Although several organisms can cause dysentery, shigella are the most important. The illness also includes abdominal cramps, fever and rectal pain. Less common complications include sepsis, seizures, kidney failure.
Epidemics usually occur in impoverished areas.
They affect people of all ages, with the highest age-specific incidence occurring among adults and the highest case fatality rates occurring among children. No epidemics have occurred in the region since then, but Sd1 continues to occur sporadically in the Western hemisphere. In Africa, epidemic dysentery due to Sd1 appeared in eastern Zaire in 1979 and has subsequently been confirmed in Angola, Burundi, Equatorial Guinea, Ethiopia, Kenya, Malawi, Mozambique, Rwanda, Sao Tom and Principe, South Africa, Swaziland, Tanzania, Uganda, Zambia, and Zimbabwe. During an epidemic, all dysentery patients should receive an antibiotic to which Sd1 from local cases has been shown to be sensitive. Dehydration should be treated with oral rehydration salts or, if severe, with intravenous fluids.