Drug-Resistant Shigella Rising Among Gay and Bisexual Men

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Source: Freepik

UK health officials report a rise in cases of an ‘extremely drug-resistant’ Shigella infection.

In a recent press release, the UK Health Security Agency (UKHSA) warned of a rise in drug-resistant Shigella cases among gay, bisexual, and other men who have sex with men (MSM). According to health officials, the UK had reported 16 cases of Shigella sonnei between April 1, 2020, and August 31, 2021. However, the number increased to 47 between September 1 2021 and January 10, 2022.

Health officials first reported the rise of this particular strain in a previous UKHSA briefing. According to researchers, the bacteria has developed resistance to a wide variety of antibiotics including azithromycin, quinolones, and ceftriaxone. Moreover, genome sequencing of cases revealed the presence of an antimicrobial resistance gene within most strains.

Shigella is often mistaken for food poisoning due to the similarity of symptoms which include abdominal pain, diarrhea, fever, and nausea. Additionally, people can also develop bloody stools, painful bowel movements, and even sepsis. While most cases resolve within 4-8 days of antibiotic use, severe infections can last for weeks and require hospitalization. However, the increasing resistance has limited the availability of effective antibiotics for the disease.

Transmission occurs through the fecal-oral route or through sexual intercourse involving anal contact. Unwashed hands can also transmit bacteria to others, either through direct contact or contaminated objects.

Public Health Risks

Majority of the recent cases seem to have occurred among gay, bisexual, and other men who have sex with men. Therefore, Dr. Gauri Godbole at the UKHSA has advised people to practise good hygiene after sex. Moreover, she has encouraged them to look out for symptoms and undergo a sexual health screening in case of infection. However, gay men are not the only ones at risk. The earlier briefing from UKHSA had also warned of a spillover into the community through food handlers and carers.

It’s important that gay, bisexual and other men who have sex with men do not dismiss their symptoms and speak to their GP or sexual health clinic, mentioning Shigella, if they are unwell.

Dr. Gauri Godbole, Consultant Medical Microbiologist at UKHSA

Dr. Godbole also advises an abstinence period of 7 days after the last symptom. Furthermore, infected individuals are told to avoid spas, sharing towels, hot tubs, swimming pools and even cooking until a week after the symptoms end.

Source: UK Health Security Agency

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