Shigella superbug: Why US and Canada are concerned
A dangerous and hard-to-treat sexually transmitted infection (STI) caused by drug-resistant Shigella bacteria is spreading in the United States, alarming health officials. Shigellosis, a severe intestinal infection, is becoming increasingly challenging to treat due to the rise of extensively drug-resistant (XDR) strains. The bug, which causes diarrhea with blood or mucus, stomach pain, cramps, fever, and vomiting, has been primarily transmitted through contaminated food or water and among young children in day care.
However, it is now recognized as an endemic STI among certain communities of gay, bisexual, and other men who have sex with men (GBMSM).
Shigella bacteria, capable of causing life-threatening dehydration and septic shock, are transmitted through infected feces entering the mouth via unwashed hands or tainted food and water. Children under five are most susceptible, often contracting the infection from schoolmates or contaminated environments. Travelers to areas with poor sanitation and homeless individuals also face a higher risk.
Experts blame the growing prevalence of sexually transmitted Shigella on a lack of awareness about the infection's mode of transmission. Cambridge geneticist Kate Baker, a lead author of a July study, expressed concern over the increasing risk posed by sexually transmitted Shigella among GBMSM. She noted that the strains spread through sex are particularly dangerous, with infected individuals often requiring a different treatment regimen than those who contracted the infection through travel.
The Centers for Disease Control and Prevention (CDC) is urging greater attention and development of prevention strategies due to the emergence of XDR Shigellosis, a strain resistant to all five standard antibiotics used to treat it. Canada has also reported cases of XDR Shigella, with around 880 annual cases and an increasing proportion of XDR cases, from 1% in 2018 to 6.6% in 2022. Notable outbreaks in Montreal and Calgary have involved multidrug-resistant strains.
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