Federal health authorities are sounding the alarm over a lesser-known sexually transmitted infection that is spreading across the United States and becoming increasingly difficult to treat. The Centers for Disease Control and Prevention (CDC) has documented a sharp rise in cases of shigellosis caused by extensively drug-resistant strains of the Shigella bacteria, which are now resistant to five common antibiotics.
While shigellosis has traditionally been associated with contaminated food or water, the current outbreak is notable for its transmission through sexual contact, particularly among men who have sex with men. This shift has transformed a familiar gastrointestinal illness into a complex sexual health challenge, prompting urgent public health guidance.
Rising resistance, limited options
According to a CDC analysis published in the Morbidity and Mortality Weekly Report, the proportion of extensively drug-resistant Shigella samples jumped from 0% in 2011 to 8.5% by 2023. The analysis, which examined over 16,800 samples, identified 510 extensively drug-resistant cases. These strains neutralize five of the most common treatments: ampicillin, azithromycin, ceftriaxone, ciprofloxacin, and trimethoprim-sulfamethoxazole.
The lack of effective oral antibiotics is a major concern. The Food and Drug Administration (FDA) has approved few oral options for these resistant strains, leaving physicians with limited choices. In severe cases, patients may require intravenous antibiotics and hospitalization. The CDC reports that 37.6% of patients with extensively drug-resistant shigellosis needed hospital care.
Dr. Rick Pescatore, an emergency physician and public health advocate, has been vocal about the severity of the situation. In a recent social media post, he emphasized that this is not just a stomach bug—it's a growing public health threat that demands attention.
Transmission and symptoms
Shigella is highly contagious, and even a tiny amount of fecal matter can cause infection. The bacteria can be passed through oral-anal contact, and the CDC notes that sexual practices involving the mouth or anus can spread the infection. Symptoms typically include diarrhea (often bloody), fever, and abdominal pain, appearing one to two days after exposure.
While many people recover without antibiotics, those with severe symptoms—such as high fever, bloody stools, or signs of dehydration—should seek medical care immediately. Self-medication is strongly discouraged, as inappropriate antibiotic use can worsen resistance.
Prevention and community action
Public health officials are emphasizing prevention. The California Department of Public Health advises avoiding sexual contact with anyone who has had diarrhea in the past two weeks, and using barrier protection during intimate contact. Frequent handwashing, especially after using the bathroom, is also critical.
For the Latino community, which often faces barriers to healthcare access, these warnings are particularly relevant. Many Latinos in the US may be uninsured or underinsured, making it harder to seek timely testing and treatment. Community health centers and clinics are working to raise awareness, but the message is clear: prevention is the best defense.
As the outbreak continues, researchers are calling for investment in new antibiotics and rapid diagnostic tests. The CDC is monitoring the situation closely, and health officials urge anyone with symptoms to get tested promptly. For more on related health alerts, see our coverage of the FDA's salmonella investigation.
In the meantime, staying informed and practicing good hygiene are the most effective tools we have. This is not just a medical issue—it's a community health issue that requires collective action.
