Cases of the highly contagious and drug-resistant bacterial disease Shigella are increasing across the United States, prompting updated warnings from dozens of doctors this month. Shigella infections can lead to severe symptoms including bloody diarrhea, fever, vomiting, dehydration, stomach cramps, seizures, blood infections, and in rare instances, death.
Shifting Demographics of Infection Risk
While experts have long recognized that drug-resistant strains of Shigella disproportionately affect children under five years old, a new federal report indicates a significant shift. Doctors from health departments nationwide announced last Thursday that white men are now the most susceptible group to infections from drug-resistant Shigella. This finding could alter how hospitals respond to this pervasive illness, as noted in the report.
Annual Infection and Mortality Statistics
According to the medical Merck Manuals textbook, there are approximately 450,000 Shigella cases and 38 deaths each year in the United States. The majority of individuals recover by consuming water and electrolyte-rich drinks like Pedialyte, as recommended by the Mayo Clinic. However, serious infections, which can persist for months, often require antibiotics to reduce symptom severity and duration.
Challenges with Drug-Resistant Strains
This presents a significant problem for the 242,000 people annually who contract drug-resistant strains of Shigella, based on CDC data. Treatment options for these resistant strains are limited to just a few drugs, such as ceftriaxone and pivmecillinam. The new federal report also highlights increased transmission of an "excessively drug-resistant" strain over the past decade, for which there is no government-approved oral antibiotic. It remains unclear how many of the annual drug-resistant infections are attributed to this excessive strain.
"The high transmission potential of XDR Shigella strains underscores the importance of susceptibility testing and timely reporting of this nationally notifiable disease for prevention," the doctors emphasized in their report.
High-Risk Groups and Transmission Methods
Shigella spreads primarily through person-to-person contact by touching or swallowing items contaminated with the bacteria. Exposure can occur when individuals touch their mouths or consume tainted food or drinks. The bacteria also spreads during sexual contact involving the anus, placing men who have sex with men at elevated risk. Additionally, people who are homeless and have limited access to clean water and toilets face higher susceptibility.
Preventive Measures Recommended
To stay safe, the clinic advises maintaining awareness and taking proactive steps to prevent infections. Key preventive measures include washing hands with soap and water for at least 20 seconds before eating, engaging in sexual activity, or changing a diaper. It is also recommended to avoid sexual contact for at least two weeks with anyone experiencing diarrhea or who has recently recovered from it. These simple actions can significantly reduce the risk of contracting this dangerous bacterial disease.
