CDC on Friday issued a public health advisory warning of a surge in serious gastrointestinal infections caused by Shigella bacteria that are highly resistant to antibiotics and pose a "serious public health threat."

CDC warns of increase in drug-resistant Shigella infections

Shigella is a bacteria that causes an estimated 450,000 infections in the United States every year. Shigella infections, known as shigellosis, typically cause diarrhea, fever, and abdominal cramps.

Shigella can spread quickly through direct person-to-person contact, including through sexual contact. It can also spread through contaminated food and water, and infected people can spread the bacteria to others for weeks after their symptoms subside.

According to Janet Hill, COO of the Rock Island County Health Department, shigellosis typically lasts between five to seven days.

"It must be confirmed by a lab test and it is a nationally notifiable disease so that's why the CDC is sounding the alarms because there are increased cases throughout the country," Hill said.

According to CDC, 5% of all Shigella infections were drug-resistant in 2022, up from 0% in 2015 and 1% in 2019. These strains are resistant to five antibiotics recommended to fight shigellosis, including azithromycin, ciprofloxacin, and ceftriaxone.

"Most cases [of shigellosis] do not require antibiotics to be treated, usually it's just waiting it out and it could be five to seven days of pretty miserable conditions," Hill said. "This particular strain is showing some antibiotic resistance, which is just another reminder that when you are prescribed an antibiotic, it's really important to take it as directed for the full time that your medical provider has said."

Drug-resistant Shigella infections "are challenging to treat and easily transmissible, especially among vulnerable populations," said Naeemah Logan, a medical officer at CDC. These infections "are a serious public health threat, and we want to ensure that providers are aware of the increasing potential for antibiotics to fail."

Shigellosis typically affects children under the age of four the most, but CDC said it's seen a recent increase in drug-resistant shigellosis among adults, including men who have sex with men, international travelers, people with HIV, and people experiencing homelessness.

Drug-resistant shigellosis has been reported in 29 states, but most have been reported in California, Colorado, and Massachusetts, according to CDC.

"We typically see Shigella cases peak in the summer months and decline in the fall and winter. However, Shigella activity increased in Fall 2022, and we are now seeing some antibiotic-resistant cases, which are confirmed via antibiotic susceptibility testing," said Brian Spencer, a spokesperson for Colorado's Department of Public Health and Environment.

Spencer added that cases have slowed down, but authorities expect cases could increase in the coming months.

While CDC said it doesn't have recommendations for treating drug-resistant Shigella, the agency recommends washing your hands with soap and water, especially before sexual activity, preparing food or eating, and after going to the bathroom, changing a diaper, or cleaning up after someone who went to the bathroom.

"If you diarrhea lasts longer than usual or if it's bloody or accompanied with severe stomach cramping, get to the doctor to determine whether it's a run-of-the-mill norovirus or if it's shigellosis," Hill said. (Sun, Washington Post, 2/25; Noone, The Hill, 2/28; Tin, CBS News, 2/27)