CDC warns about bacterial infection rising among gay & bi men

CDC warns about bacterial infection rising among gay & bi men

The Centers for Disease Control (CDC) has issued a warning to healthcare providers about a rise in antibiotic-resistant shigellosis, a condition overrepresented among gay, bisexual, and other men who have sex with men (MSM) as well as people living with HIV.

The bacterial infection shigellosis (pr. shig-uh-LO-sis) affects the digestive tract and usually causes inflammatory diarrhea that can be bloody. The infection may also lead to fever, abdominal cramping, and tenesmus, a continual or recurrent urge to evacuate the bowels. Infections are generally self-limiting, which means that patients will usually recover without taking any form of medicine.

According to the CDC, Shigella bacteria are transmitted by the fecal-oral route, directly through person-to-person contact, including sexual contact, and indirectly through contaminated food, water, and other ingested materials. The bacteria are easily transmitted, even in low-infectious amounts. Outbreaks tend to occur among people in close-contact settings.

The agency says that in 2015, all cases of shigellosis reported in the U.S. responded well to antibiotic treatment. As of 2022, however, about 5 percent of shigella infections did not respond to traditional therapies.

Historically, shigellosis has affected children in the U.S., but the CDC has seen a rise in cases in recent years among gay, bisexual, and other MSM populations. The bacteria are easily passed on during sex, particularly during rimming, and other sexual contacts that may result in fecal-oral contact.

Shigella normally passes through the body’s digestive system, with or without treatment, in a matter of days. Sexually active individuals are advised to refrain from sexual activity for at least two weeks after symptoms end, and should take extra care washing their hands while avoiding other potentially transmissible activities, like preparing food for others.

While infected patients don’t always require treatment, effective medication helps shorten the illness’s duration. Those living with HIV, in particular, benefit from antibiotic treatment.

The CDC warning indicated that in the years 2015 to 2022, patients with antibiotic-resistant Shigella totaled 232. Of those, 82 percent were men, 13 percent were women, and 5 percent were children. Among 41 patients who answered questions about recent sexual activity, 88 percent reported male-to-male sexual contact.

The CDC advised healthcare providers to share the following guidelines for patients with suspected shigellosis, during diarrhea and for two weeks after it ends:

  • Stay home from school or from healthcare, food service, or childcare jobs while sick.
  • 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.
  • Do not prepare food for others, if possible.
  • Stay out of recreational water, including swimming pools, hot tubs, water playgrounds, oceans, lakes, and rivers.

Two weeks after symptoms end:

  • 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.

If you experience a bad bout of diarrhea in the days following a sexual encounter, consider getting tested for Shigella.

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