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    "en": "Shigellosis is an acute invasive enteric infection caused by bacteria belonging to genus Shigella (WHO, 2005). <br /> <p>WHO, 2005. <a href=\"https://www.who.int/publications-detail-redirect/9241592330\">Guidelines for the control of shigellosis, including epidemics due to Shigella dysenteriae type 1. World Health Organization (WHO)</a>. Accessed 16 December 2019.</p>"
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      "Shigellosis is clinically manifested by diarrhoea that is frequently bloody. Oher common symptoms are abdominal cramps and tenesmus (unproductive, painful straining), fever and loss of appetite (WHO, 2005). The majority of cases and deaths are among children less than five years of age (WHO, 2005). Shigellosis is endemic in many developing countries and also occurs in epidemics causing considerable morbidity and mortality. It is estimated to cause at least 80 million cases of bloody diarrhoea and 700,000 deaths each year. Ninety-nine percent of infections caused by Shigella occur in developing countries, and the majority of cases (~70%), and of deaths (~60%), occur among children less than five years of age. Probably less than 1% of cases are treated in hospital. Among the four species of Shigella, Shigella dysenteriae type 1 (Sd1) is especially important because it causes the most severe disease and may occur in large regional epidemics. Major obstacles to the control of shigellosis include the ease with which Shigella spreads from person to person and the rapidity with which it develops antimicrobial resistance (WHO, 2005). All species of Shigella cause acute bloody diarrhoea by invading and causing patchy destruction of the colonic epithelium. This leads to the formation of micro-ulcers and inflammatory exudates, and causes inflammatory cells (polymorphonuclear leucocytes, PMNs) and blood to appear in the stool. The diarrhoeal stool contains 106–108 Shigellae per gram. Once excreted, the organism is very sensitive to environmental conditions and dies rapidly, especially when dried or exposed to direct sunlight (WHO, 2005). Definitive diagnosis can only be made by isolating the organism from stool and serotyping the isolate. Culture is also required to determine antimicrobial sensitivity (WHO, 2005). The World Health Organization (WHO) has published guidance on case classification and surveillance standards (WHO, 2005)."
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