Health officials issue warning over an 'extremely antibiotic-resistant' bug mainly affecting gay men

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Health officials issue warning over an ‘extremely antibiotic-resistant’ strain of shigella that is mainly affecting gay and bisexual men

  • Gay and bisexual men warned about infectious sexually transmitted infection
  • Just 16 cases spotted over 17 months in UK but 47 detected in last four months
  • Health chiefs worried about treatment-resistant strain and spread in community


Gay and bisexual men were today warned about the rapid spread of a superbug that is being spread through sex.

UK Health Security Agency (UKHSA) bosses have spotted a huge spike in cases of an ‘extremely’ antibiotic-resistant version of shigella sonnei. 

The gut infection can cause diarrhoea, stomach cramps and a fever. Some patients will need to be hospitalised. 

Forty-seven cases of the infection were reported in the four months from September to December. For comparison, just 16 were logged over the previous 17 months, from April 2020 to August 2021. 

Shigella is endemic in England, and triggers thousands of infections each year. 

Health chiefs have been tracking the particular strain that has prompted the warning since 2018.

Effective treatment options are ‘limited’ for the strain, the UKHSA warned today.

The UK Health Security Agency (UKHSA) said there has been an increase in cases of Shigella sonnei, a gut infection that causes diarrhoea, stomach cramps and a fever. Pictured: Enterobacteriaceae bacteria, which Shigella is a species of

The UK Health Security Agency (UKHSA) said there has been an increase in cases of Shigella sonnei, a gut infection that causes diarrhoea, stomach cramps and a fever. Pictured: Enterobacteriaceae bacteria, which Shigella is a species of

What is Shigella? 

Shigella is a gut infection that causes severe diarrhoea and stomach cramps.

Among gay and bisexual men it’s thought to be spread primarily through the faecal-oral route during sex, either directly or via unwashed hands as only a tiny amount of bacteria is needed to spread the infection.

People can get Shigella by licking skin, condoms, or toys which have faeces on them, even when this is not visible.

Symptoms often develop around one to three days after sex and include frequent diarrhoea (sometimes containing blood), stomach cramps, feeling feverish and some people report vomiting.

Men experiencing these symptoms should be advised to visit their doctor or a sexual health clinic to get tested.

To lower the risk gay and bisexual men are advised to: 

  • wash their hands after sex (and buttocks and penis too if they can, by showering), especially if they’re fingering or handling used condoms, wash sex toys or douching equipment
  • change condoms between anal and oral sex
  • use a barrier for rimming (such as a square of latex) 
  • use latex gloves for fingering or fisting

Source: UKHSA

It has become resistant to quinolones and azithromycin, two of the most common types of antibiotics once used to kill it off. 

The infection is caused by bacteria found in faeces, which is usually spread through sex involving anal contact.

It can also be transmitted through unwashed hands, if infected people contaminate surfaces for others to touch. 

Dr Gauri Godbole, consultant medical microbiologist at UKHSA, added: ‘Practising good hygiene after sex is really important to keep you and your partners safe. 

‘Avoid oral sex immediately after anal sex, and change condoms between anal or oral sex and wash your hands with soap after sexual contact. 

‘It’s important gay, bisexual and other men who have sex with men don’t dismiss their symptoms and speak to their GP or sexual health clinic, mentioning shigella, if they are unwell.’

He advised men with shigella to get tested for other STIs, including HIV, as they may have been exposed to other infections. 

Infected people should stay hydrated, rest and not have sex until a week after their last symptoms, Dr Godbole said.

They should also avoid all spas, swimming, hot tubs and sharing towels, and avoid preparing food for other people until a week after symptoms stop. 

Three of the cases had recently travelled to the UK from Spain or Turkey. 

Buit is not just men who have sex with men that officials are worried about in regards to the spread of the Shigella strain.  

In a briefing note in December, the UKHSA also warned about spillover of the virus in food handlers and carers, who have triggered outbreaks across the globe by continuing to work when unwell.

Symptoms usually start within four days of being exposed to the infection, and its symptoms can be mistaken for food poisoning.

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