Shigella Cases Surge in U.S., Drug‑Resistant Strains Rise

Across the United States, cases of Shigella, a highly contagious bacterial infection that can cause bloody diarrhea, fever, vomiting and in severe cases seizures and death, have risen, prompting warnings from dozens of doctors.

The disease, known as shigellosis, affects about 450,000 people each year and is responsible for 38 deaths, according to the Merck Manuals textbook. A recent case in Louisiana involved a child who developed shigellosis after swimming in a lake, a situation that highlighted the potential for environmental exposure.

Drug‑resistant strains of Shigella have long been a concern, especially for children under five. A federal report released in April added that white men are now the most susceptible group for infections with drug‑resistant strains. Treatment options are limited to a few antibiotics, such as ceftriaxone and pivmecillinam, and an increasingly common “excessively drug‑resistant” (XDR) strain has no government‑approved oral antibiotic. The report emphasized the need for susceptibility testing and timely reporting of this nationally notifiable disease.

No vaccine is currently available, though a candidate showed high‑level protection in a two‑week clinical trial among U.S. adults. Prevention relies on hand hygiene, safe food and water practices, and avoiding sexual contact for at least two weeks after someone has had diarrhea.

A July study in the U.K. found that the spread of Shigella through sexual contact grew 15 percent faster annually from 2015 to 2020, especially among men who have sex with men. Homeless individuals with limited access to clean water and toilets are also at higher risk.