Other Organisms Shigella

Shigella requires a very low dose to cause infection and does not grow very well in food. Thus, it is more commonly spread case to case, especially among kindergarten and primary school children. Affected patients may excrete the organisms for weeks. Nevertheless, some large and important outbreaks have been caused by food contaminated by sewage-polluted water or food handlers. In 1995, an extensive S. sonnei outbreak caused by lettuce imported from Spain affected people in many countries in northern Europe. In another outbreak caused by shrimp, infection was transmitted by a food handler who mixed the shrimp by hand with mayonnaise and tomato sauce. The incubation period is 24-48 h, and although bloody or mucoid diarrhea is the usual symptom, it is characteristically accompanied by tenesmus—a feeling of wanting to defecate without being able to do so.

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