The literature additionally notes travellers and men who have sex with men in relation to dissemination of multiresistant strains ^[1].

Prevention is described in the sources as relying on vaccination and sanitation strategies, which are presented as crucial measures for reducing worldwide morbidity and mortality ^[2]. The literature also links rising antibiotic resistance to difficulty in managing severe disease, underscoring the importance of prevention-oriented control ^[2]. No source-backed detail on vaccine schedules, targeted interventions, or setting-specific hygiene measures is available in the supplied material.

For surveillance purposes, shigellosis should be interpreted as a globally distributed enteric infection with disproportionate burden in young children in low-resource settings and ongoing concern for antimicrobial resistance ^[1][2]. The disease burden is also shaped by international dissemination of resistant strains and by populations noted in the sources, including travellers and men who have sex with men ^[1]. Because the supplied material emphasizes clinical spectrum and burden rather than formal case definitions, source-backed detail on surveillance thresholds or laboratory criteria is not yet available ^[1][2].

1. 1 Kotloff KL et al. Shigellosis. Lancet. 2018 Feb 24. PMID: 29254859. doi: 10.1016/S0140-6736(17)33296-8. PubMed: https://pubmed.ncbi.nlm.nih.gov/29254859/
2. 2 Hendrick J et al. Shigellosis. Lancet. 2025 Oct 4. PMID: 40915309. doi: 10.1016/S0140-6736(25)01033-5. PubMed: https://pubmed.ncbi.nlm.nih.gov/40915309/
3. 3 Pakbin B et al. Molecular Mechanisms of Shigella Pathogenesis; Recent Advances. Int J Mol Sci. 2023 Jan 26. PMID: 36768771. doi: 10.3390/ijms24032448. PubMed: https://pubmed.ncbi.nlm.nih.gov/36768771/
4. 4 Shigellosis. Diarrhoea and Malnutrition in Childhood. 1986. doi: 10.1016/b978-0-407-00401-6.50013-0. DOI: https://doi.org/10.1016/b978-0-407-00401-6.50013-0
5. 5 Shigellosis. Definitions. 2020. doi: 10.32388/175ifu. DOI: https://doi.org/10.32388/175ifu
6. 6 Shigellosis. Encyclopedia of Environmental Health. 2019. doi: 10.1016/b978-0-12-409548-9.11346-6. DOI: https://doi.org/10.1016/b978-0-12-409548-9.11346-6

ICD-10

ICD-11

Total cases

196K

Peak month

2008-11

Coverage

6 reporting countries · 2000-01-01 → 2026-06-20