U.S. cases of drug-resistant Shigella infections are increasing, with no Food & Drug Administration (FDA) approved oral treatment available, according to a new report from the Centers for Disease Control & Prevention (CDC).
In a study published April 9 in the CDC’s Morbidity and Mortality Weekly Report, health officials described the rise of Shigella cases as “a public health threat,” which can cause diarrhea, fever and more.
According to the latest data, of the 17,000 samples tested, the amount found to have drug-resistant Shigella bacteria increased from 0 percent in 2011 to 8.5 percent in 2023.
“Whereas earlier U.S. outbreaks involved drug-susceptible strains and primarily affected children, national surveillance data indicate that most XDR [drug-resistant] cases occurred among adult men,” the study said. “Approximately one-third of patients were hospitalized.”
Shigella infection can be spread through fecal-oral transmission, sexual contact, or through contaminated food, water, or fomites, according to the CDC.
While most infections resolve themselves without needing treatment, researchers said antibiotics are used for severe illness or to reduce transmission in high-risk settings.
What To Know In CA:
California typically sees around 2,500 cases of Shigella infections annually, as reported by the California Department of Public Health. However, officials have noted an increase in antibiotic-resistant strains over the past few years.
Historically, the illness in the U.S. primarily affected children aged 1–4, but the CDC has recently observed a rise in antimicrobial-resistant Shigella cases among adults.
Infections with extensively drug-resistant (XDR) Shigella have been rising across California for several years, with a notable spike in cases in 2024 to date, according to the California Department of Public Health.
In 2025, Los Angeles County reported a surge in extensively drug-resistant shigellosis. They identified 68 cases in 2024, up from 45 in 2023 and five in 2021. The first case in LAC was reported in 2017.
Over the first five months of 2024, 12 percent of the Shigella samples sequenced in California were the XDR type. This was even more noticeable among young men, specifically those aged 25–34, where 21 percent of the isolates were identified as XDR, and especially gay and bisexual men who have sex with other men, but also among people experiencing homelessness, international travelers and people living with HIV.
The California Department of Public Health states that a Shigella infection can cause symptoms such as diarrhea (sometimes bloody), fever, nausea, vomiting, stomach cramps, and tenesmus (the painful, often ineffective urge to pass stool).
To protect against Shigellosis, the illness caused by Shigella bacteria, the California Department of Public Health suggests the following preventative measures:
For more information, you can visit the CA Department of Health website.
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