Dysentery
Encyclopedia
Dysentery is an inflammatory
disorder of the intestine
, especially of the colon
, that results in severe diarrhea
containing mucus
and/or blood
in the faeces with fever
and abdominal pain
. If left untreated, dysentery can be fatal.
There are differences between dysentery and normal bloody diarrhoea. While diarrhoea caused by dysentery is typically of small volume, very bloody, and containing many PMNs and RBC
s; normal bloody diarrhoea is more watery and may not contain any PMNs or mucus.
can occur, which, in the most severe cases, can last for years. In some caustic occasions, vomiting of blood, severe abdominal pain, fever
, shock, and delirium
can all be symptoms.
, bacteria
l, or protozoa
n infections or parasitic
infestations. 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 lining, leading to the inflammatory immune response
. This can cause elevated temperature, painful spasms of the intestinal muscles (cramping), swelling due to water leaking from capillaries of the intestine (edema
), and further tissue damage by the body's immune cells and the chemicals, called cytokine
s, they release 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.
Some microorganisms – for example, bacteria of the genus Shigella
– secrete substances known as cytotoxins, which kill and damage intestinal tissue on contact. Viruses directly attack the intestinal cells, taking over their metabolic machinery to make copies of themselves, which leads to cell death.
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." Others define the term more broadly. 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.
, an infection by the amoeba
Entamoeba histolytica
, and is then known as amoebic dysentery
. Proper treatment of the underlying infection of amoebic dysentery
is important; insufficiently treated amoebiasis can lie dormant for years and then lead to severe, potentially fatal, complications.
, an infection by bacteria
of the genus Shigella
, and is then known as bacillary disentery (or Marlow Syndrome).
, abdominal pain
, and frequent watery and usually foul-smelling diarrhea
accompanied by mucus
and blood
, rectal pain, and fever
. Vomiting
, rapid weight loss, and generalized muscle aches sometimes also accompany dysentery. In rare occasions, the amebic parasite will invade the body through the bloodstream and spread beyond the intestines. In such cases, it may more seriously infect other organs such as the brain
, lungs, and the liver
.
of stool samples are examined in order to identify the organism
causing dysentery. Usually, several samples must be obtained due to the changing number of amoeba, which changes daily.
Blood test
s can be used to measure abnormalities in the levels of essential minerals and salts.
. 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 amoebicidal
drug to kill the parasite and an antibiotic
to treat any associated bacterial infection.
If shigella is suspected and it is not too severe, the doctor may recommend letting it run its course — usually less than a week. The patient will be advised to replace fluids lost through diarrhea. If the shigella is severe, the doctor may prescribe antibiotics, such as ciprofloxacin
or TMP-SMX (Bactrim). 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.
Amoebic dysentery usually calls for a two-pronged attack. Treatment should start with a 10-day course of the antimicrobial drug metronidazole
(Flagyl). To finish off the parasite, the doctor will sometimes prescribe a course of diloxanide furoate
(available only through the Centers for Disease Control and Prevention), paromomycin (Humatin), or iodoquinol (Yodoxin).
The bark of the kapok
tree has been used in the traditional medicine of the Mayan culture to cure this disease.
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
disorder of the intestine
Intestine
In human anatomy, the intestine is the segment of the alimentary canal extending from the pyloric sphincter of the stomach to the anus and, in humans and other mammals, consists of two segments, the small intestine and the large intestine...
, especially of the colon
Colon (anatomy)
The colon is the last part of the digestive system in most vertebrates; it extracts water and salt from solid wastes before they are eliminated from the body, and is the site in which flora-aided fermentation of unabsorbed material occurs. Unlike the small intestine, the colon does not play a...
, that results in severe diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
containing mucus
Mucus
In vertebrates, mucus is a slippery secretion produced by, and covering, mucous membranes. Mucous fluid is typically produced from mucous cells found in mucous glands. Mucous cells secrete products that are rich in glycoproteins and water. Mucous fluid may also originate from mixed glands, which...
and/or blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
in the faeces with fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
and abdominal pain
Abdominal pain
Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of abdominal pain can be difficult, because many diseases can result in this symptom. Abdominal pain is a common problem...
. If left untreated, dysentery can be fatal.
There are differences between dysentery and normal bloody diarrhoea. While diarrhoea caused by dysentery is typically of small volume, very bloody, and containing many PMNs and RBC
Red blood cell
Red blood cells are the most common type of blood cell and the vertebrate organism's principal means of delivering oxygen to the body tissues via the blood flow through the circulatory system...
s; normal bloody diarrhoea is more watery and may not contain any PMNs or mucus.
Signs and symptoms
In developed countries, dysentery is, in general, a mild illness, causing mild symptoms normally consisting of mild stomach pains and frequent passage of faeces. Symptoms normally present themselves after one to three days and are usually no longer present after a week. The frequency of urges to defecate, the volume of faeces passed, and the presence of mucus and/or blood depend on the pathogen that is causing the disease. Temporary lactose intoleranceLactose intolerance
Lactose intolerance, also called lactase deficiency or hypolactasia, is the inability to digest and metabolize lactose, a sugar found in milk...
can occur, which, in the most severe cases, can last for years. In some caustic occasions, vomiting of blood, severe abdominal pain, fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
, shock, and delirium
Delirium
Delirium or acute confusional state is a common and severe neuropsychiatric syndrome with core features of acute onset and fluctuating course, attentional deficits and generalized severe disorganization of behavior...
can all be symptoms.
Mechanism
Dysentery results from viralVirus
A virus is a small infectious agent that can replicate only inside the living cells of organisms. Viruses infect all types of organisms, from animals and plants to bacteria and archaea...
, bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...
l, or protozoa
Protozoa
Protozoa are a diverse group of single-cells eukaryotic organisms, many of which are motile. Throughout history, protozoa have been defined as single-cell protists with animal-like behavior, e.g., movement...
n infections or parasitic
Parasitism
Parasitism is a type of symbiotic relationship between organisms of different species where one organism, the parasite, benefits at the expense of the other, the host. Traditionally parasite referred to organisms with lifestages that needed more than one host . These are now called macroparasites...
infestations. These pathogens typically reach the large intestine
Large intestine
The large intestine is the third-to-last part of the digestive system — — in vertebrate animals. Its function is to absorb water from the remaining indigestible food matter, and then to pass useless waste material from the body...
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 lining, leading to the inflammatory immune response
Inflammation
Inflammation is part of the complex biological response of vascular tissues to harmful stimuli, such as pathogens, damaged cells, or irritants. Inflammation is a protective attempt by the organism to remove the injurious stimuli and to initiate the healing process...
. This can cause elevated temperature, painful spasms of the intestinal muscles (cramping), swelling due to water leaking from capillaries of the intestine (edema
Edema
Edema or oedema ; both words from the Greek , oídēma "swelling"), formerly known as dropsy or hydropsy, is an abnormal accumulation of fluid beneath the skin or in one or more cavities of the body that produces swelling...
), and further tissue damage by the body's immune cells and the chemicals, called cytokine
Cytokine
Cytokines are small cell-signaling protein molecules that are secreted by the glial cells of the nervous system and by numerous cells of the immune system and are a category of signaling molecules used extensively in intercellular communication...
s, they release 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.
Some microorganisms – for example, bacteria of the genus Shigella
Shigella
Shigella is a genus of Gram-negative, nonspore forming, non-motile, rod-shaped bacteria closely related to Escherichia coli and Salmonella. The causative agent of human shigellosis, Shigella causes disease in primates, but not in other mammals. It is only naturally found in humans and apes. During...
– secrete substances known as cytotoxins, which kill and damage intestinal tissue on contact. Viruses directly attack the intestinal cells, taking over their metabolic machinery to make copies of themselves, which leads to cell death.
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." Others define the term more broadly. 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.
Amoebic dysentery
Dysentery may be caused by amoebiasisAmoebiasis
Entamebiasis is a term for the infection more commonly known as amoebiasis.It became the preferred term in MeSH in 1991, but the term amoebiasis is used by the World Health Organization and by those working in the field of amoebiasis research....
, an infection by the amoeba
Amoeba
Amoeba is a genus of Protozoa.History=The amoeba was first discovered by August Johann Rösel von Rosenhof in 1757. Early naturalists referred to Amoeba as the Proteus animalcule after the Greek god Proteus, who could change his shape...
Entamoeba histolytica
Entamoeba histolytica
Entamoeba histolytica is an anaerobic parasitic protozoan, part of the genus Entamoeba. Predominantly infecting humans and other primates, E. histolytica is estimated to infect about 50 million people worldwide...
, and is then known as amoebic dysentery
Amoebic dysentery
Amoebic dysentery is a type of dysentery caused primarily by the amoeba Entamoeba histolytica. Amoebic dysentery is transmitted through contaminated food and water. Amoebae spread by forming infective cysts which can be found in stools, and spread if whoever touches them does not sanitize their...
. Proper treatment of the underlying infection of amoebic dysentery
Amoebic dysentery
Amoebic dysentery is a type of dysentery caused primarily by the amoeba Entamoeba histolytica. Amoebic dysentery is transmitted through contaminated food and water. Amoebae spread by forming infective cysts which can be found in stools, and spread if whoever touches them does not sanitize their...
is important; insufficiently treated amoebiasis can lie dormant for years and then lead to severe, potentially fatal, complications.
Bacillary dysentery
Severe dysentery may also be caused by shigellosisShigellosis
Shigellosis, also known as bacillary dysentery or Marlow Syndrome, in its most severe manifestation, is a foodborne illness caused by infection by bacteria of the genus Shigella. Shigellosis rarely occurs in animals other than humans and other primates like monkeys and chimpanzees...
, an infection by bacteria
Bacteria
Bacteria are a large domain of prokaryotic microorganisms. Typically a few micrometres in length, bacteria have a wide range of shapes, ranging from spheres to rods and spirals...
of the genus Shigella
Shigella
Shigella is a genus of Gram-negative, nonspore forming, non-motile, rod-shaped bacteria closely related to Escherichia coli and Salmonella. The causative agent of human shigellosis, Shigella causes disease in primates, but not in other mammals. It is only naturally found in humans and apes. During...
, and is then known as bacillary disentery (or Marlow Syndrome).
Diagnosis
A clinical diagnosis may be made by taking a history and doing a brief examination. Treatment is usually started without or before confirmation by laboratory analysis.Medical history
Exposed individuals may experience either mild, severe, or even no symptoms at all. In extreme cases dysentery patients may pass over a litre of fluid an hour. More often, individuals will complain of nauseaNausea
Nausea , is a sensation of unease and discomfort in the upper stomach with an involuntary urge to vomit. It often, but not always, precedes vomiting...
, abdominal pain
Abdominal pain
Abdominal pain can be one of the symptoms associated with transient disorders or serious disease. Making a definitive diagnosis of the cause of abdominal pain can be difficult, because many diseases can result in this symptom. Abdominal pain is a common problem...
, and frequent watery and usually foul-smelling diarrhea
Diarrhea
Diarrhea , also spelled diarrhoea, is the condition of having three or more loose or liquid bowel movements per day. It is a common cause of death in developing countries and the second most common cause of infant deaths worldwide. The loss of fluids through diarrhea can cause dehydration and...
accompanied by mucus
Mucus
In vertebrates, mucus is a slippery secretion produced by, and covering, mucous membranes. Mucous fluid is typically produced from mucous cells found in mucous glands. Mucous cells secrete products that are rich in glycoproteins and water. Mucous fluid may also originate from mixed glands, which...
and blood
Blood
Blood is a specialized bodily fluid in animals that delivers necessary substances such as nutrients and oxygen to the cells and transports metabolic waste products away from those same cells....
, rectal pain, and fever
Fever
Fever is a common medical sign characterized by an elevation of temperature above the normal range of due to an increase in the body temperature regulatory set-point. This increase in set-point triggers increased muscle tone and shivering.As a person's temperature increases, there is, in...
. Vomiting
Vomiting
Vomiting is the forceful expulsion of the contents of one's stomach through the mouth and sometimes the nose...
, rapid weight loss, and generalized muscle aches sometimes also accompany dysentery. In rare occasions, the amebic parasite will invade the body through the bloodstream and spread beyond the intestines. In such cases, it may more seriously infect other organs such as the brain
Human brain
The human brain has the same general structure as the brains of other mammals, but is over three times larger than the brain of a typical mammal with an equivalent body size. Estimates for the number of neurons in the human brain range from 80 to 120 billion...
, lungs, and the liver
Liver
The liver is a vital organ present in vertebrates and some other animals. It has a wide range of functions, including detoxification, protein synthesis, and production of biochemicals necessary for digestion...
.
Physical exam
The mouth, skin, and lips may appear dry due to dehydration. Lower abdominal tenderness may also be present.Stool and blood tests
CulturesCell culture
Cell culture is the complex process by which cells are grown under controlled conditions. In practice, the term "cell culture" has come to refer to the culturing of cells derived from singlecellular eukaryotes, especially animal cells. However, there are also cultures of plants, fungi and microbes,...
of stool samples are examined in order to identify the organism
Organism
In biology, an organism is any contiguous living system . In at least some form, all organisms are capable of response to stimuli, reproduction, growth and development, and maintenance of homoeostasis as a stable whole.An organism may either be unicellular or, as in the case of humans, comprise...
causing dysentery. Usually, several samples must be obtained due to the changing number of amoeba, which changes daily.
Blood test
Blood test
A blood test is a laboratory analysis performed on a blood sample that is usually extracted from a vein in the arm using a needle, or via fingerprick....
s can be used to measure abnormalities in the levels of essential minerals and salts.
Prevention
To reduce the risk of contracting dysentery the following precautions are suggested:- Washing one's hands after using the toilet, after contact with an infected person, and regularly throughout the day.
- Washing one's hands before handling, cooking and eating food, handling babies, and feeding young or elderly people.
- Keeping contact with someone known to have dysentery to a minimum.
- Washing laundry on the hottest setting possible.
- Avoiding sharing items such as towels and face cloths.
Treatment
Dysentery is initially managed by maintaining fluid intake using oral rehydration therapyOral rehydration therapy
Oral rehydration therapy is a simple treatment for dehydration associated with diarrhoea, particularly gastroenteritis or gastroenteropathy, such as that caused by cholera or rotavirus. ORT consists of a solution of salts and sugars which is taken by mouth...
. 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 amoebicidal
Amebicide
An amebicide is an agent used in the treatment of amoebozoa infections.Among these agents are the following, linked to the infections they are used to treat:...
drug to kill the parasite and an antibiotic
Antibiotic
An antibacterial is a compound or substance that kills or slows down the growth of bacteria.The term is often used synonymously with the term antibiotic; today, however, with increased knowledge of the causative agents of various infectious diseases, antibiotic has come to denote a broader range of...
to treat any associated bacterial infection.
If shigella is suspected and it is not too severe, the doctor may recommend letting it run its course — usually less than a week. The patient will be advised to replace fluids lost through diarrhea. If the shigella is severe, the doctor may prescribe antibiotics, such as ciprofloxacin
Ciprofloxacin
Ciprofloxacin is a synthetic chemotherapeutic antibiotic of the fluoroquinolone drug class.It is a second-generation fluoroquinolone antibacterial. It kills bacteria by interfering with the enzymes that cause DNA to rewind after being copied, which stops synthesis of DNA and of...
or TMP-SMX (Bactrim). 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.
Amoebic dysentery usually calls for a two-pronged attack. Treatment should start with a 10-day course of the antimicrobial drug metronidazole
Metronidazole
Metronidazole is a nitroimidazole antibiotic medication used particularly for anaerobic bacteria and protozoa. Metronidazole is an antibiotic, amebicide, and antiprotozoal....
(Flagyl). To finish off the parasite, the doctor will sometimes prescribe a course of diloxanide furoate
Diloxanide furoate
Diloxanide furoate is an anti-protozoal drug used in the treatment of Entamoeba histolytica and some other protozoal infections.-Safety and effectiveness:...
(available only through the Centers for Disease Control and Prevention), paromomycin (Humatin), or iodoquinol (Yodoxin).
The bark of the kapok
Kapok
Ceiba pentandra is a tropical tree of the order Malvales and the family Malvaceae , native to Mexico, Central America and the Caribbean, northern South America, and to tropical west Africa...
tree has been used in the traditional medicine of the Mayan culture to cure this disease.
Prognosis
With correct treatment, most cases of amoebic and bacterial dysentery subside within 10 days, and most individuals will achieve a full recovery within 2 to 4 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 prolong recovery and significantly raises the risk for serious complications.Epidemiology
The World Health Organization (WHO) has estimated that 80 million cases of Shigellosis are contracted annually, with 700,000 of these resulting in death. Amebiasis is infecting over 50 million people each year, killing about 50,000.In history
- 1085 – The Duke of ApuliaApuliaApulia is a region in Southern Italy bordering the Adriatic Sea in the east, the Ionian Sea to the southeast, and the Strait of Òtranto and Gulf of Taranto in the south. Its most southern portion, known as Salento peninsula, forms a high heel on the "boot" of Italy. The region comprises , and...
Robert GuiscardRobert GuiscardRobert d'Hauteville, known as Guiscard, Duke of Apulia and Calabria, from Latin Viscardus and Old French Viscart, often rendered the Resourceful, the Cunning, the Wily, the Fox, or the Weasel was a Norman adventurer conspicuous in the conquest of southern Italy and Sicily...
died of 'hot flux' in the summer of 1085, ending the Norman invasion of Byzantium and causing a civil war between his two sons Bohemond and Roger BorsaRoger BorsaRoger Borsa was the Norman Duke of Apulia and effective ruler of southern Italy from 1085 until his death. He was the son of Robert Guiscard, the conqueror of southern Italy and Sicily; Roger was not as adept as his father, and most of his reign was spent in feudal anarchy.-Biography:Roger was the...
for the inheritance of the duchy. - 1191 – Philip II of FrancePhilip II of FrancePhilip II Augustus was the King of France from 1180 until his death. A member of the House of Capet, Philip Augustus was born at Gonesse in the Val-d'Oise, the son of Louis VII and his third wife, Adela of Champagne...
became severely ill with dysentery during the Third CrusadeThird CrusadeThe Third Crusade , also known as the Kings' Crusade, was an attempt by European leaders to reconquer the Holy Land from Saladin...
at the Siege of Acre in 1191 and, in part, as a result, returned to France and left Richard I of EnglandRichard I of EnglandRichard I was King of England from 6 July 1189 until his death. He also ruled as Duke of Normandy, Duke of Aquitaine, Duke of Gascony, Lord of Cyprus, Count of Anjou, Count of Maine, Count of Nantes, and Overlord of Brittany at various times during the same period...
in charge. - 1216 – King John of EnglandJohn of EnglandJohn , also known as John Lackland , was King of England from 6 April 1199 until his death...
died of dysentery at Newark CastleNewark Castle, NottinghamshireNewark Castle, in Newark, in the English county of Nottinghamshire was built by Alexander, consecrated Bishop of Lincoln in 1123, who established it as a mint. His rebuild here was probably the model for that at Sleaford Castle, also built by Alexander....
on 18 October 1216. - 1596 – Sir Francis DrakeFrancis DrakeSir Francis Drake, Vice Admiral was an English sea captain, privateer, navigator, slaver, and politician of the Elizabethan era. Elizabeth I of England awarded Drake a knighthood in 1581. He was second-in-command of the English fleet against the Spanish Armada in 1588. He also carried out the...
died of dysentery in January 1596, after unsuccessfully attacking San Juan, Puerto RicoSan Juan, Puerto RicoSan Juan , officially Municipio de la Ciudad Capital San Juan Bautista , is the capital and most populous municipality in Puerto Rico, an unincorporated territory of the United States. As of the 2010 census, it had a population of 395,326 making it the 46th-largest city under the jurisdiction of...
. - 19th century – As late as the nineteenth century, the 'bloody flux,' it is estimated, killed more soldiers and sailors than did combat. Typhus and dysentery decimated Napoleon's Grande Armée in Russia. More than 80,000 Union troops died of dysentery during the American Civil War.
- 1896 – Phan Dinh PhungPhan Dinh PhungPhan Đình Phùng was a Vietnamese revolutionary who led rebel armies against French colonial forces in Vietnam. He was the most prominent of the Confucian court scholars involved in anti-French military campaigns in the 19th century and was cited after his death by 20th-century nationalists as a...
, a VietnameseVietnamese peopleThe Vietnamese people are an ethnic group originating from present-day northern Vietnam and southern China. They are the majority ethnic group of Vietnam, comprising 86% of the population as of the 1999 census, and are officially known as Kinh to distinguish them from other ethnic groups in Vietnam...
revolutionary who led rebel armies against French colonial forcesFrench colonial empireThe French colonial empire was the set of territories outside Europe that were under French rule primarily from the 17th century to the late 1960s. In the 19th and 20th centuries, the colonial empire of France was the second-largest in the world behind the British Empire. The French colonial empire...
in Vietnam, died of dysentery as the French surrounded his forces on January 21, 1896. - 1930 – The French explorer and writer, Michel VieuchangeMichel VieuchangeMichel Vieuchange, born Nevers in 1904 and died Agadir in 1930, was a French adventurer who was the first European to visit the abandoned ruins of the walled city of Smara, in the interior of the Sahara....
, died of dysentery in AgadirAgadirAgadir is a major city in southwest Morocco, capital of the Agadir province and the Sous-Massa-Draa economic region .-Etymology:...
on 30 November 1930, on his return from the "forbidden city" of SmaraSmaraSmara, also Semara , is a city in the Moroccan-Administered Western Sahara, with a population estimated at 42,056.-History:The largest city in its province, Smara was founded in the Saguia el-Hamra as an oasis for travellers in 1869. It is the only major city in Western Sahara that was not founded...
. He was nursed by his brother, Doctor Jean VieuchangeJean VieuchangeJean Joseph Marie Vieuchange was a French adventurer and doctor, best known for preparing for publication the hand-written notebooks of his brother, Michel, describing his discovery of Smara in the Western Sahara in November 1930....
, who was unable to save him. The notebooks and photographs, edited by Jean Vieuchange, went on to become bestsellers. - 1942 – The Selarang Barracks IncidentSelarang Barracks IncidentThe Selarang Barracks Incident also known as the Barrack Square Incident or the Selarang Square Squeeze, was an event during the Second World War started on 30 August 1942. The barracks was sited in Changi, Singapore and were used by the Japanese to hold 17,000 Anglo-Australian prisoners-of-war...
in the summer of 1942 during the Second World War involved the forced crowding of 17,000 AngloAngloAnglo is a prefix indicating a relation to the Angles, England or the English people, as in the terms Anglo-Saxon, Anglo-American, Anglo-Celtic, Anglo-African and Anglo-Indian. It is often used alone, somewhat loosely, to refer to people of British Isles descent in The Americas, Australia and...
-Australian prisoners-of-war (POWs) 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 capitulation of the Australian commanders due to the spreading of dysentry among their men.