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CDPH Reports Cluster of Shigella Infections Among Men Who Have Sex with Men 

Date: 8/29/2016 
Number: 16-055 
Contact: Ali Bay, (916) 440-7259 

SACRAMENTO –  The California Department of Public Health (CDPH), in collaboration with the Los Angeles County Department of Public Health and several Southern California local public health agencies, are investigating a cluster of Shigella infections predominantly affecting men who have sex with men (MSM). As of Aug. 25, 2016, 14 patients infected with an uncommon strain of Shigella have been identified. All patients are adult men. Illnesses have occurred since May 2016, with five individuals requiring hospitalization.
Shigella is a type of bacteria that causes shigellosis, a diarrheal disease. Symptoms of shigellosis include diarrhea which can be bloody, fever and abdominal pain. Occasionally, the infection can spread to the bloodstream and be life-threatening. Illnesses can be especially severe in those with weakened immune systems, such as those living with HIV infection.

“It is important that men who have sex with men consult their health care provider if they have diarrhea, especially if it is bloody, to determine if they are suffering from an infection or other illness,” said Dr. Karen Smith, CDPH director and state public health officer. “Your provider can order tests to obtain an accurate diagnosis and prescribe the appropriate antibiotic treatment if needed.” 

Shigella transmission can occur through person-to-person contact, eating food contaminated by someone who has shigellosis, or swallowing contaminated recreational (e.g., lake or river) or drinking water. Transmission of Shigella among MSM is often through sex, typically through oral or anal contact.

MSM are more likely to develop shigellosis than the general adult population. Shigellosis outbreaks among MSM have been reported in California and other states, as well as internationally. There are currently strains of Shigella that are highly resistant to antibiotics that appear to be circulating among MSM in California and nationwide.

CDPH advises health care providers to be on alert for MSM presenting with symptoms consistent with shigellosis to consider it as a potential cause of diarrheal disease. Stool culture with antimicrobial susceptibility testing is important to make sure that if a patient is treated with an antibiotic, it is an appropriate one.

For people diagnosed with shigellosis, CDPH recommends the following:

  • Wash hands thoroughly with soap and water after using the bathroom.
  • Do not prepare food for others while you are sick. After you get better, wash your hands with soap and water before preparing food for others.
  • Avoid sex until two weeks after recovery. When having sex again, wash your body and hands before and after sex. Use barriers to reduce exposure during sex.
  • Avoid swimming pools and spas while ill. 
To reduce the risk of shigellosis in general:

  • Wash your hands with soap and water before eating, after changing a diaper and after using the bathroom.
  • Avoid sex with a person who has diarrhea or who has recently recovered from diarrhea.
  • Use condoms and other barriers during sex.
  • Wash your genitals, anus and hands before and after sexual activity.
  • Avoid swallowing recreational (e.g., lake or river) water.
Additional information about shigellosis among MSM is at:
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