Prognosis

Shigellosis generally causes less morbidity and mortality in high-income countries than in low- and middle-income countries. This is mostly due to the causative agent being Shigella sonnei in high-income countries, which is associated with a less severe illness.[4][5]​ Easier access to primary care (and specialist care if required) is also a likely contributor.

Prognosis

In otherwise healthy adults, most cases of shigellosis are mild and self-limiting, and chronic carriage is uncommon.[6] Without antibiotics the course of the illness may last slightly longer, and shedding of organisms in the stool may continue for up to 6 weeks.[5]

Shigella is the second most common cause of diarrhoea-related death globally.[45] Mortality is highest in south Asia and sub-Saharan Africa.[6] One meta-analysis found that Shigella infection was significantly associated with mortality in children in resource-limited settings, but dysentery was not.[46] Reliance on dysentery to identify children with Shigella infection may not adequately identify children at risk of death.[46]

In high-income countries, even with more severe disease, mortality is very low, estimated at 0.1% in the US.[10]

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