Shigellosis is a clinical syndrome resulting from invasion of the epithelium lining the terminal ileum, colon, and rectum by Shigella species, and is the principal cause of bacillary diarrhoea in humans [3][1]. These intestinal pathogens require only a very low infectious dose to establish illness [2][4].
Disease overview
Bacterial Evidence-backed information EN 5/7 applicable sections · ZH 5/7 applicable sections Updated Oct 23, 2026
Shigellosis is a clinical syndrome caused by Shigella invasion of the distal intestinal epithelium, occurring worldwide across all age groups [1]. The greatest disease burden falls on young children in low- and middle-income settings, while high-income countries see concentrated risk among travelers and gbMSM [2][1]. Sexual transmission among men who have sex with men represents an emerging public-health concern [2].
Read the full clinical and epidemiological profile 6
Manifestations range from acute watery diarrhoea to fulminant dysentery with frequent scant bloody stools, fever, prostration, and abdominal cramps [1]. The classic descending infection begins with few large-volume stools and progresses to many small-volume bloody, mucoid stools [4]. Severe diarrhoea, fever, or bloody stools with abundant faecal leukocytes should raise suspicion of shigellosis [4].
Infections occur globally and across all ages, but endemic disease among children aged 1–4 years in low- and middle-income countries constitutes most of the burden [1]. In high-income settings, international travelers and gbMSM are the main affected groups [2]. Approximately 164,000 annual deaths are attributable to shigellosis despite reductions in mortality over recent decades [1].
Shigellae spread efficiently through person-to-person contact, with as few as 200 viable organisms sufficient to cause disease in susceptible persons [4]. Sexual contact, particularly among gbMSM, is a recognized route, facilitated by the low infectious dose and possible asymptomatic carriage [2]. The dynamics of sexual transmission are not yet fully understood [2].
To reduce sexual transmission, at-risk groups should adopt less risky sexual behaviors, use protective measures, clean sex toys thoroughly, and maintain good personal hygiene [2]. Partners with diarrhoea should avoid sexual contact during illness and for at least 1–2 weeks after symptom resolution, refraining from oral–anal contact for 4–6 weeks [2]. Raising awareness among clinicians and at-risk populations about sexual transmission is essential for appropriate counseling [2].
- 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 Pirš M et al. Sexually transmitted shigellosis. Acta Dermatovenerol Alp Pannonica Adriat. 2024 Dec. PMID: 39707895. PubMed: https://pubmed.ncbi.nlm.nih.gov/39707895/
- 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 DuPont HL et al. Shigella. Infect Dis Clin North Am. 1988 Sep. PMID: 3074117. PubMed: https://pubmed.ncbi.nlm.nih.gov/3074117/
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Vaccine
Showing 5 of 43 related publications.
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