Editing Dysentery

{{Short description|Intestinal inflammation causing bloody diarrhea}}
{{Use dmy dates|date=December 2017}}
{{Use American English|date=December 2017}}
{{Infobox medical condition (new)
| name = Dysentery
| synonyms = Bloody diarrhea
| image = Dysentery Patient, Burma Hospital, Siam Art.IWMART1541787.jpg
| caption = A depiction of a soldier with dysentery in the ‘F’ & ‘H’ Force Hospital, Canchanburi, Siam. Artist: Charles Thrale, 1933
| field = [[Infectious disease (medical specialty)|Infectious disease]]
| symptoms = Bloody diarrhea, [[abdominal pain]], [[fever]]<ref name=WHO2014/><ref name=Dor2009/>
| complications = [[Dehydration]]<ref name=EMRO2019/>
| onset = 
| duration = Less than a week<ref name=NHS2019/>
| types = 
| causes = Usually ''[[Shigella]]'' or ''[[Entamoeba histolytica]]''<ref name=WHO2014/>
| risks    = Contamination of food and water with feces due to poor [[sanitation]]<ref name=Mar2013/>
| diagnosis = Based on symptoms, [[Stool test]]
| differential = 
| prevention = [[Hand washing]], [[food safety]]<ref name=NHS2019/>
| treatment = Drinking sufficient fluids, [[antibiotics]] (severe cases)<ref name=NHS2019/>
| medication = 
| prognosis = 
| frequency = Occurs often in many parts of the world<ref name=WHO2016Shig/>
| deaths = 1.1 million a year<ref name=WHO2016Shig/>
}}

'''Dysentery''' ({{IPAc-en|UK|ˈ|d|ɪ|s|ən|t|ər|i}} {{respell|DISS|ən|tər|ee}},<ref>{{cite Lexico|dysentery |access-date=2021-08-31}}</ref> {{IPAc-en|US|ˈ|d|ɪ|s|ən|t|ɛr|i}} {{respell|DISS|ən|terr|ee}}),<ref>{{cite Merriam-Webster|dysentery |access-date=2022-04-24}}</ref> historically known as the '''bloody flux''',<ref>{{cite OED|bloody flux|id=302050}}</ref> is a type of [[gastroenteritis]] that results in [[blood]]y [[diarrhea]].<ref name=WHO2014>{{cite web |title=Dysentery |url=https://www.who.int/topics/dysentery/en/|website=who.int |access-date=28 November 2014|url-status=dead|archiveurl= https://web.archive.org/web/20141205051849/http://www.who.int/topics/dysentery/en/ |archive-date=5 December 2014|df=dmy-all}}</ref><ref name=CDC2019>{{cite web |title=Controlling the Spread of Infections in Evacuation Centers {{!}}Health and Safety Concerns |url=https://www.cdc.gov/disasters/disease/infectevac.html |work = U.S. Centers for Disease Control and Prevention |access-date=15 November 2019}}</ref> Other symptoms may include [[fever]], abdominal pain, and a [[rectal tenesmus|feeling of incomplete defecation]].<ref name=Dor2009>{{DorlandsDict|three/000033012|Dysentery}}</ref><ref name=Mar2013/><ref name=Tri2017/> Complications may include [[dehydration]].<ref name=EMRO2019>{{cite web |title=WHO EMRO {{!}} Dysentery {{!}} Health topics |url=http://www.emro.who.int/health-topics/dysentery/index.html |website=www.emro.who.int |access-date=15 November 2019}}</ref>

The cause of dysentery is usually the bacteria from genus ''[[Shigella]]'', in which case it is known as [[shigellosis]], or the amoeba ''[[Entamoeba histolytica]]''; then it is called [[amoebiasis]].<ref name=WHO2014/> Other causes may include certain chemicals, other bacteria, other protozoa, or [[parasitic worms]].<ref name=Dor2009/> It may spread between people.<ref name=NHS2019>{{cite web |title=Dysentery |url=https://www.nhs.uk/conditions/dysentery/ |website=nhs.uk |access-date=15 November 2019 |language=en |date=18 October 2017}}</ref> Risk factors include contamination of food and water with [[feces]] due to poor [[sanitation]].<ref name=Mar2013>{{cite journal | vauthors = Marie C, Petri WA | title = Amoebic dysentery | journal = BMJ Clinical Evidence | volume = 2013 | date = August 2013 | pmid = 23991750 | pmc = 3758071 }}</ref> The underlying mechanism involves [[inflammation]] of the [[intestine]], especially of the [[colon (anatomy)|colon]].<ref name=Dor2009/>

Efforts to prevent dysentery include [[hand washing]] and [[food safety]] measures while traveling in countries of high risk.<ref name=NHS2019/> While the condition generally resolves on its own within a week, drinking sufficient fluids such as [[oral rehydration solution]] is important.<ref name=NHS2019/> Antibiotics such as [[azithromycin]] may be used to treat cases associated with travelling in the [[developing world]].<ref name=Tri2017>{{cite journal | vauthors = Tribble DR | title = Antibiotic Therapy for Acute Watery Diarrhea and Dysentery | journal = Military Medicine | volume = 182 | issue = S2 | pages = 17–25 | date = September 2017 | pmid = 28885920 | pmc = 5650106 | doi = 10.7205/MILMED-D-17-00068 | doi-access = free }}</ref> While medications used to decrease diarrhea such as [[loperamide]] are not recommended on their own, they may be used together with antibiotics.<ref name=Tri2017/><ref name=NHS2019/>

''Shigella'' results in about 165 million cases of diarrhea and 1.1 million deaths a year with nearly all cases in the developing world.<ref name=WHO2016Shig>{{cite web |title=Dysentery (Shigellosis) |url=https://www.who.int/selection_medicines/committees/expert/21/applications/s6_paed_antibiotics_appendix5_dysentery.pdf |website=WHO |access-date=15 November 2019 |page=2 |date=November 2016 |archive-date=20 September 2018 |archive-url=https://web.archive.org/web/20180920174136/http://www.who.int/selection_medicines/committees/expert/21/applications/s6_paed_antibiotics_appendix5_dysentery.pdf |url-status=dead }}</ref> In areas with poor sanitation nearly half of cases of diarrhea are due to ''Entamoeba histolytica''.<ref name=Mar2013/> ''Entamoeba histolytica'' affects millions of people and results in more than 55,000 deaths a year.<ref name=Shir2018>{{cite journal | vauthors = Shirley DT, Farr L, Watanabe K, Moonah S | title = A Review of the Global Burden, New Diagnostics, and Current Therapeutics for Amebiasis | journal = Open Forum Infectious Diseases | volume = 5 | issue = 7 | pages = ofy161 | date = July 2018 | pmid = 30046644 | pmc = 6055529 | doi = 10.1093/ofid/ofy161 | doi-access = free }}</ref> It commonly occurs in less developed areas of Central and South America, Africa, and Asia.<ref name=Shir2018/> Dysentery has been described at least since the time of [[Hippocrates]].<ref>{{cite book | vauthors = Grove D |title=Tapeworms, Lice, and Prions: A compendium of unpleasant infections |date=2013 |publisher=OUP Oxford |isbn=978-0-8493-0072-1 |page=PT517 |url=https://books.google.com/books?id=KpxKAgAAQBAJ&pg=PT517 |language=en}}</ref>

== Signs and symptoms ==
The most common form of dysentery is bacillary dysentery, which is typically a mild sickness, causing symptoms normally consisting of mild abdominal pains and frequent passage of loose stools or diarrhea. Symptoms normally present themselves after 1–3 days, and are usually no longer present after a week. The frequency of urges to defecate, the large volume of liquid feces ejected, and the presence of blood, mucus, or pus depends on the [[pathogen]] causing the disease. Temporary [[lactose intolerance]] can occur, as well. In some occasions, severe abdominal cramps, [[fever]], [[Shock (circulatory)|shock]], and [[delirium]] can all be symptoms.<ref name=Dor2009/><ref name="pmid359524">{{cite journal | vauthors = DuPont HL | title = Interventions in diarrheas of infants and young children | journal = Journal of the American Veterinary Medical Association | volume = 173 | issue = 5 Pt 2 | pages = 649–53 | date = September 1978 | pmid = 359524 }}</ref><ref name="pmid2664748">{{cite journal | vauthors = DeWitt TG | title = Acute diarrhea in children | journal = Pediatrics in Review | volume = 11 | issue = 1 | pages = 6–13 | date = July 1989 | pmid = 2664748 | doi = 10.1542/pir.11-1-6 }}</ref><ref>{{cite web|url=http://www.nhs.uk/Conditions/Dysentery/Pages/Symptoms.aspx|title=Dysentery symptoms|website=[[National Health Service (England)|National Health Service]]|access-date=January 22, 2010|url-status=live|archive-url=https://web.archive.org/web/20100323184106/http://www.nhs.uk/Conditions/Dysentery/Pages/Symptoms.aspx|archive-date=23 March 2010|df=dmy-all}}</ref>

In extreme cases, people may pass more than one liter of fluid per hour. More often, individuals will complain of [[diarrhea]] with [[blood]], accompanied by extreme abdominal pain, [[rectal pain]] and a low-grade [[fever]]. Rapid weight loss and [[muscle ache]]s sometimes also accompany dysentery, while [[nausea]] and [[vomiting]] are rare.

On rare occasions, the [[Amoeba|amoebic parasite]] will invade the body through the bloodstream and [[Systemic disease|spread beyond the intestines]]. In such cases, it may more seriously infect other organs such as the [[Human brain|brain]], [[Human lungs|lungs]], and most commonly the [[Human liver|liver]].<ref name=Diagnosis>{{cite web | website=mdguidelines.com | title=Dysentery-Diagnosis | url=http://www.mdguidelines.com/dysentery/diagnosis | access-date=November 17, 2010 | url-status=live | archive-url=https://web.archive.org/web/20110714063637/http://www.mdguidelines.com/dysentery/diagnosis | archive-date=14 July 2011 | df=dmy-all }}</ref>

==Cause==

[[File:A cross-section of diseased intestines (dysentery). Coloured Wellcome V0009858ER.jpg|thumb|Cross-section of diseased intestines. Colored lithograph {{circa|1843}}]]

Dysentery results from [[bacteria]]l or [[Parasitism|parasitic]] infections. Viruses do not generally cause the disease.<ref name=CDC2019/> These pathogens typically reach the [[large intestine]] after entering orally, through ingestion of contaminated food or water, oral contact with contaminated objects or hands, and so on. Each specific pathogen has its own mechanism or pathogenesis, but in general, the result is damage to the intestinal linings, leading to the [[Inflammation|inflammatory immune responses]]. This can cause [[Fever|elevated physical temperature]], painful spasms of the intestinal muscles ([[cramping]]), swelling due to fluid leaking from capillaries of the intestine ([[edema]]) and further tissue damage by the body's immune cells and the chemicals, called [[cytokine]]s, which are released to fight the infection. The result can be impaired nutrient absorption, excessive water and mineral loss through the stools due to breakdown of the control mechanisms in the intestinal tissue that normally remove water from the stools, and in severe cases, the entry of pathogenic organisms into the bloodstream. [[Anemia]] may also arise due to the blood loss through diarrhea.{{citation needed|date=July 2020}}

Bacterial infections that cause bloody diarrhea are typically classified as being either invasive or toxogenic. Invasive species cause damage directly by invading into the mucosa. The toxogenic species do not invade, but cause cellular damage by secreting toxins, resulting in bloody diarrhea. This is also in contrast to toxins that cause watery diarrhea, which usually do not cause cellular damage, but rather they take over cellular machinery for a portion of life of the cell.<ref>{{cite book|title= Boards and Beyond: Infectious Disease: A Companion Book to the Boards and Beyond Website | vauthors = Ryan J |year=2016|edition=Version 9-26-2016 | publisher = CreateSpace Independent Publishing Platform | isbn = 978-1-5237-0935-9 }}</ref>

Definitions of dysentery can vary by region and by medical specialty. The U. S. Centers for Disease Control and Prevention (CDC) limits its definition to "diarrhea with visible blood".<ref>{{cite web|title=Laboratory Methods for the Diagnosis of Epidemic Dysentery and Cholera |url=https://www.cdc.gov/ncidod/dbmd/diseaseinfo/cholera/complete.pdf |work=WHO/CDS/CSR/EDC/99.8 |publisher=Centers for Disease Control and Prevention. Atlanta, Georgia 1999 |url-status=dead |archive-url=https://web.archive.org/web/20120305065701/http://www.cdc.gov/ncidod/dbmd/diseaseinfo/cholera/complete.pdf |archive-date=March 5, 2012 }}</ref> Others define the term more broadly.<ref name=TFD>{{cite web|title=Dysentery|url=http://medical-dictionary.thefreedictionary.com/dysentery|publisher=TheFreeDictionary's Medical dictionary}}</ref> These differences in definition must be taken into account when defining mechanisms. For example, using the CDC definition requires that intestinal tissue be so severely damaged that blood vessels have ruptured, allowing visible quantities of blood to be lost with defecation. Other definitions require less specific damage.{{citation needed|date=June 2021}}

===Amoebic dysentery===
{{main|Amoebiasis}}

[[Amoebiasis]], also known as amoebic dysentery, is caused by an infection from the [[amoeba]] ''[[Entamoeba histolytica]]'',<ref>{{cite journal |author=WHO | title=''Amoebiasis''. Report of a WHO Expert Committee |journal=WHO Technical Report Series |year=1969 |volume=421 |pages=1–52 |pmid=4978968 | author-link=World Health Organization }}</ref> which is found mainly in tropical areas.<ref>{{MeshName|Amebic+Dysentery}}</ref> Proper treatment of the underlying infection of amoebic dysentery is important; insufficiently treated amoebiasis can lie dormant for years and subsequently lead to [[Amoebiasis#Complications|severe, potentially fatal, complications]].{{citation needed|date=June 2021}}

When amoebae inside the bowel of an infected person are ready to leave the body, they group together and form a shell that surrounds and protects them. This group of amoebae is known as a cyst, which is then passed out of the person's body in the feces and can survive outside the body. If hygiene standards are poor – for example, if the person does not dispose of the feces hygienically – then it can contaminate the surroundings, such as nearby food and water.
If another person then eats or drinks food or water that has been contaminated with feces containing the cyst, that person will also become infected with the amoebae. Amoebic dysentery is particularly common in parts of the world where human feces are used as fertilizer.
After entering the person's body through the mouth, the cyst travels down into the stomach. The amoebae inside the cyst are protected from the stomach's digestive acid. From the stomach, the cyst travels to the intestines, where it breaks open and releases the amoebae, causing the infection. The amoebae can burrow into the walls of the intestines and cause small abscesses and ulcers to form. The cycle then begins again.{{citation needed|date=July 2020}}

===Bacillary dysentery===
{{Main|Bacillary dysentery}}

Dysentery may also be caused by [[shigellosis]], an infection by [[bacteria]] of the genus ''Shigella'', and is then known as bacillary dysentery (or Marlow syndrome). The term ''bacillary dysentery'' etymologically might seem to refer to any dysentery caused by any [[bacillus (shape)|bacilliform]] bacteria, but its meaning is restricted by convention to ''Shigella'' dysentery.{{cn|date=December 2022}}

===Other bacteria===

Some strains of ''[[Escherichia coli]]'' cause bloody diarrhea. The typical culprits are [[shigatoxigenic and verotoxigenic Escherichia coli|enterohemorrhagic ''Escherichia coli'']], of which [[Escherichia coli O157:H7|O157:H7]] is the best known. These types of ''E. coli'' also make Shiga toxin.<ref>{{Cite journal |last1=Phillips |first1=A |last2=Navabpour |first2=S |last3=Hicks |first3=S |last4=Dougan |first4=G |last5=Wallis |first5=T |last6=Frankel |first6=G |date=2000 |title=Enterohaemorrhagic Escherichia coli O157:H7 target Peyer's patches in humans and cause attaching/effacing lesions in both human and bovine intestine |journal=Gut |volume=47 |issue=3 |pages=377–381 |doi=10.1136/gut.47.3.377 |pmc=1728033 |pmid=10940275}}</ref>

==Diagnosis==
A diagnosis may be made by taking a history and doing a brief examination. Dysentery should not be confused with [[hematochezia]], which is the passage of fresh blood through the anus, usually in or with stools.<ref>{{Citation |last=Wilson |first=I. Dodd |title=Hematemesis, Melena, and Hematochezia |date=1990 |work=Clinical Methods: The History, Physical, and Laboratory Examinations |editor-last=Walker |editor-first=H. Kenneth |url=https://www.ncbi.nlm.nih.gov/books/NBK411/ |access-date=2024-10-28 |edition=3rd |place=Boston |publisher=Butterworths |isbn=978-0-409-90077-4 |pmid=21250251 |editor2-last=Hall |editor2-first=W. Dallas |editor3-last=Hurst |editor3-first=J. Willis}}</ref>

===Physical exam===
The mouth, skin, and lips may appear dry due to dehydration. Lower abdominal tenderness may also be present.<ref name=Diagnosis/>

===Stool and blood tests===

[[cell culture|Cultures]] of [[stool sample]]s are examined to identify the organism causing dysentery. Usually, several samples must be obtained due to the number of amoebae, which changes daily.<ref name=Diagnosis/> [[Blood test]]s can be used to measure abnormalities in the levels of essential [[electrolyte|minerals and salts]].<ref name=Diagnosis/>

==Prevention==
Efforts to prevent dysentery include [[hand washing]] and [[food safety]] measures while traveling in areas of high risk.<ref name=NHS2019/>

===Vaccine===
Although there is currently no vaccine that protects against ''Shigella'' infection, several are in development.<ref name=":0" /><ref>{{Cite web|url=http://who.int/immunization/research/vaccine_pipeline_tracker_spreadsheet/en/|title=WHO vaccine pipeline tracker|website=World Health Organization|language=en-GB|access-date=2016-07-21|url-status=dead|archive-url=https://web.archive.org/web/20160725174627/http://who.int/immunization/research/vaccine_pipeline_tracker_spreadsheet/en/|archive-date=25 July 2016|df=dmy-all}}</ref> Vaccination may eventually become a part of the strategy to reduce the incidence and severity of diarrhea, particularly among children in low-resource settings. For example, ''Shigella'' is a longstanding World Health Organization (WHO) target for vaccine development, and sharp declines in age-specific diarrhea/dysentery attack rates for this pathogen indicate that natural immunity does develop following exposure; thus, vaccination to prevent this disease should be feasible. The development of vaccines against these types of infection has been hampered by technical constraints, insufficient support for coordination, and a lack of market forces for research and development. Most vaccine development efforts are taking place in the public sector or as research programs within biotechnology companies.{{citation needed|date=July 2020}}

== Treatment ==
Dysentery is managed by maintaining fluids using [[oral rehydration therapy]].<ref name=NHS2019/> If this treatment cannot be adequately maintained due to vomiting or the profuseness of diarrhea, hospital admission may be required for [[intravenous]] fluid replacement. In ideal situations, no antimicrobial therapy should be administered until microbiological microscopy and culture studies have established the specific infection involved. When laboratory services are not available, it may be necessary to administer a combination of drugs, including an [[amebicide|amoebicidal]] drug to kill the [[parasite]], and an [[antibiotic]] to treat any associated bacterial infection.{{cn|date=December 2022}} [[Laudanum]] (Deodorized Tincture of Opium)] may be used for severe pain and to combat severe diarrhea.

If shigellosis is suspected and it is not too severe, letting it run its course may be reasonable – usually less than a week. If the case is severe, antibiotics such as [[ciprofloxacin]] or [[Trimethoprim/sulfamethoxazole|TMP-SMX]] may be useful. However, many strains of ''Shigella'' are becoming resistant to common antibiotics, and effective medications are often in short supply in developing countries. If necessary, a doctor may have to reserve antibiotics for those at highest risk for death, including young children, people over 50, and anyone suffering from dehydration or malnutrition.{{cn|date=December 2022}}

Amoebic dysentery is often treated with two antimicrobial drugs such as [[metronidazole]] and [[paromomycin]] or [[iodoquinol]].<ref>{{cite web|title=Chapter 3 Infectious Diseases Related To Travel|url=http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/amebiasis|website=CDC|access-date=9 June 2014|date=August 1, 2013|url-status=live|archive-url=https://web.archive.org/web/20140714124434/http://wwwnc.cdc.gov/travel/yellowbook/2014/chapter-3-infectious-diseases-related-to-travel/amebiasis|archive-date=14 July 2014|df=dmy-all}}</ref>

==Prognosis==

With correct treatment, most cases of amoebic and bacterial dysentery subside within 10 days, and most individuals achieve a full recovery within two to four weeks after beginning proper treatment. If the disease is left untreated, the prognosis varies with the immune status of the individual patient and the severity of disease. Extreme dehydration can delay recovery and significantly raises the risk for serious complications including death.<ref>{{cite web | author=mdguidelines.com | title=Dysentery-Prognosis | url=http://www.mdguidelines.com/dysentery/prognosis | access-date=2010-11-17 | url-status=live | archive-url=https://web.archive.org/web/20110714063659/http://www.mdguidelines.com/dysentery/prognosis | archive-date=14 July 2011 | df=dmy-all }}</ref>

==Epidemiology==

Insufficient data exists, but ''Shigella'' is estimated to have caused the death of 34,000 children under the age of five in 2013, and 40,000 deaths in people over five years of age.<ref name=":0">{{cite journal | vauthors = Mani S, Wierzba T, Walker RI | title = Status of vaccine research and development for Shigella | journal = Vaccine | volume = 34 | issue = 26 | pages = 2887–2894 | date = June 2016 | pmid = 26979135 | doi = 10.1016/j.vaccine.2016.02.075 | doi-access = free }}</ref> Amoebiasis infects over 50 million people each year, of whom 50,000 die (one per thousand).<ref>{{Cite book  | vauthors = Byrne JP  | title = Encyclopedia of Pestilence, Pandemics, and Plagues: A-M  | url = https://books.google.com/books?id=5Pvi-ksuKFIC&pg=PA175  | publisher = ABC-CLIO  | year = 2008  | pages = 175–176  | isbn = 978-0-313-34102-1  }}{{Dead link|date=December 2023 |bot=InternetArchiveBot |fix-attempted=yes }}</ref>

==History==
Shigella evolved with the human expansion out of Africa 50,000 to 200,000 years ago.<ref>{{Cite journal |last1=Pupo |first1=Gulietta M. |last2=Lan |first2=Ruiting |last3=Reeves |first3=Peter R. |date=2000-08-22 |title=Multiple independent origins of Shigella clones of<i>Escherichia coli</i>and convergent evolution of many of their characteristics |journal=Proceedings of the National Academy of Sciences |volume=97 |issue=19 |pages=10567–10572 |doi=10.1073/pnas.180094797 |doi-access=free |pmid=10954745 |issn=0027-8424|pmc=27065 |bibcode=2000PNAS...9710567P }}</ref>

The seed, leaves, and bark of the [[Ceiba pentandra|kapok]] tree have been used in traditional medicines by indigenous peoples of the rainforest regions in the Americas, west-central Africa, and Southeast Asia in the treatment of this disease.<ref>{{cite web|title=Kapok Tree|url=http://www.blueplanetbiomes.org/kapok.htm|work=Blue Planet and Biomoes|access-date=7 February 2012|url-status=live|archive-url=https://web.archive.org/web/20120222030907/http://www.blueplanetbiomes.org/kapok.htm|archive-date=22 February 2012|df=dmy-all}}</ref><ref>{{cite web|title=Ceiba pentandra|url=http://www.zoo.org/page.aspx?pid=1954|work=Human Uses and Cultural Importance|access-date=7 February 2012|url-status=live|archive-url=https://web.archive.org/web/20120215181027/http://www.zoo.org/page.aspx?pid=1954|archive-date=15 February 2012|df=dmy-all}}</ref><ref>{{cite web|url=http://www.encyclocenter.com/Kapok-Emergent-24736.html|title=Kapok Emergent Tree Of Tropical Rain Forest Used To Treat Asthma Dysentery Fever Kidney Diseases|website=encyclocenter.com|access-date=27 April 2018|url-status=dead|archive-url=https://web.archive.org/web/20120510224631/http://www.encyclocenter.com/Kapok-Emergent-24736.html|archive-date=10 May 2012|df=dmy-all}}</ref>

In 1915, Australian [[bacteriologist]] [[Fannie Eleanor Williams]] was serving as a medic in Greece with the [[First Australian Imperial Force|Australian Imperial Force]], receiving casualties directly from [[Gallipoli campaign|Gallipoli]]. In Gallipoli, dysentery was severely affecting soldiers and causing significant loss of manpower. Williams carried out [[serological]] investigations into dysentery, co-authoring several groundbreaking papers with Sir [[Charles James Martin (physiologist)|Charles Martin]], director of the [[Lister Institute of Preventive Medicine|Lister Institute]].<ref>{{Cite web |last=Digital |first=Carter |title=Fannie Williams |url=https://discovery.wehi.edu.au/timeline/fannie-williams |access-date=2022-11-02 |website=Walter and Eliza Hall Institute of Medical Research |language=en}}</ref> The result of their work into dysentery was increased demand for specific [[Diagnosis|diagnostics]] and curative sera.<ref>{{cite web |author=Kirsty Harris |title=Fannie Eleanor Williams: Bacteriologist and Serologist |url=http://www.womenaustralia.info/leaders/sti/pdfs/10_Harris.pdf |publisher=Seizing the Initiative: Australian Women Leaders in Politics, Workplaces and Communities. |access-date=21 December 2022}}</ref>

''[[Bacillus subtilis]]'' was marketed throughout America and Europe from 1946 as an immunostimulatory aid in the treatment of gut and urinary tract diseases such as rotavirus and ''Shigella'',<ref name="mazza">{{cite journal | vauthors = Mazza P | title = The use of Bacillus subtilis as an antidiarrhoeal microorganism | journal = Bollettino Chimico Farmaceutico | volume = 133 | issue = 1 | pages = 3–18 | date = January 1994 | pmid = 8166962 }}</ref> but declined in popularity after the introduction of consumer antibiotics.

==Notable cases==
[[File:A Soviet soldier dies of dysentery as a result of eating unw Wellcome L0032151.jpg|thumb|A [[Red Army]] soldier dies of dysentery after eating unwashed vegetables. This is a common way of contracting dysentery. From a health advisory pamphlet given to soldiers.]]

* '''580''': Childesinda, son of [[Chilperic I]], Frankish king, died of dysentery as a child
* '''580''': [[Austregilde]], Frankish queen, died of dysentery. According to [[Gregory of Tours]] she blamed her doctors for her death and asked her husband, King [[Guntram]], to have the doctors executed after she died, which he did.<ref>Gregory of Tours. ''A History of the Franks'', Pantianos Classics, 1916</ref>
* '''642''': [[Cyrus of Alexandria]], [[Greek Orthodox Patriarch of Alexandria]] and [[List of governors of Roman Egypt|governor of Egypt]], died of dysentery on 21 March 642.
* '''685''': [[Constantine IV]], the Byzantine emperor, died of dysentery on September 685.
* '''1183''': [[Henry the Young King]] died of dysentery at the castle of [[Martel, Lot|Martel]] on 11 June 1183.
* '''1216''': [[John, King of England]] died of dysentery at [[Newark Castle, Nottinghamshire|Newark Castle]] on 19 October 1216.<ref>{{cite book |vauthors=Warren WL |year=1991 |title=King John |location=London |publisher=Methuen |isbn=978-0-413-45520-8 |page=253 |url=https://books.google.com/books?id=Vt5HPgAACAAJ&pg=PA253 }}</ref>
* '''1270''': [[Louis IX]] of France died of dysentery in [[Tunis]] while commanding his troops for the [[Eighth Crusade]] on 25 August 1270.
* '''1307''': [[Edward I of England]] caught dysentery on his way to the Scottish border and died in his servants' arms on 7 July 1307.
* '''1322''': [[Philip V of France]] died of dysentery at the [[Abbey of Longchamp]] (site of the present hippodrome in the [[Bois de Boulogne]]) in Paris while visiting his daughter, Blanche, who had taken her vows as a nun there in 1322. He died on 3 January 1322.
* '''1376''': [[Edward the Black Prince]], son of Edward III of England and heir to the English throne. Died of apparent dysentery in June, after a months-long period of illness during which he predicted his own imminent death, in his 46th year.
* '''1422''': King [[Henry V of England#Death|Henry V of England]] died suddenly on 31 August 1422 at the [[Château de Vincennes]], apparently from dysentery,<ref>{{cite web|url=https://www.bbc.co.uk/history/historic_figures/henry_v_king.shtml|title=BBC – History – Henry V|website=bbc.co.uk|access-date=27 April 2018|url-status=live|archive-url=https://web.archive.org/web/20180213161713/http://www.bbc.co.uk/history/historic_figures/henry_v_king.shtml|archive-date=13 February 2018|df=dmy-all}}</ref> which he had contracted during the [[siege of Meaux]]. He was 35 years old and had reigned for nine years.
* '''1536''': [[Erasmus]], Dutch renaissance humanist and theologian. At [[Basel]].<ref>{{CathEncy|wstitle=Desiderius Erasmus|name-list-style=vanc }}</ref>
* '''1596''': Sir [[Francis Drake]], [[vice admiral]], died of dysentery on 28 January 1596 whilst anchored off the coast of [[Portobelo]].<ref>{{cite web|url=https://www.bbc.co.uk/history/historic_figures/drake_francis.shtml|title=BBC – History – Sir Francis Drake|website=bbc.co.uk|access-date=27 April 2018|url-status=live|archive-url=https://web.archive.org/web/20180212034636/http://www.bbc.co.uk/history/historic_figures/drake_francis.shtml|archive-date=12 February 2018|df=dmy-all}}</ref>
* '''1605''': [[Akbar]], ruler of the Mughal Empire of South Asia, died of dysentery. On 3 October 1605, he fell ill with an attack of dysentery, from which he never recovered. He is believed to have died on or about 27 October 1605, after which his body was buried in [[Tomb of Akbar the Great|a mausoleum]] in [[Agra]], present-day [[India]].<ref>{{Harvnb|Majumdar|1984|pp=168–169}}</ref>
* '''1675''': [[Jacques Marquette]] died of dysentery on his way north from what is today Chicago, traveling to the mission where he intended to spend the rest of his life.<ref>{{cite web |vauthors=Engels A |title=Louis Jolliet (1645-1700) and Jacques Marquette (1637-1675) |work=Discoverers Web  |url=http://www.win.tue.nl/~engels/discovery/jolmar.html |archive-url=https://web.archive.org/web/20130308110354/http://www.win.tue.nl/~engels/discovery/jolmar.html |archive-date=8 March 2013 }}</ref>
* '''1676''': [[Nathaniel Bacon (Virginia colonist)|Nathaniel Bacon]] died of dysentery after taking control of Virginia following [[Bacon's Rebellion]]. He is believed to have died in October 1676, allowing Virginia's ruling elite to regain control.<ref>{{cite book|title=Give Me Liberty! An American History |vauthors=Foner E |year=2012 |publisher=W. W. Norton and Company|location=New York; London|edition=brief|isbn=9780393920321}}</ref>
* '''1680''': [[Shivaji]], founder and ruler of the [[Maratha Empire]] of South Asia, died of dysentery on 3 April 1680. In 1680, Shivaji fell ill with fever and dysentery, dying around 3–5 April 1680 at the age of 52 on the eve of [[Hanuman Jayanti]]. He was cremated at [[Raigad Fort]], where his [[Samadhi]] is built in [[Mahad]], Raigad district of Maharashtra, India.<ref>{{cite book |vauthors=Sarkar J |author-link=Jadunath Sarkar |title=Shivaji and His Times|url=https://archive.org/details/shivajihistimes00sarkrich|edition=Second|publisher=Longmans, Green and Co.|location=London|year=1920 |orig-year=1919 |ref={{sfnref|Sarkar, Shivaji and His Times|1920}}}}</ref>{{sfn|Sarkar, Shivaji and His Times|1920|p=382}}
* '''1827''': [[Nandi (mother of Shaka)|Queen Nandi kaBhebhe]], (mother of [[Shaka|Shaka Zulu]]) died of dysentery on 10 October 1827.<ref>{{cite book |vauthors=Morris DR |title=The washing of the spears : a history of the rise of the Zulu nation under Shaka and its fall in the Zulu War of 1879 |date=1998 |publisher=Da Capo Press |location=New York |isbn=978-0-306-80866-1 |edition=1st}}</ref>[[File:Kanyu Riverside Camp- Dysentery Ward Art.IWMART16893.jpg|thumb|Allied [[Prisoner of war|prisoners of war]] with dysentery in a Japanese camp in [[Thailand in World War II|Thailand]] in 1943]]
* '''1873''': The explorer [[David Livingstone]] died of dysentery on 1 May 1873.<ref>{{cite book|vauthors=Livingstone D |veditors=Waller H |title=The Last Journals of David Livingstone, in Central Africa, from 1865 to His Death: Continued by a Narrative of His Last Moments and Sufferings, Obtained from His Faithful Servants Chuma and Susi; in Two Volumes|url=https://books.google.com/books?id=S_dgAAAAcAAJ|year=1874|publisher=J. Murray}}</ref>
* '''1885''': [[Alfonso XII]] King of Spain from 29 December 1874 to 25 November 1885 died of dysentery at the age of 27 
* '''1896''': [[Phan Đình Phùng]], a [[Vietnamese people|Vietnamese]] revolutionary who led rebel armies against [[French colonial empire|French colonial forces]] in Vietnam, died of dysentery as the French surrounded his forces on 21 January 1896.<ref>{{cite book|title=Vietnamese anticolonialism, 1885–1925 |vauthors=Marr DG |year=1970 |publisher=University of California |location=Berkeley, California|isbn=978-0-520-01813-6 |page=68 |url=https://books.google.com/books?id=lu_TB0X8B4YC&pg=PA68 }}</ref>
* '''1910''': [[Luo Yixiu]], first wife of [[Mao Zedong]], died of dysentery on 11 February 1910. She was 20 years old.{{sfnm|1a1=Chang|1a2=Halliday|1y=2005|1p=7|2a1=Pantsov|2a2=Levine|2y=2012|2pp=28, 589|3a1=Lü|3y=2009|3p=[http://dangshi.people.com.cn/GB/144956/11272977.html 2]}}
<!-- Please complete sentence * '''1908''': [[Mirza Ghulam Ahmad]] Qadiani, the founder of Ahmadyya Muslim Community<ref>{{cite web|url=http://www.alislam.org/library/links/00000082.html|title=Re-Institution of Khilafat – Islam Ahmadiyya|date=23 February 2000|website=alislam.org|access-date=27 April 2018}}</ref> -->
* '''1930''': The French explorer and writer [[Michel Vieuchange]] died of dysentery in [[Agadir]] on 30 November 1930, on his return from the "forbidden city" of [[Smara]]. He was nursed by his brother, Doctor [[Jean Vieuchange]], who was unable to save him. The notebooks and photographs, edited by Jean Vieuchange, went on to become bestsellers.<ref>{{Cite book |vauthors=de Meaux A |year=2004 |title=L'ultime désert: vie et mort de Michel Vieuchange |language=fr |publisher=Phébus |location=Paris |isbn=978-2-85940-997-5 |pages=29, 245–249 & 253 }}</ref><ref>{{Cite book |vauthors=Vieuchange M |author-link1=Michel Vieuchange |year=1988 |orig-year=1932 |title=Smara: The Forbidden City |others=Fletcher Allen, Edgar (translation); [[Jean Vieuchange|Vieuchange, Jean]] (editor; introduction, notes, postscript); [[Paul Claudel|Claudel, Paul]] (preface). |publisher=Ecco |location=New York |edition=Reprint |isbn=978-0-88001-146-4 }}</ref>
* '''1942''': The [[Selarang Barracks incident]] in the summer of 1942 during [[World War II]] involved the forced crowding of 17,000 [[United Kingdom|Anglo]]-[[Australia]]n [[prisoners-of-war]] (POWs) by their [[Empire of Japan|Japanese captors]] in the areas around the barracks square for nearly five days with little water and no sanitation after the Selarang Barracks POWs refused to sign a pledge not to escape. The incident ended with the surrender of the Australian commanders due to the spreading of dysentery among their men.<ref name="Thompson">{{cite book |vauthors=Thompson P |title=The Battle For Singapore—The True Story of the Greatest Catastrophe of World War II |publisher=United Kingdom: Portraits Books |year=2005 |pages=389–390 |isbn=978-0-7499-5085-9 }}</ref>

== See also ==
{{Portal|Medicine}}
* [[Cholera]]

== References ==
{{reflist}}

===Works cited===
{{refbegin|2}}
* {{cite book |last1=Chang |first1=Jung |last2=Halliday |first2=Jon |author1-link=Jung Chang |author2-link=Jon Halliday |title=Mao: The Unknown Story |year=2005 |publisher=Jonathan Cape |location=London |isbn=978-0-224-07126-0 }}
* {{cite journal |last=Lü |first=Chun 吕春 |year=2009 |title=Six Women who Influenced Mao Zedong 影响毛泽东一生的六位女性 |journal=Dangshi Wenyuan 党史文苑 |url=http://dangshi.people.com.cn/GB/144956/11272977.html }}
* {{cite book |title=The Mughul Empire |first=R.C. |last=Majumdar |authorlink=R. C. Majumdar |year=1984 |publisher=[[Bharatiya Vidya Bhavan]] |place=Bombay}}
* {{cite book |last1=Pantsov |first1=Alexander V. |last2=Levine |first2=Steven I. |title=Mao: The Real Story |year=2012 |publisher=Simon & Schuster |location=New York and London |isbn=978-1-4516-5447-9 }}
{{refend}}
{{Commons}}
{{Medical condition classification and resources
|  DiseasesDB     =
|  ICD10          = {{ICD10|A|09|0|a|00}}, {{ICD10|A|03|9|a|00}}, {{ICD10|A|06|0|a|00}}, {{ICD10|A|07|9|a|00}}
|  ICD9           = {{ICD9|004}}, {{ICD9|007.9}}, {{ICD9|009.0}}
|  ICDO           =
|  OMIM           =
|  MedlinePlus    =
|  eMedicineSubj  =
|  eMedicineTopic =
|  MeshID         = D004403
}}
{{Protozoal diseases}}
{{Gram-negative bacterial diseases}}
{{Digestive system diseases}}
{{Authority control}}

[[Category:Conditions diagnosed by stool test]]
[[Category:Diarrhea]]
[[Category:Intestinal infectious diseases]]
[[Category:Waterborne diseases]]
[[Category:Wikipedia medicine articles ready to translate]]