Shigella In CA: State Monitoring Drug-Resistant Stomach Infection

CALIFORNIA — Public health officials in California are monitoring the spread of an antibiotic-resistant "Superbug" that can cause severe bouts of diarrhea.

The stomach bug, which causes the diarrheal condition known as shigellosis, poses a “serious public health threat,” the Centers for Disease Control and Prevention said in a public health alert.

This week, the CDC warned health officials of a rise in extensively drug-resistant Shigella infections that can cause severe bouts with inflammatory diarrhea. The bacteria is easily spread, and federal health officials are asking healthcare providers in California to report cases to local or state health departments.

In an average year, California reports about 2,500 cases of Shigella infections, according to a report by the California Department of Public Health. However, officials are seeing a rise in strains resistant to antibiotic treatment over the last couple years.

Drug-resistant infections have been reported in more than half of all states with the most cases in California — 76, so far, according to the CDC.

Of 237 patients with resistant infections, The CDC found that most occurred during the pandemic between 2020 and 2022, The Washington Post reported.

In 2022, about 5 percent of infections were caused by the more drug-resistant strain, compared to 0 percent in 2015, the agency said.

Historically in the United States, the illness has predominantly affected children ages 1-4, but the CDC said it has observed an increase in cases of antimicrobial-resistant Shigella among adults, especially gay and bisexual men who have sex with other men, but also among people experiencing homelessness, international travelers and people living with HIV.

Shigella spreads when infected fecal matter enters the mouth or the nose, according to the CDC. That can happen during sexual activity, but also because of poor hand-washing after diaper changes, unsanitary food handling or swimming in contaminated water.

Symptoms — diarrhea, sometimes with blood in it, along with severe stomach cramps and fever — are typically seen within one to four days of exposure. Symptoms are unpleasant, but usually subside within a week. The symptoms are sometimes confused with those of food poisoning.

About 6,400 U.S. patients require hospitalization for Shigella every year, according to the CDC. Death is rare, but people who are immunocompromised, including those with untreated HIV or people undergoing chemotherapy for cancer, are more susceptible.

On Tuesday, the CDC held an emergency call with the Colorado Department of Public Health and Environment and the U.K. Health Security Agency to alert doctors that the new form of the bacterium doesn’t respond to usual antibiotic treatments.

“We do not have all the answers today,” Dr. Louise Francois Watkins, a medical officer at the CDC’s National Center for Emerging and Zoonotic Infectious Diseases, said on the call, adding she is unable to recommend a specific treatment.

In January, the U.K. Health Security Agency said an outbreak of nearly 200 cases of drug-resistant Shigella likely stemmed from a single infection, which health officials said illustrates how quickly infections can spread and the importance of infection control.

The European Centre for Disease Prevention and Control also issued a Shigella alert Friday that said about 221 cases of the illness and 37 suspected cases in 10 countries in Europe, the United States and the United Kingdom had been linked to travel in Cabo Verde, West Africa.

The source of the common infection has not yet been identified given the multiple ways it could have been spread, the European health agency said.