You might have seen shigella mentioned in the news recently. The UK Health Security Agency (UKHSA) has announced a rise in the number of cases of an extremely drug-resistant strain of shigella The UKHSA has reported that in the last 4 months (September 2021- January 2022) there have been 47 cases, compared to 16 cases in the previous 17 month period. The recent strain is increasingly resistant to antibiotics.

About shigella

Shigella is a sexually transmitted infection (STI) that is caused by bacteria found in poo. It affects your gut and can cause:

  • severe diarrhoea, which can have blood or mucus in it

  • nausea

  • stomach cramps

  • pain in your tummy (abdomen)

  • a high temperature (fever)

Only a tiny amount of bacteria is needed to spread the infection. And someone can carry the infection even if they don’t have any symptoms. So people might not know that they have it.

How is shigella spread?

You can catch shigella by getting the bacteria in your mouth. This means any sex involving rimming, anal sex, fingering, fisting or sharing sex toys can be a risk. It can also be spread when people do not wash their hands well.

What are the symptoms of shigella?

Symptoms usually start 1-4 days after you’ve had contact with the infection. It can feel like food poisoning. You might experience diarrhoea, a high temperature and feel sick, or be sick (vomiting).

Most people do get better without treatment. And symptoms usually only last a week.

But in some cases, people get very unwell and need to go to a hospital. This is because the severe diarrhoea and sickness make them dangerously dehydrated. Treatment in a hospital might need intravenous antibiotics.

How do you treat it?

If you have shigella it’s important to stay hydrated: drink plenty of fluids and take rehydration salts or sports drinks. And get plenty of rest.

Paracetamol can help with fever and pain. Avoid diarrhoea medications as this can make it worse.

Do not have any sex until 7 days after your symptoms have ended. This makes sure you won’t pass on the infection.

Some cases of shigella will need treatment with antibiotics. Your GP or local sexual health clinic can prescribe you a short course of antibiotics to clear the infection.

The recent strain of shigella is extremely antibiotic-resistant. This means that the antibiotic usually used to treat it is not effective at clearing the infection. So your treatment options might be limited. If you do have the resistant strain, you might be asked for a stool sample so that you get the right treatment.

The group most at risk of catching shigella are men who have sex with other men. Do not dismiss your symptoms, especially if you have recently had anal sex or any anal play. Make sure to talk to your GP or local sexual health clinic and tell them you may have shigella.

What can I do to reduce the risk?

Practice good hygiene during and after sex:

  • wash your hands, genitals and bottom with soap after any sexual activity

  • don’t have oral sex straight after anal sex

  • change condoms between oral and anal sex

If you have shigella, remember it’s not only spread through sex. To avoid passing it on, make sure you do not share towels or face cloths with anyone you live with. And wash your laundry at a high temperature.

Wash your hands with soap and water throughout the day, after using the toilet and before touching food. Avoid contact with babies or elderly people and make sure you wash your hands well if you cannot avoid contact.

Do not use saunas, spas, swimming pools, jacuzzis or hot tubs until 7 days after your symptoms have gone away.

If you think you have shigella: speak to your GP, your local sexual health clinic or call NHS 101 for advice.

If you've been exposed to shigella this means you have also been exposed to other STIs. it is important you do a sexual health screen: you can order an online test or speak to your local sexual health clinic.

Further information:

Written by Helen Burkitt. Senior Sexual Health and Contraception Nurse
Last updated at: 22 June 2023