CDC Warns Of Drug Resistant Stomach Bug: 1 Case Reported In Wisconsin

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

In Wisconsin, one XDR Shigella infection has been detected, according to a statement from Department of Health Services Communications Staff Jennifer Miller. The CDC defined the XDR bacteria as strains resistant to all commonly recommended antibiotic therapies. When people contract shigellosis, they usually get better without antibiotic treatment within 5-7 days, Miller said; Mild cases may only need fluids and rest.

In 2022, about 5 percent of infections were caused by the more drug-resistant strain, compared to zero percent in 2015, the CDC said in a public health alert.

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, which officials advise refraining from if you have diarrhea; 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.

"Contact your healthcare provider if you or one of your family members has bloody or prolonged diarrhea (diarrhea lasting more than 3 days) or severe stomach cramping or tenderness, especially if you also have a fever or feel very sick," Miller said. "Tell your healthcare provider if you have other medical conditions or a weakened immune system—for example, because of an HIV infection or chemotherapy treatment. If your healthcare provider prescribes an antibiotic, take it exactly as directed and finish taking all the pills even if you feel better."

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.

Here are some more tips from the Wisconsin DHS to avoid contracting shigella:

• Carefully wash your hands with soap and water during key times:
  • Before any sexual activity.
  • Before preparing food or eating.
  • After going to the bathroom, changing a diaper, or cleaning up after someone who went to the bathroom.
• Take care when changing diapers.
  • As soon as you change a diaper, throw it away in a covered, lined garbage can.
  • Clean up any leaks or spills from the diaper right away. Wash your hands and the child’s hands with soap and water right away.
• Avoid swallowing water from ponds, lakes, or swimming pools.
• When traveling internationally, follow safe food and water habits and wash hands often with soap and water.