Shigellosis – Causes, Symptoms, Treatment, and Prevention

Shigellosis, also known as bacillary dysentery, is a highly contagious bacterial infection that affects the intestines and causes gastroenteritis. It is primarily spread through contact with contaminated feces and can lead to severe diarrhea and dehydration.

The bacteria responsible for shigellosis, known as Shigella, can be transmitted through multiple means, including direct person-to-person contact, consumption of contaminated food or water, and exposure to unsanitary conditions.

The symptoms of shigellosis typically manifest within one to three days after exposure and can include abdominal cramps, fever, and bloody diarrhea. If left untreated, shigellosis can lead to serious complications, such as rectal bleeding and hemolytic uremic syndrome.

Fortunately, shigellosis can be effectively treated with antibiotics. However, due to the emergence of antibiotic-resistant strains, it is important to consult a healthcare professional for an accurate diagnosis and appropriate treatment.

Prevention is key in limiting the spread of shigellosis. Practicing good hygiene, such as frequent handwashing with soap and water, can significantly reduce the risk of infection. Additionally, proper food handling and preparation, as well as maintaining clean and sanitary living conditions, can help prevent outbreaks of shigellosis.

Symptoms of Shigellosis

Shigellosis is a highly contagious bacterial infection caused by the Shigella bacteria. It is commonly spread through contaminated food or water, and outbreaks can occur in areas with poor sanitation and hygiene practices.

The most common symptom of shigellosis is diarrhea, which can be watery or bloody. Other symptoms may include abdominal pain, fever, and cramps. In severe cases, the infection can lead to dehydration, especially in young children and older adults.

Shigellosis is a form of gastroenteritis that affects the intestines, causing inflammation and irritation. As a result, individuals infected with shigella may experience frequent, urgent bowel movements and a constant feeling of needing to go to the bathroom.

If left untreated, shigellosis can persist for several weeks and may require antibiotics to clear the infection. It is important to seek medical attention if you suspect you have shigellosis or have been in contact with someone who has the infection.

To prevent the spread of shigellosis, it is essential to practice good hygiene, such as washing hands thoroughly with soap and water, especially after using the bathroom or changing diapers. Avoiding contaminated food and water sources is also crucial in preventing shigellosis outbreaks.

Common signs and symptoms

Shigellosis, also known as bacillary dysentery, is an infection caused by the Shigella bacteria. It is commonly characterized by gastrointestinal symptoms that can range from mild to severe.

Gastrointestinal symptoms

• Abdominal pain and cramps
• Watery or bloody diarrhea
• Fever
• Nausea and vomiting

In some cases, the diarrhea can be so severe that it leads to dehydration. This is especially true in young children, older adults, and individuals with weakened immune systems. Dehydration can be dangerous and requires prompt medical attention.

Transmission and contagiousness

Shigellosis is highly contagious and can spread from person to person through the fecal-oral route. This means that the bacteria can be transmitted through contaminated food, water, or surfaces and objects that have been contaminated with the bacteria.

Outbreaks of shigellosis can occur in areas with poor sanitation or where proper hygiene practices are not followed. It is important to practice good hygiene, such as washing hands with soap and water before handling food and after using the bathroom, to prevent the spread of the infection.

Treatment and prevention

Most cases of shigellosis resolve on their own within a week or two. However, treatment with antibiotics may be necessary to reduce the duration and severity of symptoms and to prevent complications.

Prevention of shigellosis involves proper sanitation and hygiene practices. This includes washing hands regularly, especially before eating or preparing food, and after using the bathroom. It is also important to drink clean and safe water, cook food thoroughly, and avoid eating raw or undercooked seafood.

Overall, understanding the common signs and symptoms of shigellosis, as well as practicing good hygiene and sanitation, can help prevent and control the spread of this bacterial infection.

Mild symptoms

In cases of shigellosis, mild symptoms are commonly observed in infected individuals. These symptoms usually manifest within one to three days after exposure to the contagious bacteria. The most common symptom is diarrhea, which can be watery or bloody. Other symptoms may include abdominal cramps, fever, and nausea.

While mild, these symptoms can cause discomfort and may lead to dehydration. It is important to stay hydrated by drinking plenty of fluids, such as water, clear broths, and oral rehydration solutions. Severe dehydration may require medical attention and intravenous fluids.

In some cases, shigellosis can lead to gastroenteritis, an inflammation of the stomach and intestines. This can result in more severe symptoms, including persistent diarrhea and vomiting. If these symptoms occur or if there are concerns about dehydration, it is recommended to seek medical care immediately.

Transmission

Shigellosis is highly contagious and can easily spread from person to person. The bacteria are typically transmitted through the fecal-oral route, meaning that the bacteria are transmitted when someone ingests fecal matter contaminated with the bacteria. This can occur through improper hand hygiene or ingestion of contaminated food or water.

Treatment and Prevention

Most cases of shigellosis resolve on their own within a week. However, it is important to seek medical attention, especially in cases of severe symptoms or if the infected individual is at a higher risk of complications.

Antibiotics may be prescribed by a healthcare provider to treat shigellosis and reduce the duration of symptoms. It is important to complete the full course of antibiotics as prescribed to ensure the bacteria are completely eliminated from the body and prevent the spread of antibiotic-resistant strains of the bacteria.

Prevention is crucial in minimizing the risk of shigellosis. This includes practicing good hand hygiene, especially after using the bathroom or changing diapers. It is also important to properly clean and sanitize food preparation surfaces and to avoid consuming undercooked foods. Additionally, ensuring access to clean and safe drinking water can help reduce the risk of outbreaks.

Severe symptoms

Severe symptoms of shigellosis can occur when bacteria cause a severe infection in the intestines. This can result in watery or bloody diarrhea, which may contain mucus or pus. The infection can lead to abdominal pain and cramping, along with fever and vomiting. In some cases, individuals may experience rectal bleeding.

If left untreated, severe shigellosis can lead to complications such as dehydration. It is important to replace fluids and electrolytes lost from diarrhea to prevent dehydration, especially in young children and older adults. Severe cases may require hospitalization for intravenous fluids and supportive care.

Shigellosis is highly contagious and can spread from person to person, especially in situations with poor hygiene and sanitation. Outbreaks can occur in communities, daycare centers, and long-term care facilities. To prevent the spread of shigellosis, it is important to practice good hand hygiene, especially after using the bathroom and before preparing or eating food.

Antibiotics are commonly used to treat severe cases of shigellosis. They can help reduce the duration and severity of symptoms and prevent the spread of the infection to others. However, antibiotic resistance is a growing concern, and healthcare providers may need to test the bacteria for susceptibility before prescribing specific antibiotics.

It is important to avoid contact with feces and to properly dispose of contaminated items to prevent the spread of shigellosis. Thoroughly washing and cooking food, and properly disinfecting surfaces can also help prevent infection.

Complications of Shigellosis

Shigellosis, an infection caused by a type of bacteria called Shigella, can lead to various complications if left untreated or not managed properly. The most common symptom of this infection is diarrhea, which can be severe and watery, often accompanied by abdominal cramps and fever.

One of the main complicating factors of shigellosis is dehydration, which can occur due to the excessive loss of fluids from prolonged diarrhea. It is important to replenish fluids and electrolytes to prevent dehydration, especially in young children and older adults.

In rare cases, shigellosis can lead to more serious complications, such as rectal bleeding, hemolytic uremic syndrome (HUS), or seizures. These complications are more commonly seen in young children and individuals with weakened immune systems.

Outbreaks and Contagiousness

Shigellosis is highly contagious and can easily spread from person to person, especially in settings where personal hygiene is inadequate or in crowded environments. Outbreaks of shigellosis can occur in daycare centers, schools, or among individuals living in close quarters.

Treatment and Prevention

Antibiotics are often prescribed to treat shigellosis and shorten the duration of symptoms. However, due to the emergence of drug-resistant strains of Shigella, it is important to consult a healthcare professional before starting any treatment.

Preventing the spread of shigellosis involves practicing good hygiene, such as washing hands regularly with soap and water, especially after using the toilet or changing diapers. Proper food handling and preparation, as well as avoiding close contact with individuals who have a shigellosis infection, can also help reduce the risk of transmission.

It is important to note that shigella bacteria can be present in the feces of individuals who have had the infection, even after symptoms have resolved. Therefore, practicing proper hygiene and sanitation is essential to prevent the further spread of the bacteria.

Treatment for Shigellosis

Shigellosis is an infection caused by the bacteria Shigella. It is a highly contagious disease that primarily affects the gastrointestinal tract, causing severe gastroenteritis with symptoms such as diarrhea and abdominal cramps.

Antibiotics as the primary treatment

When it comes to treating shigellosis, antibiotics play a crucial role. They are typically prescribed by healthcare professionals to help control the infection and reduce the severity of symptoms. Commonly used antibiotics for shigellosis include ciprofloxacin, azithromycin, and trimethoprim-sulfamethoxazole.

Important note: It is essential to consult with a healthcare professional before taking any antibiotics for shigellosis. They will prescribe the most suitable medication based on the specific circumstances and the antibiotic resistance patterns in the area.

Preventing dehydration

Due to the prolonged diarrhea caused by shigellosis, it is crucial to prevent dehydration, especially in young children and older adults. Rehydration solutions can be used to replace lost fluids and electrolytes. These solutions can be purchased at pharmacies or made at home using a specific recipe recommended by healthcare professionals.

Proper hygiene practices: In addition to antibiotic treatment and fluid replacement, practicing good hygiene is vital to prevent the spread of shigellosis. This includes frequent handwashing with soap and clean water, especially after using the toilet and before eating meals. Avoiding close contact with infected individuals is also advisable during an outbreak.

In conclusion, treatment for shigellosis involves the use of antibiotics to control the infection and alleviate symptoms. It is important to seek medical advice before taking any medications. Additionally, preventing dehydration through rehydration solutions and practicing good hygiene are essential measures to manage the disease and prevent its transmission.

Fluid and electrolyte replacement

Shigellosis, also known as bacillary dysentery, is a contagious bacterial infection caused by a group of bacteria called Shigella. This infection primarily affects the gastrointestinal tract, causing symptoms such as severe diarrhea, abdominal cramps, and fever. It is commonly transmitted through the consumption of contaminated food or water, and can also spread through person-to-person contact.

One of the major complications of shigellosis is dehydration, which can occur due to excessive fluid loss from the body during episodes of diarrhea. Therefore, fluid and electrolyte replacement plays a crucial role in the management of shigellosis.

Treatment options

Patients with shigellosis may require intravenous or oral fluid replacement therapy, depending on the severity of their symptoms. Oral rehydration solutions, which contain a precise balance of electrolytes and glucose, are often recommended for mild to moderate cases. These solutions help replenish the body’s water and electrolyte levels, preventing dehydration.

Severe cases of shigellosis, especially in children or individuals with compromised immune systems, may require hospitalization and intravenous fluid replacement therapy. Intravenous fluids provide a faster and more reliable way to rehydrate the body and restore electrolyte balance.

Prevention strategies

In addition to treatment, preventing the spread of shigellosis is essential to control outbreaks. This can be achieved through various preventive measures:

• Practicing good hand hygiene by washing hands thoroughly with soap and water before eating or preparing food, and after using the toilet.
• Avoiding close contact with individuals who have diarrhea or are known to be infected with Shigella.
• Properly disposing of feces to prevent contamination of water sources and food.
• Ensuring the proper sanitation and hygiene of food preparation areas.
• Thoroughly cooking food, especially meat and poultry, to kill any potential bacteria.

By implementing these prevention strategies and seeking timely treatment, the spread and severity of shigellosis can be significantly reduced.

Antibiotics

In the treatment of shigellosis, antibiotics play a crucial role. Shigellosis is caused by a group of bacteria called Shigella, which can cause severe gastrointestinal symptoms such as diarrhea and gastroenteritis. Antibiotics help to kill the bacteria and reduce the duration and severity of the infection.

Shigellosis can be a particularly dangerous infection, especially in young children, the elderly, and individuals with weakened immune systems. If left untreated, it can lead to complications such as dehydration, bloodstream infection, and even death.

Choosing the Right Antibiotics

Not all antibiotics are effective against Shigella bacteria, so it is important to choose the right one. The choice of antibiotic depends on the specific strain of Shigella and its resistance patterns in the community. Commonly used antibiotics for shigellosis include:

Antibiotic	Dosage	Treatment Duration
Ciprofloxacin	500 mg twice a day	3 days
Azithromycin	1,000 mg once a day	3 days
Ceftriaxone	1 g once a day	3-7 days

It is important to complete the full course of antibiotics as prescribed by the healthcare provider, even if symptoms improve. This helps to ensure that all the bacteria are eliminated from the body and reduces the risk of antibiotic resistance.

Preventing Antibiotic Resistance

Antibiotic resistance is a growing concern in the treatment of shigellosis. Overuse or misuse of antibiotics can lead to the development of resistant strains of Shigella bacteria, making it harder to treat future infections. To prevent antibiotic resistance:

• Only take antibiotics when prescribed by a healthcare professional
• Take the full course of antibiotics as directed, even if you start feeling better
• Do not share or use leftover antibiotics

It is also important to practice good personal hygiene to prevent the spread of Shigella bacteria. This includes frequent hand washing, especially after using the toilet or changing diapers, and avoiding close contact with individuals who have a shigellosis infection. Proper disposal of feces is crucial to prevent contamination of water sources and the spread of the infection.

By taking appropriate antibiotics, following prescribed treatment regimens, and practicing good hygiene, individuals can effectively manage shigellosis and prevent the spread of this contagious disease.

Preventing Shigellosis

To prevent shigellosis, it is important to take certain precautions. Shigellosis is a highly contagious infection that spreads through contact with infected individuals or by consuming contaminated food or water. The bacteria that cause shigellosis can survive outside of the human body for prolonged periods of time, especially in feces.

Here are some steps you can take to prevent the spread of shigellosis:

1. Practice good hygiene: Wash your hands frequently with soap and water, especially before eating or preparing food, and after using the bathroom or changing diapers. Hand sanitizers can be used in addition to handwashing, but they should not replace it.

2. Cook food thoroughly: Make sure to cook food, especially meat, poultry, and eggs, to their recommended internal temperatures. This kills any bacteria that may be present.

3. Avoid unpasteurized products: Do not consume unpasteurized milk and dairy products, as they can be a source of shigellosis bacteria.

4. Avoid cross-contamination: Keep raw and cooked foods separate to prevent the spread of bacteria. Use separate cutting boards and utensils for raw and cooked foods, and wash them thoroughly after each use.

5. Stay hydrated: Shigellosis can cause diarrhea, which can lead to dehydration. Drink plenty of fluids to stay hydrated and replace any fluids lost due to diarrhea.

6. Stay home if you are sick: If you have diarrhea or are experiencing symptoms of shigellosis, avoid going to work or school until you have fully recovered. This reduces the risk of spreading the infection to others.

7. Antibiotics: If you are diagnosed with shigellosis, your healthcare provider may prescribe antibiotics to treat the infection. It is important to take the full course of antibiotics as prescribed to ensure that the infection is completely eliminated.

By following these preventative measures, you can reduce your risk of contracting shigellosis and help prevent outbreaks of this gastrointestinal infection.

Good hygiene practices

Practicing good hygiene is crucial in preventing the spread of shigellosis. Here are some key practices to follow:

1. Handwashing

Regular and thorough handwashing is the most effective way to prevent the spread of shigella bacteria. Make sure to wash your hands with soap and clean water:

• After using the restroom
• Before preparing or eating food
• After changing diapers or cleaning up a child who has diarrhea

2. Proper food preparation

It is important to handle and prepare food properly to prevent contamination and the risk of infection:

• Wash fruits and vegetables thoroughly before consumption
• Cook food to the appropriate internal temperature
• Avoid cross-contamination by using separate cutting boards and utensils for raw and cooked foods

Note: Shigella bacteria can be easily spread through contaminated food, so it is crucial to follow good food safety practices.

3. Dispose of feces properly

Shigella bacteria can be found in feces, so it is important to take proper precautions when handling feces:

• Flush human waste down the toilet and ensure proper sanitation of the toilet area
• Thoroughly clean and disinfect any surfaces or objects that have come into contact with feces
• Wash your hands immediately after handling feces

Note: Shigella is highly contagious, and even a small amount of contaminated feces can cause an outbreak.

By following these good hygiene practices, you can significantly reduce the risk of shigellosis infection and its associated symptoms, such as diarrhea and dehydration. In severe cases, antibiotics may be prescribed to treat the infection.

Proper food handling

One of the key ways to prevent the spread of shigellosis, a type of gastroenteritis caused by the bacteria from the Shigella group, is through proper food handling. Shigellosis is highly contagious and is typically spread through the fecal-oral route. This means that the bacteria can be found in the feces of an infected person and can contaminate food and water if proper hygiene practices are not followed.

To reduce the risk of shigellosis and other foodborne illnesses, it is important to follow these guidelines for proper food handling:

1. Wash your hands thoroughly with soap and water before handling food.
2. Wash all fruits and vegetables under running water before eating or cooking them.
3. Cook food to the proper internal temperature to kill any bacteria present. Use a food thermometer to ensure that food reaches the recommended temperature.
4. Store food properly in the refrigerator or freezer to prevent bacterial growth. Keep raw meats separate from other foods to avoid cross-contamination.
5. Avoid consuming raw or undercooked eggs, poultry, seafood, and meat, as they may contain harmful bacteria.

In addition to following these guidelines, it is important to be aware of any outbreaks of shigellosis in your area. If an outbreak occurs, it may be necessary to take additional precautions, such as avoiding certain foods or avoiding public places where the infection may be more likely to spread.

If you or someone you know develops symptoms of shigellosis, such as diarrhea, fever, and dehydration, it is important to seek medical attention. Antibiotics may be prescribed to treat the infection and reduce the duration of symptoms.

By practicing proper food handling techniques and staying informed about shigellosis outbreaks, you can reduce your risk of contracting this bacterial infection and help prevent its spread to others.

Safe water sources

One of the key ways to prevent the spread of shigellosis is through the use of safe water sources. This is important because the bacteria that cause shigellosis can be found in feces and can contaminate water sources.

Safe water sources are those that are free from contamination and are unlikely to cause infection. It is crucial to drink water from sources that have been treated and purified to remove any bacteria or other harmful pathogens.

Contaminated water can lead to outbreaks of shigellosis, as well as other types of infections such as diarrhea and gastroenteritis. It is vital to ensure that water used for drinking, cooking, and cleaning is safe and free from any potential sources of contamination.

Methods of ensuring safe water sources

There are several methods that can be used to ensure that water sources are safe:

1. Boiling: Boiling water for at least one minute can kill the bacteria that cause shigellosis. This method is effective in areas where safe water sources are not readily available.
2. Chlorination: Adding chlorine to water can effectively kill bacteria and other pathogens. Chlorine tablets or liquid chlorine can be used to treat water and make it safe to drink.
3. Filtration: Filtration systems can remove bacteria and other contaminants from water, making it safe for consumption. These systems are effective in removing most pathogens, including those that cause shigellosis.
4. Use of bottled water: Drinking bottled water that has been properly treated and purified is a good option in areas where safe water sources are not available.

Importance of safe water sources in shigellosis prevention

Access to safe water sources is crucial in preventing the spread of shigellosis. Consuming contaminated water can lead to dehydration, which is a serious complication of shigellosis. It is important to note that shigellosis can be treated with antibiotics, but prevention through the use of safe water sources is the best approach.

By ensuring that water sources are safe and free from contamination, the risk of shigellosis and other waterborne diseases can be significantly reduced. It is essential to promote awareness and educate individuals and communities about the importance of using safe water sources to prevent the spread of infection.

Safe water sources:	Unsafe water sources:
Treated and purified water	Untreated water from lakes, rivers, or ponds
Bottled water	Water from untrusted sources
Water treated with chlorine or filtration systems	Water from wells without proper treatment

By following these guidelines and using safe water sources, individuals can reduce the risk of shigellosis and maintain good health.

Personal cleanliness

Personal cleanliness is crucial in preventing the spread of shigellosis. Since the bacteria causing shigellosis can be found in the feces of infected individuals, it is important to practice good hygiene to minimize the risk of infection.

One of the most effective ways to prevent the spread of shigellosis is to wash your hands frequently with soap and water, especially after using the toilet, changing diapers, or before preparing or consuming food. Hand sanitizers are also useful when soap and water are not readily available.

Proper hygiene extends beyond hand washing. Individuals with shigellosis should avoid preparing food for others until they have been symptom-free for at least 48 hours. It is also important to clean and disinfect surfaces that may have come into contact with infected feces.

Preventing outbreaks

In settings where shigellosis outbreaks have occurred, it is crucial to implement appropriate preventive measures. This includes educating individuals about the importance of personal cleanliness and providing access to clean water and sanitation facilities. Prompt identification and treatment of infected individuals with antibiotics can also help prevent further spread.

Managing and preventing dehydration

Diarrhea is a common symptom of shigellosis and can lead to dehydration, especially in young children and older adults. It is important to stay hydrated by drinking plenty of fluids and, if necessary, using oral rehydration solutions. In severe cases, intravenous fluids may be required.

In conclusion, practicing good personal cleanliness is essential in preventing shigellosis. By maintaining proper hygiene and following preventive measures, such as washing hands regularly and avoiding the preparation of food while symptomatic, individuals can reduce the risk of infection and transmission of this contagious bacterial infection.

Vaccination

Vaccination is an effective method of preventing shigellosis, a highly contagious bacterial infection that causes gastroenteritis. Shigella bacteria are transmitted through fecal-oral route, usually due to poor hygiene practices or contaminated food and water sources. Vaccination helps in building immunity against these bacteria and reduces the risk of infection.

Types of Shigellosis Vaccines

There are several types of shigellosis vaccines available:

• Oral Vaccine: This vaccine is taken by mouth and contains live, attenuated (weakened) Shigella bacteria. It provides immunity against multiple strains of Shigella and has been found to be effective in reducing the severity of diarrhea and duration of illness.
• Inactivated Vaccine: This vaccine contains killed Shigella bacteria and is administered through injection. It is less commonly used compared to the oral vaccine and requires multiple doses to provide protection.

Benefits of Vaccination

Vaccination offers several benefits in the prevention of shigellosis:

1. Reduced Risk of Infection: Vaccination helps in building immunity against Shigella bacteria, reducing the risk of getting infected during an outbreak or in places with poor sanitation conditions.
2. Less Severe Symptoms: Even if a vaccinated individual gets infected with Shigella, the symptoms are usually less severe and the illness resolves faster compared to those who are not vaccinated.
3. Prevention of Complications: Shigellosis can lead to complications such as dehydration, especially in young children and older adults. Vaccination decreases the risk of severe diarrhea and dehydration.
4. Control of Outbreaks: Vaccination plays a crucial role in controlling shigellosis outbreaks, especially in communities where the disease is endemic or during travel to high-risk areas.

It is important to note that while vaccination is an effective preventive measure, it does not provide 100% protection. Practicing good hygiene, such as washing hands frequently with soap and water, avoiding contaminated food and water, and proper disposal of feces, is still necessary to reduce the risk of shigellosis infection.

Q&A:

What is shigellosis?

Shigellosis is an infectious disease caused by a group of bacteria called Shigella. It affects the intestines and causes symptoms such as diarrhea, fever, and stomach cramps.

How is shigellosis spread?

Shigellosis is usually spread through contaminated food or water, or by direct contact with an infected person. Poor hand hygiene and unsanitary conditions can contribute to the spread of the bacteria.

What are the symptoms of shigellosis?

The main symptoms of shigellosis include diarrhea, which may be bloody, fever, stomach cramps, and occasionally nausea and vomiting. The severity of the symptoms can vary from mild to severe.

How is shigellosis diagnosed?

Shigellosis can be diagnosed through laboratory tests on a stool sample. These tests can identify the presence of the Shigella bacteria and help determine the appropriate treatment.

How is shigellosis treated and prevented?

Shigellosis is usually treated with antibiotics to help alleviate the symptoms and prevent complications. Prevention methods include practicing good hand hygiene, thoroughly cooking food, and avoiding unsafe water sources.

What is shigellosis?

Shigellosis is an infectious disease caused by a group of bacteria called Shigella. It is characterized by diarrhea, abdominal pain, fever, and sometimes blood in the stool.

How is shigellosis transmitted?

Shigellosis is most commonly transmitted through the ingestion of contaminated food or water. It can also be passed from person to person through poor hygiene practices, such as not washing hands properly after using the bathroom.

What are the symptoms of shigellosis?

The symptoms of shigellosis include diarrhea, which may be watery or bloody, abdominal pain, fever, and sometimes vomiting. Some people may also experience symptoms such as headache, muscle aches, and fatigue.

How is shigellosis treated?

Shigellosis is usually treated with antibiotics. The specific antibiotic used will depend on the sensitivity of the bacteria to different drugs. It is important to complete the full course of antibiotics prescribed by a healthcare provider to ensure that all the bacteria are eliminated from the body.