XDR Shigella

Shigellosis is an acute enteric infection that is an important cause of domestically acquired and travel associated bacterial diarrhea in the United States. Shigellosis usually causes inflammatory diarrhea that can be bloody and may also lead to fever, abdominal cramping, and tenesmus. The U.S. Centers for Disease Control (CDC) issued recent  health alert with monitoring noting an increase in Extensively Drug-Resistant (XDR) Shigellosis in the United States.

The CDC has observed an increase in XDR Shigella infections among adult populations, especially:

  • Gay, bisexual, and other men who have sex with men (MSM)
  • People experiencing homelessness
  • International travelers
  • People living with HIV

Patients with suspected or confirmed shigellosis  should  follow prevention measures to keep others healthy. All patients with suspected or confirmed shigellosis should:

  • Stay home from school or from healthcare, food service, or childcare jobs while sick or until your healthcare provider says it’s safe to return. Do not prepare food for others.
  • During diarrhea and for 2 weeks after it ends abstain from sex (anal, oral, penile, or vaginal).
    • Wash hands often with soap and water for at least 20 seconds, including at key times
      • such as after using the toilet, before and after changing diapers, cleaning up after
      • someone who is sick, and before preparing or eating food.
  • Closely follow safer sex practices for at least 2 weeks after resuming sex to prevent the spread of Shigella bacteria that may remain in stool:
    • Wash hands, genitals, and anus with soap and water before and after sexual activity.
    • Wash hands after touching sex toys, external and internal condoms, dental dams, and any other items that might have been in contact with the vagina or anus.
    • Use condoms or dental dams during oral-genital sex and oral-anal sex.
    • Use latex gloves during anal fingering or fisting.
    • Wash sex toys with soap and water after each use.
  • Stay out of recreational water, including swimming pools, hot tubs, water playgrounds, oceans, lakes, and rivers.