Features of bacillary dysentery:
(1) The oral inoculum required to cause disease is relatively small. For Shigella flexneri this is <= 180 organisms.
(2) The inoculum is small enough that flies and other insects can contribute to its spread.
(3) The infection spreads rapidly through families and close contacts.
(4) Infections tend to occur during the summer.
(5) Spread can be epidemic during a disaster, especially when people are crowded together and public services are disrupted.
Control measures:
(1) scrupulous hand hygiene
(2) clean water, which can be achieved by filtering followed by chlorination
(3) clean food that is well-cooked
(4) continued hygiene after recovery (since some patients may become asymptomatic long-term carriers)
(5) effective sewage and sanitation
(6) control of insects with insecticides, fly traps, waste disposal and treatment of breeding sites
(7) proper breastfeeding can help reduce infection is infants
