Shigella: the sexually transmitted diarrhoea that is becoming resistant
Definition : Shigellosis is an intestinal infection caused by Shigella bacteria, passed on through invisible traces of faeces, notably during rimming; it circulates among men who have sex with men, with strains increasingly resistant to antibiotics.
- Keywords
- shigellosis, Shigella, dysentery, diarrhoea, rimming, STI
- Topics
- Sexual Health & Prevention
- Updated
What is shigellosis?
Shigellosis is a gut infection caused by Shigella bacteria. It’s associated with travel and contaminated water, but for several years it has also spread sexually, especially between men. A tiny amount of bacteria is enough to get infected.
How is it passed on during sex?
By the faecal-oral route: microscopic particles of faeces get into the mouth. AIDES reports increasingly documented sexual transmission, especially through:
- rimming (rimming risks);
- fingers, fisting, toys then brought to the mouth;
- scat play (risks);
- touching a condom or glove after anal sex.
What are the symptoms?
According to AIDES, they appear 1 to 4 days after infection:
- frequent diarrhoea, sometimes with blood or mucus;
- stomach cramps and pain;
- high fever, vomiting.
Severe cases risk dehydration, bloodstream infection or kidney complications. See a doctor quickly if diarrhoea lasts more than a few days, contains blood, comes with high fever, or if you live with HIV.
Why is there so much concern?
Because the strains circulating between men are increasingly multidrug-resistant. AIDES reports more than 2,300 multidrug-resistant Shigella infections in Europe and the US since 2023, and about 10% highly resistant strains each year in France. Institut Pasteur warned about a Shigella sonnei strain resistant to nearly all the usual antibiotics. Hence the importance of a stool sample before any treatment, to choose an antibiotic that works.
How to protect yourself?
Recommendations shared by AIDES and health authorities:
- wash your hands and genital and anal area before and after sex;
- gloves for fingering and fisting, a dental dam for rimming;
- a new condom on toys, toys washed after use;
- no sex while you have symptoms and for 7 days after they stop;
- don’t prepare food for others while ill.
And hepatitis A?
It spreads the same way. If you rim, get vaccinated against hepatitis A (hepatitis A): there’s no vaccine against Shigella.
Informational article based on official sources. It does not replace medical advice: if in doubt, if you have symptoms or took a risk, see a health professional or a sexual health clinic.
Sources
Figures and recommendations checked against: