Clinical manifestations usually present between 12 hours and 3 days of ingestion of the organism and the average incubation period is 3 days. Once ingested, it multiplies in the small intestine then enters the colon, where it produces shigella enterotoxins and serotype toxin 1, which cause watery or bloody diarrhea. Shigella is relatively resistant to acid in the stomach, and few organisms are required to cause the disease. It can occur in all age groups, but high-risk groups include the very young, the elderly, and immunocompromised individuals. It is common in developing countries and is transmitted via the ingestion of contaminated food, poor sanitation, or direct person-to-person contact. Shigellosis is a form of bacterial diarrhea caused by the Shigella species.
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