California Monitors Drug-Resistant Stomach Infection Shigella

Public health officials in California are closely monitoring the spread of a superbug that is resistant to antibiotics and can cause severe diarrhea. The Centers for Disease Control and Prevention (CDC) has issued a public health alert warning that the bacteria responsible for shigellosis, a diarrheal condition, is posing a serious threat to public health. The CDC has reported a rise in extensively drug-resistant Shigella infections, which can cause severe bouts of inflammatory diarrhea. This is an easily spread bacteria, and federal health officials are urging healthcare providers in California to report cases to local or state health departments.

According to a report by the California Department of Public Health, in an average year, California sees around 2,500 cases of Shigella infections. However, officials have seen a rise in strains resistant to antibiotic treatment over the last few years. The CDC has reported that drug-resistant infections have been reported in more than half of all states, with the most cases in California, at 76 so far.

The CDC found that most of the 237 patients with resistant infections occurred during the pandemic between 2020 and 2022, with The Washington Post reporting an increase in the more drug-resistant strain from 0 percent in 2015 to about 5 percent in 2022.

The illness has traditionally affected children ages 1-4 in the United States, but the CDC has observed an increase in cases of antimicrobial-resistant Shigella among adults, especially gay and bisexual men who have sex with other men, people experiencing homelessness, international travelers, and people living with HIV.

The bacteria responsible for Shigella spreads when infected fecal matter enters the mouth or the nose, typically through sexual activity, poor hand-washing after diaper changes, unsanitary food handling, or swimming in contaminated water. Symptoms, including diarrhea, sometimes with blood in it, along with severe stomach cramps and fever, are typically seen within one to four days of exposure. While unpleasant, symptoms usually subside within a week, and they are sometimes confused with those of food poisoning.

The CDC has stated that approximately 6,400 U.S. patients require hospitalization for Shigella every year, and death is rare. People who are immunocompromised, including those with untreated HIV or people undergoing chemotherapy for cancer, are more susceptible.

The CDC recently held an emergency call with the Colorado Department of Public Health and Environment and the U.K. Health Security Agency to alert doctors that the new form of the bacterium does not respond to usual antibiotic treatments. Dr. Louise Francois Watkins, a medical officer at the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, said on the call that she is unable to recommend a specific treatment.

The European Centre for Disease Prevention and Control has also issued a Shigella alert, stating that about 221 cases of the illness and 37 suspected cases in ten countries in Europe, the United States, and the United Kingdom have been linked to travel in Cabo Verde, West Africa. The source of the common infection has not yet been identified, given the multiple ways it could have been spread, according to the European health agency.