Cases of ‘extremely drug-resistant’ Shigella spike in the UK

There has been a concerning rise in cases of “extremely antibiotic-resistant” Shigella sonnei infections, the UK Health Security Agency (UKHSA) had announced. While the infection tends to be most common in young children, cases have mainly been in gay, bisexual, and other men who have sex with men.

The NHS says: “Commonly people with Shigella infection have travelled to a country where disposal of sewage is poor and water and food may be contaminated. However, infection can also be caught in the UK.

“The bacteria can be found in the bowels of people that have or are recovering from the infection for about four weeks and sometimes even longer.”

Since the beginning of 2023, the number of extensively-antibiotic resistant Shigella cases has increased by 53 percent. The increase is believed to have been driven by a cluster of extensively-antibiotic resistant Shigella sonnei, of which there have been 97 cases in 2020 (up to including November), compared to just four cases last year.

Because it doesn’t respond to the antibiotics typically used to treat Shigella, it’s proven difficult to treat.

Cases have been diagnosed in all regions in England, but are concentrated in London (45), the North West (21) and South East (12).

January 2022 saw a similar rise in cases of extensively antibiotic-resistant Shigella sonnei infections caused by another outbreak strain.

Since the easing of Covid restrictions, cases of Shigella have been rising – annual causes are now higher than the average before the pandemic.

The NHS says you can become infected with Shigella by having contact with people who have the illness if they don’t follow strict hygiene measures.

It explains: “This can happen if someone with the infection doesn’t wash their hands after going to the toilet and then touches food, surfaces, or another person.

“Infection occurs through eating any food contaminated with the bacteria or by drinking or swimming in unrelated water.

“You may also be at risk through sexual activities including oral or anal contact.”

Dr Gauri Godbole, Consultant Medical Microbiologist at UKHSA, said one of the best ways to protect yourself and your partners is to practice good hygiene after sex.

He continued: “Avoid oral sex immediately after anal sex, and change condoms between anal or oral sex and wash your hands with soap after sexual contact. It’s important that gay, bisexual, and other men who have sex with men (GBMSM) do not dismiss their symptoms and speak to their GP or sexual health clinic, mentioning Shigella, if they are unwell.

“GBMSM with Shigella may have been exposed to other sexually transmitted infections (STIs) including HIV, so a sexual health screen at a clinic or ordering tests online is recommended.”

Shigella is very infections, and although symptoms can be unpleasant, in most cases they will subside within a week.

Some individuals need hospitalisation and require intravenous antibiotic treatment, but effective antibiotic treatments are limited for this extremely resistant strain.

Antibiotic treatment is recommended for people with severe symptoms, those requiring hospital admission, those with prolonged diarrhoea (beyond seven days) or in those who have underlying immunodeficiency.

If you’ve been diagnosed with the infection, give yourself time to recover – keep hydrated and get lots of rest.

Don’t have sec until seven days after your last symptom and avoid spas, swimming, jacuzzis, hot tubs and sharing towels, as well as preparing food for other people until a week after symptoms stop.

The UKHSA said reducing transmission is key to protecting more vulnerable groups.

For more information about Shigella visit Sexwise or call the free National Sexual Health Helpline at 0300 123 7123.

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