Dirty fingers bring Shigella

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As a public health microbiologist trainee last year, I learned a mnemonic: Dirty Fingers Bring Shigella. The first letter in each word helps me remember the different groups of Shigella, which coincide with the species names: Shigella dysenteriae (Group A), S. flexneri (Group B), S. boydii (Group C), and S. sonnei (Group D). S. sonnei accounts for a significant proportion of cases in the USA. 

This mnemonic came to mind while listening to a presentation on extensively drug-resistant (XDR) Shigella during the California Association of Public Health Laboratory Directors (CAPHLD) Annual Institute. This bacteria is a big concern for public health professionals in the United States because it is easily spread (mainly) by consuming contaminated food (it only takes 1–100 Shigella cells to get sick with it). It causes both domestically acquired and travel-associated acute inflammatory diarrhoea. Infections with XDR strains are made worse because the treatment plan options to combat these strains are extremely limited, and the bacteria can quickly transfer antibiotic-resistant genes to other bacteria. The good news is that antibiotic treatment usually is not recommended. The bad news is that antibiotic treatment becomes limited for people who need it the most: people with weak immune systems, children, and people experiencing homelessness, among those who are particularly at risk of contracting the illness. 

I have been testing stool specimens from patients infected with Shigella for a few months. Based on my experience, it is a bug that takes a long time to clear from one's system. It's better to prevent getting infected by Shigella. Since dirty fingers bring Shigella, washing your hands thoroughly before eating and/or preparing food is the best way to avoid getting sick. Even Donan now knows the drill.

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