Ireland 
Shigella is a common, highly infectious cause of traveller’s diarrhoea. In some cases it can cause severe illness. In recent news the risk of infection has been highlighted following the deaths of British holiday makers in Cape Verde. These cases underline several important points that all travellers should be aware of for before travelling abroad:
- Traveller’s diarrhoea is the most common travel related illness.
Traveller’s diarrhoea caused by Shigella and other bacterial infections such as salmonella and E.coli is one of the most common infections experienced by people travelling overseas. In most cases it is preventable, treatable, and can be self-managed with good hydration, and appropriate medication when required. - Standards of medical care vary worldwide
It is important to have awareness that the quality and availability of medical care differ greatly between countries. Limited resources or lack of specialist expertise can lead to misdiagnosis or delays in appropriate treatment which may result in serious complications and the risk of death. Always travel with a medical kit. - Comprehensive travel medical insurance is essential
All travellers should ensure they have full travel medical insurance that covers pre-existing medical conditions, hospital treatment abroad and emergency evacuation or repatriation. Adequate insurance enables access to appropriate care and transfer to facilities equipped to manage severe illness which can be lifesaving.
What is Shigella?
Shigella is a bacteria that cause an intestinal infection which can result in severe diarrhoea, stomach cramps and fever. It is mostly spread through ingestion of contaminated food or water, poor hand hygiene, contaminated surfaces and from person – person.
Shigella is particularly prevalent in regions with limited sanitation and clean water infrastructure, but cases occur worldwide, including in high-income countries.
Risk is highest in parts of South and Southeast Asia, Africa, Central and South America.
Why Travellers Are at Risk?
Shigella is highly contagious. Only a very small number of bacteria are needed to cause infection, making it easy to spread. Consumption of contaminated untreated water (tap water) and food, poor hand hygiene and close person to person contact in crowded environments including all-inclusive resorts make this a significant risk for travellers.
Preventing Shigella Infection While Travelling
To reduce the risk of Shigella infection and other bacterial infections that cause Traveller’s diarrhoea, strict hygiene practices are essential.
- Wash hands frequently with soap and water, especially after using the toilet and before eating.
- Use alcohol-based hand sanitiser if soap and water are unavailable.
- Drink only bottled, boiled, treated or purified water. Do not have ice in drinks.
- Eat hot freshly cooked food.
- Avoid raw or undercooked foods, including salads and unpeeled fruit.
Signs and Symptoms of Shigella Infection
Symptoms usually begin 1–3 days after exposure -but may appear up to a week later. Common symptoms include:
- Sudden onset of diarrhoea (can be bloody or mucus-streaked)
- Abdominal cramps
- Fever
- Nausea or vomiting
- Urgent need to pass stools
Most infections last 5–7 days. Prompt recognition and appropriate treatment are essential to reduce complications and prevent the spread to others.
When Shigella Becomes Serious
Although many cases of shigella are self-limiting, symptoms can be more severe and increase the risk of life- threatening complications particularly in children, older adults, pregnant women, and those with weakened immune systems. These include:
- Severe dehydration (little or no urination, a very dry mouth and throat, feeling dizzy when standing)
- Bloody diarrhoea
- Frequent vomiting that prevents being able to keep liquids down
- Seizures (particularly in young children with high fever)
- Reactive arthritis
- Sepsis
Treatment of Shigella in Travellers
- Maintain hydration: drink plenty of clean water (bottled) and use oral rehydration solutions (ORS) particularly when diarrhoea is frequent.
- Consider loperamide but do not use if the diarrhoea contains blood or if there is a fever
- Where medical attention is not immediately available. consider travelling with Azithromycin an antibiotic to treat severe diarrhoea. This should not be used if blood is present in the diarrhoea or there is a fever.
- Seek medical advice early especially if you are at increased risk of complications including those with immunosuppression and long- term health conditions.
- Wash contaminated clothing, bedding and clean high use areas such as the toilet, handles and surfaces regularly to kill bacteria and reduce the spread of infection.
Seek medical attention urgently if symptoms lasting more than 48 hours
Shigella is a common, highly infectious cause of traveller’s diarrhoea that can be more serious than many people realise. Early recognition, good hydration, and timely medical care can prevent complications and speed recovery.
Before travelling, ensure you have:
- Oral rehydration salts
- Hand sanitiser
- Travel health insurance and knowledge of how to access care
Good preparation, awareness, and food /water hygiene can make the difference between a brief illness and a trip-ending medical emergency.
For further information and advice on your risk of Shigella and other causes of traveller’s diarrhoea, including prevention and treatment options, medical kits and traveller’s diarrhoea kits, speak with one of our experienced Nomad Masta travel clinicians today.
https://travelhealthpro.org.uk/news/876/shigella-and-salmonella-cases-reported-in-travellers-returning-from-cape-verde
