What is Shigella?

In recent years, the rise of antibiotic-resistant bacteria has become a global health concern, posing a significant threat to public health. One such pathogen that has garnered attention is Shigella, a bacterium responsible for causing shigellosis – a diarrhoeal disease affecting millions worldwide.

Shigellosis is highly contagious and is mainly transmitted through the faecal-oral route, often resulting from contaminated food, water, or contact with infected individuals – including during sexual contact, especially oral sex and oro-anal sex. 

Common Shigellosis symptoms include acute onset of diarrhoea (which may be watery or contain traces of pus, mucous or blood), fever, nausea, vomiting and abdominal cramps. In severe cases, the infection can lead to dehydration, which may require medical attention. The symptoms usually appear one to two days after exposure and can persist for up to a week.

Even though Shigella can affect anyone, certain populations are at a higher risk of severe complications. Children under the age of five, the elderly, and individuals with weakened immune systems, including some people living with HIV (PLHIV), are particularly vulnerable.

Shigella has long been a cause of concern due to its ability to rapidly develop resistance to commonly used antibiotics. Over time, the misuse and overuse of these drugs have allowed the bacteria to evolve and develop mechanisms to withstand the very medications designed to treat them. This antibiotic resistance not only complicates the management of Shigella infections but also increases the risk of severe and prolonged illnesses.

The treatment of shigellosis typically involves the use of antibiotics to alleviate symptoms and prevent complications. However, with the rise of antibiotic-resistant strains, healthcare providers may find themselves limited in their treatment options. This scenario not only extends the duration and severity of the illness but also increases the risk of complications such as dehydration, which can be particularly dangerous for individuals with compromised immune systems.

Preventive Measures:

  • Practicing safer sex (e.g. using barrier protection) and good hygiene can prevent the spread of shigellosis.
  • Wash your hands often and thoroughly, especially after using the toilet and before eating or preparing food.
  • Wash your hands before and after sex and after handling used condoms or sex toys.
  • If you have gastrointestinal symptoms, avoid having sex, preparing food or drink for others, or providing personal care for others until 48 hours after symptoms resolve.
  • Men who have sexual contact with other men and returned overseas travellers should be aware of the symptoms of shigellosis and seek medical care if symptoms develop. Shigellosis can be diagnosed with a stool sample.
  • People who have been diagnosed with shigellosis should abstain from sex while symptomatic and for one week after symptoms completely resolve. For a further two weeks after symptoms resolve:
    • Use barrier protection (such as condoms and dams) during sex
    • Limit sexual activities with faecal-oral exposure, such as rimming, which may significantly increase the risk of spreading infection
    • Shower and wash hands before and after sex
  • People who work as food handlers, childcare workers, healthcare workers, and people who work in a residential facility such as aged care facilities, disability group homes, prisons, and other residential facilities, should not return to work until advised by their Local Public Health Unit.
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