The County Health and Human Services Agency (HHSA) recently issued a health advisory on shigellosis indicating that men who have sex with men (MSM) are at increased risk for this disease.

Shigellosis is an infection caused by the Shigella species of bacteria usually resulting in a diarrheal illness lasting 5 to 7 days.  In 2016, 232 cases of shigellosis were reported in San Diego County, a 26 percent increase compared to 2015, and a larger proportion of cases (66 percent) were among men, many self-identified as MSM.

An uncommon type of drug-resistant Shigella caused an outbreak in Southern California counties in 2016.  Of the 34 cases in the outbreak, three were reported in San Diego.  Thirteen patients were hospitalized and one died.  All cases were among men, and most self-identified as MSM.

Shigella is very contagious and infection can occur with person-to-person contact, eating food contaminated by someone who has shigellosis, or swallowing recreational or drinking water that was contaminated by the bacteria.  Shigellosis can be prevented by frequent and thorough hand washing, disinfecting any areas that may be contaminated such as restrooms or diaper changing areas, avoiding swallowing water from untreated pools and ponds, and not preparing or serving food to others when having diarrhea.

HHSA recommends that MSM should:

• Be aware of their HIV status
• Be aware of the local increase in shigellosis, which can be a severe illness, particularly in those with reduced immunity

Seek care for diarrheal illness, especially with fever or bloody diarrhea, and be sure that their provider tests to see if symptoms could be caused by Shigella

• Discuss antibiotic treatment for shigellosis with their providers to shorten duration of illness and reduce the risk of infecting others
• Abstain from sex for at least two weeks after shigellosis to prevent spreading the illness to others

More information about shigellosis can be found at the Centers for Disease Control and Prevention website on Shigella.  A fact sheet for MSM on shigellosis can be found here and information about HIV testing can be found at the County Hepatitis, STD, HIV Program website.