Stomach Bug That's 'Extensively Drug Resistant' Hits IL, CDC Issues Warning

ILLINOIS — Public health officials are monitoring a rise in extensively drug-resistant Shigella infections that can cause severe bouts of inflammatory diarrhea. The bacteria is easily spread, and the Centers for Disease Control and Prevention is asking healthcare providers in Illinois and others to report cases to local or state health departments.

The stomach bug, which causes the diarrheal condition known as shigellosis, poses a “serious public health threat,” the CDC said in a public health alert.

In 2022, about 5 percent of infections were caused by the more drug-resistant strain, compared to 0 percent in 2015, the agency said. According to the Illinois Department of Public Health, about 18,000 laboratory-confirmed cases of shigellosis are reported in the United States each year, including 1,300 in Illinois.

But health officials warn that because many milder cases are not diagnosed or reported, the actual number of infections may be 20 times greater. Shigellosis is particularly common and causes recurrent problems in settings where hygiene is poor and can sometimes sweep through entire communities.

Shigellosis is more common in summer than winter. Children, especially toddlers from 2 to 4 years of age, are the most likely to get shigellosis, state health officials said.

An IDPH spokesman told Patch on Wednesday that the department sent the CDC's warning out to its statewide list of healthcare facilities on Friday advising that they report any suspected cases or reportable diseases to their respective county health departments.

The spokesman did not immediately respond to a question about how much the department monitors cases of shigella or how they will be tracked now that the CDC has issued the warning.

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.