What is ‘Shigella’: A Bacteria Spreading in the Israeli Army

Doctors in Israel say that some of their soldiers participating in the ground offensive in Gaza are suffering from a disease called ‘Shigella’, which affects the stomach, a very important part of the human body.

The disease is believed to be spreading in the war-torn Gaza Strip as a result of poor sanitation and unsafe food.

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What is Shigella and what are its symptoms?

Shigella is a type of bacteria, When this bacteria enters the human body, it causes a type of diarrhea known as ‘shigellosis’.

Symptoms

• Fever
• Bloody or prolonged diarrhea
• Severe abdominal pain or cramping
• Dehydration

People with weakened immune systems and poor health, or those who are physically debilitated by diseases such as HIV, may experience these symptoms for a long time. If left untreated, Shigella can be fatal.

The risk of death is high after the bacteria enter the bloodstream. Children, those with HIV, diabetes, cancer, or those who are malnourished can become victims.

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How does Shigella disease spread?

According to the US Centers for Disease Control and Prevention (CDC), Shigella is ‘easily spread’ through direct or indirect contact with the feces of an infected person.

In the case of Shigella infection:

• Eating food from the hands of a person infected with Shigella
• Drinking sewage-contaminated drinking water
• Contact with Shigella-contaminated toilet parts or other objects by an infected person
• Changing the diaper of a child with Shigella disease
• Coming into contact with feces during sexual intercourse with an infected person

Shigella is often found in the homeless, international travelers, men who have sex with men, and people with weakened immune systems.

Where in the world is Shigella most common?

The CDC estimates that 80 to 165 million cases of Shigella occur worldwide each year, causing 600,000 deaths.

In 2022, the WHO said that 99 percent of Shigella infections occurred in low or middle-income countries.

Most deaths from Shigella occur in sub-Saharan Africa and South Asia, and about 60 percent occur in children under the age of five.

A study by scientists at the International Vaccine Institute in South Korea showed that shigella is 100 times more common in Asian countries such as Bangladesh, China, Pakistan, Indonesia, Vietnam, and Thailand than in industrialized countries.

How can Shigella be treated, or prevented?

The CDC says Shigella can be prevented by frequent hand washing, for example:

• Before cooking or eating
• After going to the toilet or changing a diaper
• Before sexual activity
• In many cases, treatment can be done with more rest.
• Five types of antibiotics are effective against this disease.

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However, US health officials have identified a strain of Shigella bacteria that is resistant to antibiotics, called Shigella XDR or Shigella Soni.

The CDC says five percent of Shigella cases in the U.S. in 2022 were related to drug-resistant strains. It has termed it a ‘serious threat to public health’.

The WHO has also seen an increasing number of cases linked to the XDR strain in the UK and across Europe since 2020.

How did Shigella spread among Israeli soldiers?

According to Dr. Tal Brosh, director of the Infectious Diseases Unit at Assuta Ashdod University Hospital, several Israeli Defense Forces (IDF) doctors have reported severe intestinal disease among soldiers serving in Gaza.

They say they have identified the disease as Shigella.

Affected soldiers are isolated and sent back for treatment.

One obvious cause of the outbreak, says Dr. Bruch, is food cooked by Israeli civilians that has been sent to soldiers in Gaza.

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Food can be contaminated with Shigella and other harmful bacteria, they say, because it is not cooled during transport, or not fully heated before eating.

“Once soldiers get diarrhea,” he says, “the poor hygiene conditions on the battlefield lead to person-to-person transmission.”

“Soldiers should only be sent dry food items such as canned food, crackers, protein bars, and nuts,” says Dr. Broach.

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