Due to recent developments, Man2Man has launched a campaign to create awareness around Shigella.

What is Shigella?

Shigella is a bacterial gut infection that can cause severe stomach upset. It is passed on through infected faeces (poo). This can happen through contaminated food or sexual activity. Only a very small amount of the bacteria is needed to cause infection. Sex that may involve contact with faeces is a risk, e.g. anal sex, fisting, fingering, rimming, oral sex, handling a condom or sex toy used for anal sex. Shigella can also be passed on via unwashed hands.

The European Centre of Disease Control (ECDC) recently reported on drug-resistant Shigella sonnei across Europe and Ireland amongst gbMSM. Following guidance from the HSE, Man2Man.ie is subsequently launching a campaign to raise awareness around Shigella with information on symptoms, treatment and steps you can take to protect yourself and your partners.

Across Europe, including Ireland, there are recent reports of extensively drug-resistant Shigella among gbMSM.

To find out more about Shigella and how to protect yourself and your partners visit: https://t.co/cUnISD9moN #shigella #SexualHealth pic.twitter.com/CMParfItdf

— Man2Man Programme (@Man2ManIreland) March 31, 2022

Shigella Symptoms

Symptoms usually develop between 1 and 3 days after (sexual) contact.

Common symptoms are:

• Frequent and explosive diarrhoea
• Stomach cramps
• Feeling feverish with flu-like symptoms
• Some people report vomiting
• Some people may have blood mixed with diarrhoea

What do I do if I think I have Shigella?

If you suspect you have Shigella, you should contact your healthcare provider who can organise a test. Shigella is usually diagnosed by sending a stool (poo) sample to the laboratory for testing. If you picked up Shigella sexually, testing for other STIs is recommended.

Diarrhoea caused by Shigella usually goes away within 5 to 7 days. People with mild infections will generally get better with fluids and rest. People with underlying medical conditions that weaken the immune system may be at risk of more severe illness.

Antibiotics are used to treat the infection in more severe cases and in those with underlying conditions that weaken the immune system. Antibiotics can help reduce the spread of Shigella to someone else. Recent reports from ECDC have identified strains of Shigella that are resistant to many antibiotics.

The advice continues:

If you have diarrhoea, stomach cramps or fever, avoid sex with another person until you get the all-clear.

Do not share towels; do not use health spas, jacuzzis, hot tubs or swimming pools.

If you work in the food industry, healthcare or childcare settings, stay out of work while you have symptoms. Public Health personnel will be in touch with you and you will be advised when you can return to work.

In Ireland, Shigella is a notifiable infection. This means that all cases diagnosed are notified to Public Health so that all steps necessary are taken to protect the health and wellbeing of those affected or at risk. The bacteria from cases of Shigella infection are sent to a national reference laboratory and are fully DNA sequenced to identify evidence of spread and to track antibiotic resistance.

Professor Fiona Lyons, Medical Director of the HSE Sexual Health & Crisis Pregnancy Programme said: “The recent reports of extensively drug-resistant Shigella sonnei infections in gbMSM are of concern. I encourage those who may be at risk to reduce their risk by adopting hygiene measures that can reduce the risk of infection and being vigilant to symptoms that may be Shigella.”

Reduce the Risk

You can lower your risk of getting Shigella during sex by adopting the following hygiene measures:

• Washing of hands, genital and anal areas before and after sex
• Using latex gloves for fingering or fisting and dental dams during oral-anal sex
• Not sharing sex toys and ensuring proper cleaning and disinfection after their use and between partners
• Changing condoms between anal and oral sex

Man2Man, a joint GHN & HSE initiative, is the national HIV Prevention & Sexual Health Awareness programme targeting men who have sex with men (gbMSM) in Ireland. For more information on Shigella visit Man2Man webpage here.