CDC Warns Of ‘Extensively-Drug Resistant’ Stomach Bug: What To Know In Rhode Island

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

The Rhode Island Department of Health (RIDOH) reported seven cases of the drug-resistant Shigella infection in the Ocean State, as of Thursday.

"This is a public health concern because drug-resistant shigella infections may be harder to treat, and they may last longer, increasing the chance that shigella may spread to other people," a RIDOH spokesperson said.

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.

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.

The Rhode Island Department of Health said residents can take the following steps to prevent infection: